*The Dialyzer as the Last Line of Protection against Endotoxins DOI: http://dx.doi.org/10.5772/intechopen.109358*

membrane. In the section above, the assumption of a maximum endotoxin concentration of 0.5 EU/ml was made, because standard dialysis fluid quality per ANSI/AAMI/ ISO 23500-5 [10] was assumed in any case. In order to consider the fluid volume passing through or crossing a dialyzer membrane as well as the resulting total amount of endotoxins, various phases and situations during a dialysis treatment need to be differentiated: priming, treatment, bolus, and rinse-back. In the following considerations, only configurations in which online prepared fluid is infused into the patient by crossing the dialyzer membrane are included. Configurations using saline bags or online prepared fluid bypassing the dialyzer membrane are excluded in this work because the dialyzer membrane does not act as a last endotoxin barrier in such situations. Relevant configurations, where the dialyzer acts as the last line of protection against endotoxins are:


treatment. The volume of rinse-back is limited by the volume of the blood pathway of the extracorporeal circuit and can be assumed to be not more than 500 ml. The total maximum endotoxin amount that the protein-coated membrane may be exposed to by rinse-back fluid with standard dialysis fluid quality is 500 ml × 0.5 EU/ml = 250 EU.
