A method for monitoring vascular access function during hemodialysis

Slides:



Advertisements
Similar presentations
Mesoscale Simulation of Blood Flow in Small Vessels Prosenjit Bagchi Biophysical Journal Volume 92, Issue 6, Pages (March 2007) DOI: /biophysj
Advertisements

Date of download: 6/28/2016 Copyright © ASME. All rights reserved. From: Stability of Carotid Artery Under Steady-State and Pulsatile Blood Flow: A Fluid–Structure.
Date of download: 7/8/2016 Copyright © ASME. All rights reserved. From: Lumped Parameter Thermal Model for the Study of Vascular Reactivity in the Fingertip.
Date of download: 10/6/2017 Copyright © ASME. All rights reserved.
Date of download: 10/8/2017 Copyright © ASME. All rights reserved.
Temporary hemodialysis catheters: recent advances
Volume 66, Issue 6, Pages (December 2004)
Volume 57, Issue 5, Pages (May 2000)
Volume 86, Issue 4, Pages (October 2014)
A powerful new agonist: flooding the system with growth hormone
Hemodialyzer: From macro-design to membrane nanostructure; the case of the FX- class of hemodialyzers  Claudio Ronco, Sudhir Kumar Bowry, Alessandra Brendolan,
Meghan E. Sise, Andrew M. Courtwright, Richard N. Channick 
Use of hemodialysis and hemoperfusion in poisoned patients
Anemia management in chronic kidney disease
Volume 54, Issue 1, Pages (July 1998)
Thomas J. Burke, Deepak Malhotra, Joseph I. Shapiro, M.D. 
C-reactive protein and dialysis access
Prof. Silvio Cavalcanti, DEIS, Silvia Cavani, Antonio Santoro 
Zaccaria Ricci, Claudio Ronco, Sergio Picardo  Kidney International 
Volume 67, Issue 2, Pages (February 2005)
C-reactive protein and dialysis access
Christopher D. Miller, Michelle L. Robbin, Michael Allon 
Volume 54, Issue 2, Pages (August 1998)
Vascular access surveillance: an ongoing controversy
Volume 84, Issue 6, Pages (December 2013)
Initial clinical results with the LifeSite® Hemodialysis Access System
M. Kraemer, C. Rode, V. Wizemann  Kidney International 
Volume 85, Issue 3, Pages (March 2014)
Prediction of hypertension in chronic hemodialysis patients
Volume 61, Issue 3, Pages (March 2002)
Volume 62, Issue 1, Pages (July 2002)
The importance of increased dialysis and anemia management for infant survival in pregnant women on hemodialysis  Sai Subhodhini Reddy, Jean L. Holley 
Nephrology Crosswords: Hemodialysis
Hark Rim, Ho S. Shin, Yeon S. Jung
Long-term study of mycophenolate mofetil treatment in IgA nephropathy
Volume 54, Issue 5, Pages (November 1998)
Volume 59, Issue 4, Pages (April 2001)
Gentamicin pharmacokinetics during slow daily home hemodialysis
Kt/V underestimates the hemodialysis dose in women and small men
Volume 80, Issue 8, Pages (October 2011)
Blood pressure targets in hemodialysis patients
Volume 69, Issue 10, Pages (May 2006)
Luminal surface concentration of lipoprotein (LDL) and its effect on the wall uptake of cholesterol by canine carotid arteries  Xiaoyan Deng, PhD, Yves.
Method for detecting the disconnection of an extracorporeal device using a patient's endogenous electrical voltages  E.A. Ross, C. Briz, R.J. Sadleir 
Hemodialysis arteriovenous access: Detection of stenosis and response to treatment by vascular access blood flow  Steve J. Schwab, Matthew J. Oliver,
Volume 85, Issue 3, Pages (March 2014)
Volume 83, Issue 5, Pages (May 2013)
Extracorporeal therapy in sepsis: are we there yet?
Rheological Analysis and Measurement of Neutrophil Indentation
Volume 74, Issue 8, Pages (October 2008)
Alternate-day dialysis may be needed for hemodialysis patients
Nephrology Crossword: Peritoneal Dialysis
Nephrology Crossword: Glomerulonephritis
Laura M. Dember, Erika F. Holmberg, James S. Kaufman 
Renovascular adaptive changes in chronic hypoxic polycythemia
Volume 76, Issue 1, Pages 6-7 (July 2009)
Circadian regulation of renal function
Volume 57, Issue 6, Pages (June 2000)
Noninvasive transcutaneous determination of access blood flow rate
Blood pressure and long-term mortality in United States hemodialysis patients: USRDS Waves 3 and 4 Study1  Robert N. Foley, Charles A. Herzog, Allan J.
Carmine Zoccali, Francesca Mallamaci  Kidney International 
Volume 57, Issue 5, Pages (May 2000)
Volume 73, Issue 9, Pages (May 2008)
Volume 65, Issue 4, Pages (April 2004)
The Convertibility of Online Clearance Measurements
Volume 54, Issue 6, Pages (January 1998)
Gary R. Sirken, Chetan Shah, Rasib Raja  Kidney International 
Graft flow as a predictor of thrombosis in hemodialysis grafts
Stephen Pastan, J. Michael Soucie, William M. McClellan 
Volume 56, Issue 3, Pages (September 1999)
Presentation transcript:

A method for monitoring vascular access function during hemodialysis Andrea Ciandrini, Carlo A. Lodi, Raffaele Galato, Maria C. Miscia, Maria S. Fattori, Silvio Cavalcanti  Kidney International  Volume 75, Issue 5, Pages 550-557 (March 2009) DOI: 10.1038/ki.2008.581 Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 1 Comparison between nominal set-point and actual values of extracorporeal blood flow. Symbols: Qb, blood flow in the extracorporeal circulation (m±std, n=16) measured by Transonic™ for each nominal blood flow set, Qbset, imposed by changing the rate of blood pump on the dialysis machine. The identity line (continuous line) is shown as well. Kidney International 2009 75, 550-557DOI: (10.1038/ki.2008.581) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 2 Example (pat01) of arterial (o) and venous (*) blood pressures in extracorporeal line (Panel a) and vascular access (Panel b) at different rate of extracorporeal blood flow. Intravascular arterial-venous pressure drop and QInv estimation by parabolic fitting (Panel c). Symbols: Qb, blood flow in the extracorporeal circulation measured by Transonic™; Pam and Pvm, experimental pressures in the arterial and venous drip chambers; Paf and Pvf pressures in the arterial and venous access points calculated by the Eq.s 4 e 5 (see Methods); Pf=Paf-Pvf gradient of pressure between arterial and venous access points; QInv, value of Qb for which quadratic curve fitting Pf is equal to zero. Kidney International 2009 75, 550-557DOI: (10.1038/ki.2008.581) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 3 Intravascular arterial-venous pressure drop compared with access flow for extracorporeal flow equals to 0 ml/min (Panel a) and equals to 250 ml/min (Panel a). Symbols: Pf, gradient of pressure between arterial and venous access points; Qbset, blood flow set on the blood pump of the artificial kidney; Qa, access flow. Kidney International 2009 75, 550-557DOI: (10.1038/ki.2008.581) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 4 Inversion flow compared with access flow. One point corresponds to a patient of Table 1. Linear regression (dotted line) between QInv and Qa. Symbols: QInv, inversion flow: value of Qb for which quadratic curve fitting Pf is equal to zero; Qa, access flow. Kidney International 2009 75, 550-557DOI: (10.1038/ki.2008.581) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 5 Comparison between experimental (o) and simulated (*) pressure in the arterial (Paf) access point (Panel a), venous (Pvf) access point (Panel b) and pressures gradient (Pf) between arterial and venous access points (Panel c) for different extracorporeal blood flows (Qb). Kidney International 2009 75, 550-557DOI: (10.1038/ki.2008.581) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 6 Simulated velocity patterns in the symmetry plane of AVF for extracorporeal flow Qb=150 (upper panel) and Qb=300 ml/min (lower panel). Symbols: Dv represents the AVF diameter, equal to 6.5 mm. z-Axis indicates AVF axial length; y-Axis indicates vessel cross-sectional diameter. Kidney International 2009 75, 550-557DOI: (10.1038/ki.2008.581) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 7 Schematic view of bidimensional geometric model of arterial and venous needle insertion in the AVF used for the CFD simulations. Symbols: Qb, blood flow in the extracorporeal circulation; Qa, access flow; Dv, AVF diameter. Kidney International 2009 75, 550-557DOI: (10.1038/ki.2008.581) Copyright © 2009 International Society of Nephrology Terms and Conditions