Document Detail


Correction of discrepancy between prescribed and actual blood flow rates in chronic hemodialysis patients with use of larger gauge needles.
MedLine Citation:
PMID:  12046036     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The blood flow rate delivered by the dialysis machine (d-BFR) may not be accurately reflected by the blood flow rate set on the machine (sm-BFR). High negative arterial pressure may lead to deformity of the blood pump-segment tubing, resulting in a lower stroke volume and d-BFR. The Hagen-Poiseuille law predicts that the use of larger gauge needles should make arterial pressure less negative. Twenty-two patients on chronic hemodialysis therapy with a percentage of reduction in urea (PRU) levels less than 65% and/or a greater than 10% difference between sm-BFR and d-BFR underwent dialysis using one-gauge larger arterial and venous needles. d-BFR increased by 23 +/- 5 mL/min. Arterial pressure became less negative by 58 +/- 5 mmHg, and venous pressure decreased by 31 +/- 7 mm Hg. Changes in arterial and venous pressures allowed sm-BFR to be increased to 500 mL/min in all 22 patients, resulting in an increase in d-BFR of 83 +/- 7 mL/min. This translated into an increase in PRU of 5% +/- 0.01%. All results were significant at P < 0.001. A survey showed that less than 5% of needles used in our region were 14 G. This study shows that the use of larger gauge needles can significantly increase d-BFR and PRU as a result of changes in arterial and venous pressures, resulting in a significantly increased dialysis dose at no additional cost.
Authors:
Hitesh K Mehta; Diane Deabreu; James G McDougall; Marc B Goldstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  39     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-04     Completed Date:  2002-06-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1231-5     Citation Subset:  IM    
Copyright Information:
Copyright 2002 by the National Kidney Foundation, Inc.
Affiliation:
Division of Nephrology, St Michael's Hospital, University of Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity*
Blood Pressure
Humans
Needles*
Renal Dialysis / instrumentation*,  methods
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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