An impaired vascular response is implicated in the pathogenesis of dialysis-induced hypotension, which is at least partly related to changes in extracorporeal blood temperature (Temp). However, little is known about changes in core Temp and differences in energy balance between standard and cool dialysis. In this study, core Temp and ...

Two methods have been suggested by Daugirdas and Schneditz (the rate equation), and Smye for predicting true equilibrated Kt/V (eKt/V) without the need for obtaining a blood sample 60 min after hemodialysis (HD). We compared the accuracy of these two methods when applied to pediatric HD. Thirty-eight standard pediatric HD ...

PURPOSE: This retrospective study was performed to investigate the authors' clinical observations that suggest that Tesio hemodialysis catheters may initially have suboptimal blood flow rates, which improve spontaneously after several hemodialysis treatment sessions. MATERIALS AND METHODS: Sixty Tesio twin hemodialysis catheters were placed in 49 patients during a 2-year period. ...

Two factors are necessary for an arteriovenous fistula (AVF) to be usable as dialysis access. It must have adequate blood flow, and it must have a size that will allow for cannulation. An AVF can remain patent in the face of relatively low blood flow. For effective dialysis, the AVF ...

Aspiration reliably detects almost all IV multiorifice epidural catheters. Although a supplemental epinephrine 15-microg test dose may detect the rare IV catheter that does not yield blood on aspiration, false-positive epinephrine responses may cause some women to unnecessarily undergo repeat epidural catheter insertion. We evaluated 532 consecutive eligible patients requesting ...

An on line clearance monitor automated for measurements of conductivity dialysance (Dcn) was used to measure blood access flow rate (cnQac) during hemodialysis. From mathematical analysis of transport, it was shown that cnQacc = [(Dcn*Decn)/(Dcn - Decn)] [1/bwf], where Dcn is measured with standard cocurrent flow of dialyzer blood (Qb) ...

On-line hemodiafiltration (HDF) provides the largest amount of blood purification over a wide molecular weight spectrum achievable with present renal replacement therapies. When used with state of the art dialysis membranes and treatment systems, the biocompatibility of on-line HDF is as high as can presently be defined. From an economic ...

There are potential benefits to addition of visceral organ perfusion, by means of a 9-Fr. catheter system (octopus), to distal aortic perfusion during thoracoabdominal aneurysm surgery. However, in the literature there are reports of adverse effects. The authors therefore compared two groups of patients who underwent thoracoabdominal aneurysm surgery with ...

Ion chromatography was used to detect levels of copper and zinc in blood plasma from renal dialysis patients on continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis (HD). The developed method used cobalt as an internal standard and when combined with the standard additions method improved the overall precision of the ...

BACKGROUND: Recirculation (R) and access blood flow (Qac) measurements are considered useful indicators of adequate delivery of haemodialysis. It was the purpose of this study to compare measurements of R and Qac obtained by two different techniques which are based on the same principle of indicator dilution, but which differ ...

Tidal peritoneal dialysis (TPD) was introduced to increase the efficacy of peritoneal dialysis. We measured peritoneal clearances of small solutes and beta2-microglobulin, peritoneal protein loss, and efficacy of ultrafiltration in 30 patients during TPD and intermittent peritoneal dialysis (IPD) with low-dialysate flow (1.7 L/h) and, in addition, in 17 of ...

Implementation of the Dialysis Outcomes Quality Initiative (DOQI) Guidelines for hemodialysis adequacy will necessitate an increase in delivered Kt/V for many patients. Before increasing Kt/V by prolonging the patient's treatment time, it is important to verify that the prescribed dialyzer urea clearance is being achieved. The principal determinant of dialyzer ...

Thrombus formation within hemodialysis catheters contributes to inadequate dialysis and adverse patient outcomes. A thrombolytic agent may be required to restore patency and improve blood flow. This study evaluates the efficacy of instilling low dose (1 mg/ml) t-PA in catheter lumens to restore patency in malfunctioning catheters. t-PA was utilized ...

Three modes of access for hemodialysis (HD) have been available for over 20 years, the native arterial to venous (A-V) fistula, the polytetrafluorethylene (PTFE) graft fistula, and the central venous catheter. Overall, vascular access remains the single most costly source of morbidity and hospitalization in HD patients, indicating a severe ...

OBJECTIVE: We investigated the assumption that blood flow to the microvessels underlying the peritoneum does not limit solute or water exchange between the blood and the dialysis fluid. DESIGN: Small plastic chambers were affixed to the serosal side of the liver, cecum, stomach, and abdominal wall of anesthetized rats. Solutions ...

To date there have been no standard methods for assessing the thrombogenicity of central venous catheters. A procedure for testing the thrombogenicity of intravenous lines such as the silver-impregnated catheter by continuous blood flow in vitro was therefore developed. For this test, fresh blood was drawn from healthy human donors ...

Continuous measurement of endotoxin concentration in dialysate, using a separated endotoxin-specific limulus reagent, promises rapid measurement without the complex operating procedures of the limulus reagent. To achieve high sensitivity measurements in a short period of time, an improved system featuring stopped-flow operation was developed. To prevent dispersion of the limulus ...

The insertion of central venous catheters has become an established practice in the management of children with different types of malignancies for the administration of chemotherapeutic agents, antibiotics, blood and blood products, as well as drawing blood for various investigations. A commonly encountered problem is that despite the catheter being ...

Venous catheters are increasingly used for chronic haemodialysis, with dual lumen catheters being the most commonly used as blood recirculation (REC%) is relatively low. The aim of this study was therefore to evaluate blood recirculation in dual lumen catheters, both well-functioning and malfunctioning, with reversed lumens. In our study, blood ...

Measurement of adequacy of small solute clearance on hemodialysis (HD) and peritoneal dialysis (PD) is important. In HD, formal urea kinetic modelling (UKM) is recommended because it is theoretically more accurate than the urea reduction ratio (URR) and because it allows prospective selection of an adequate prescription. However, the URR ...

BACKGROUND: In patients with arteriovenous fistulas, assessment of pH and oxygen status during hemodialysis (HD) using the extracorporeal dialysis arterial blood line is widely used both in daily routine and in most studies investigating hypoxia during HD. We designed this study to evaluate whether results of blood gas samples drawn ...

It has been suggested that the peritoneal capillary is the major determinant for peritoneal fluid transport and that an increase in the number of peritoneal capillaries may be the reason for an increased peritoneal transport rate. In this study, we investigated the impact on peritoneal fluid and solute transport of ...

BACKGROUND: Intravascular catheters are associated with severe infections in patients, but only few reports on this problem in animal research exist. OBJECTIVE: We report on catheter-related bacterial colonization and its consequences in long-term catheterized animals. MATERIAL AND METHOD: Foxhounds were instrumented with intravascular catheters and flow probes to study the ...

BACKGROUND: The arteriovenous fistula is the most widely used means of enabling vascular access for chronic haemodialysis. When interest in vascular access was at its height, in the 1970s, a substantial amount of work was carried out on the physiology of arteriovenous fistulae and on the relationship between fistula flow ...

The contact between the blood and any kind of material can lead to hemocompatibility issues that deserves some consideration. Midst some aspects to consider, special attention must be given to the rheology and the blood flow. Therefore, the speed blood influence in relation to the catheter type (central or peripheric) ...

A girl aged 3 years and 4 months weighing 16 kg was treated with plasma exchange (PE), hemodialysis (HD), and hyperbaric oxygenation (HBO) for acute hepatic failure and coma. She was given a total of 13 PEs, 13 HD sessions, and 9 HBO treatments over a period of 1 month. ...

BACKGROUND: Vascular access thrombosis accounts for at least $1 billion dollars in annual expenses and 25% of hospitalizations for chronic hemodialysis patients. Low vascular access blood flow (less than 800 ml/min) has been shown to modestly increase the relative risk for thrombosis in the subsequent three months. In this study, ...

Percutaneous placement of an intra-aortic balloon (IAB) through a femoral artery of a patient is associated with a risk of reduction of blood flow distal to the balloon insertion site. If this reduction is severe, it ultimately causes limb ischemia and necessitates IAB removal. Although clinicians intuitively know that larger ...

Blood flow in peripheral arteriovenous fistulae and grafts as used for hemodialysis access can be derived from simultaneous measurements of 1) the amount of access recirculation (AR) induced by reversing the dialysis blood lines, and 2) the dialyzer blood flow rate (Qb). The hemodynamic monitor (HDM) uses magnetic principles to ...

In a previous study, it was reported that hemodialysis with dialysate [K+] (KD) of 1.0 or 2.0 mmol/L caused an increase in BP shortly after completion of treatment due to arteriolar constriction. With this background, it was hypothesized that a low KD might decrease dialysis efficiency by a similar mechanism. ...

A rat model is introduced which enables investigations in anticoagulated blood with continuous measurements by a flow-through electrode system. In the present study, a potentiometric ion-selective electrode (ISE)-system was used for measuring Ca2+, K+, Na+ and pH in rats. The setup was adjusted to an extracorporeal blood-volume of 0.750 ml. ...

AIM: (a) To determine the normalized cellular clearance (Kcn) of urea, creatinine and phosphate in patients undergoing maintenance hemodialysis; (b) To identify the factors, particularly circulatory, which determine Kcn; (c) To evaluate whether intra-dialytic blood sampling can predict the size of the post-dialytic solute concentration rebound. METHODS: Kinetic modelling of ...

Urea kinetics has recently been re-evaluated using an on-line urea monitoring system applied to hemodiafiltration. This system allows evaluation of different components possibly responsible for the gap between prescribed and delivered dose of dialysis, such as access and cardiopulmonary recirculation, and altered dialysis parameters, such as blood flow and dialysate ...

A new venous needle (VN) that also can be used as an arterial needle (AN) has been designed to diminish the undesirable hemodynamic effects of dialysis with high blood flow rate (300-600 ml/min) in arteriovenous polytetrafluoroethylene grafts, and in accesses of short length (U.S. Patent No. 5,662,619). The preferred embodiment ...

The Ash Split Cath (Medcomp, Harleysville, PA) is a recently introduced dual lumen permanent catheter designed to be placed through the internal jugular vein into the superior vena cava by single venipuncture technique. The transcutaneous portion is a 14 French cylindrically shaped catheter with D-shaped lumens and a Dacron (DuPont, ...

A 2-year-old girl with carbamoyl phosphate synthetase deficiency underwent emergency hemodialysis (HD) for treatment of acute life-threatening hyperammonemia. HD was performed via catheters placed in each femoral vein serving as vascular access. The tip of one of the catheters (aspirating line) was in the left external iliac vein and the ...

In this study the ammonia concentration was determined in arterial and venous blood samples pre- and posthemodialysis (HD) in 18 uremic patients and in 18 health subjects (controls). The mean values (+/- SD) of ammonia in the arterial blood of uremic patients pre-HD were 98.32 +/- 26.55; post-HD, 63.18 +/- ...

OBJECTIVE: Temporary interruption of the cerebral circulation is sometimes required during the course of neurosurgical procedures. It would be beneficial to develop some type of vascular shunt system that could be used when temporary interruption of the cerebral circulation is necessary. Recent advances in the production of hemocompatible materials suggested ...

Dialyzer reuse affords a means of reducing the cost of hemodialysis with little risk, but surprisingly not widely practised in Nigeria. To provide an evaluation of a simply constructed dialyzer reprocessing system, we measured dialyzer blood compartment volume loss dialyzer urea clearance in 21 patients during reuse to determine the ...

In the last 10 years the percentage of dialysis patients suffering from clinical intradialytic intolerance has greatly increased. Profiled hemodialysis (PHD) is a new technical approach, alternative to standard hemodialysis (SHD) for the treatment of intradialytic symptomatic hypotension. It is based on intradialytic modulation of the dialysate sodium concentration, using ...

Acetate free biofiltration (AFB) is a hemodiafiltration technique based on a buffer-free dialysate and bicarbonate infusion in the postdilution mode. The performance of AFB requires a dialysis machine equipped with an automatic control system to balance the infusion rate to that of ultrafiltration. The filters employed are usually polyacrylonitrile hollow-fiber ...

Agreement and reproducibility of Daugirdas blood-based and Biostat 1000 dialysate-based Kt/V estimation were explored. Fifty-two dialysis treatments in 19 patients were studied. All patients were dialyzed by arteriovenous (AV) access. Good agreement was found in the comparison between laboratory predialysis blood urea nitrogen (BUN) and Biostat 1000 BUN. Each treatment ...

The construction and evaluation of an automated urea and creatinine biparametric biosystem using flow injection analysis (FIA) are described. The biosystem uses enzyme reactions that hydrolyse urea and creatinine producing ammonium ions. The enzymes used were creatinine deiminase and urease, which are immobilized covalently in flow reactors. The reactor with ...

Glutathione is a major cellular antioxidant that protects protein thiols and inhibits cellular damage due to oxygen free radicals. It has been reported previously that patients undergoing dialysis have low levels of blood glutathione, which may lead to increased susceptibility to oxidant stress. L-2-oxothiazolidine-4-carboxylic acid (OTZ) is a cysteine prodrug ...

From November 1, 1995, to April 30, 1997, in our outpatient dialysis facility, 7,179 or 24.3% of hemodialyses were performed with soft, cuffed, intravenous catheters as blood accesses. Inadequate blood flow (pump speed < 400 mL/min) was noted in 286 instances (4.0%). Locking of catheter lumina with 5,000 to 9,000 ...

Placement of a guiding catheter through a tortuous, narrowed, or intrinsically small vessel may result in severe reduction or occlusion of blood flow. However, nonbraided guiding catheters can be simply modified with a catheter hole punch to create a temporary stent. The stent reestablishes blood flow, which is routed through ...

The authors' previous article, "Equipment Acquisition Using Various Forms of Leasing," covers information necessary for selecting among the different kinds of leases. This article explains how to reach a proper financial analysis, preferably using two phases. Using a representative example, the article guides the reader through the first phase and ...

Haemodialysis recirculation is defined as the fraction of cleared extracorporeal blood flow which returns to the inlet of the extracorporeal blood line without systemic equilibration. There are two components of haemodialysis recirculation: the local component is related to access function and placement of access needles; the cardiopulmonary component is a ...

The management of acute myoglobinuric renal failure, the major complication of rhabdomyolysis, continues to be a treatment dilemma for the clinician as limited therapeutic options are available. Previously, we have demonstrated that continuous arteriovenous hemofiltration (CAVH) is an effective technique for removing myoglobin in an animal model. In the present ...

The blood urea concentration is artificially low immediately following high-efficiency dialysis. Post-dialysis urea rebound correlates with hemodialysis efficiency, and is inversely correlated with dialysis treatment time. We evaluated the effect of variation in the length of hemodialysis treatment on urea, creatinine and other solutes rebound. We used two protocols for ...