Short-term manual compression of hemodialysis fistula leads to a rise in cerebral oxygenation.

CONCLUSION: A significant rise in cerebral oxygenation was observed following the manual compression of arteriovenous fistula. Therefore, the arteriovenous fistula could have a role in impaired cerebral oxygenation in hemodialysis patients. PMID: 32489138 [PubMed - as supplied by publisher]
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research

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Authors: Gerrickens MW, Yadav R, Wouda R, Beerenhout CH, Scheltinga MR Abstract BACKGROUND: Some hemodialysis patients develop hemodialysis access-induced distal ischemia due to insufficient loco-regional perfusion pressure and consequent poor arterial flow. We hypothesized that patients with severe hemodialysis access-induced distal ischemia had worse survival compared with patients with mild or no hemodialysis access-induced distal ischemia. METHODS: This single-center retrospective observational cohort study included three groups of prevalent hemodialysis patients with an upper extremity vascular access betw...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
In this study, we prospectively evaluated RI changes after AVF ligation in kidney transplanted patients. METHODS: We enrolled 22 stable transplanted patients. Mean RI was measured before AVF ligation (T0), 18 to 24 h (T1) and 6 months (T6) after surgery; mean blood pressure (mBP), heart rate (HR), serum creatinine (sCr), estimated glomerular filtration rate (eGFR), 24 h proteinuria (24 h-P), immunosuppressive drug blood levels (IS) and antihypertensive drugs were also recorded. RESULTS: AVF ligation was performed 3.1 years (IQR: 2.1-3.8) after transplantation. Median AVF flow (Qa) was 1868 mL/min (IQR: 1538-2712) a...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Abstract INTRODUCTION: In response to a perceived high incidence of acute kidney injury following cardiopulmonary bypass at our institution, a quality improvement initiative consisting of a systematic change to a delivered oxygen (DO2) goal-directed perfusion practice was implemented. We sought to maintain DO2 > 270 mL/min/m2 to reduce the incidence of acute kidney injury. METHODS: 'The study population included all patients receiving isolated, non-emergent, on-pump coronary artery bypass grafting from January 2015 through December 2018, excluding patients requiring preoperative hemodi...
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
A 9-year-old boy with nephropathic cystinosis received intraperitoneal deceased donor renal transplant with steroid-free immunosuppression. Intraoperatively 20 ml of urine was noted; renal scan showed poor perfusion with acceptable renal Doppler ultrasound. Intermittent hemodialysis was reinstated on postoperative day 1 because of fluid overload with anuria. On day 5 abdominal distention, new onset fever (101.1 °F), and hypotension developed. Vancomycin, piperacillin/tazobactam, and fluconazole were initiated.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research
This case is from one of our fantastic 3rd year residents, Aaron Robinson.A woman in her 60s with SyncopeA woman in her 60s presented to a facility with syncope. She had a history of CHF, pulmonary hypertension,CAD s/pCABG, and ESRD on hemodialysis. She had a dialysis run the day prior. Prehospital VS were: BP 115/70, HR 65, RR 12. The patient did not have a 12 lead completed pre-hospital.She arrived at the ED awake, alert, and complaining only ofmild chest discomfort. A 12 lead ECG was immediately completed:Aaron showed this to me and this is what I said:Suggestive of inferior posterior MI, but not dia...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
CONCLUSIONS: IDH is common in patients on maintenance HD and is associated with a greater risk of developing intradialytic clinically significant arrhythmia. PMID: 32381584 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research
CONCLUSION: Determining pressure injury risk in critically ill patients is complex and challenging. One common pathophysiological factor is impaired tissue oxygenation and perfusion, which may be nonmodifiable. Improved risk quantification is needed and may be realized in the near future by leveraging the clinical information available in the electronic medical record through the power of predictive analytics. PMID: 32355967 [PubMed - in process]
Source: American Journal of Critical Care - Category: Nursing Authors: Tags: Am J Crit Care Source Type: research
ConclusionsCapnometry during resuscitation serves as a marker to be taken into account in relation to the viability of the transplanted organs in uncontrolled non-heart beating donors.ResumenObjetivoLos valores de capnometría durante la resucitación son un factor predictor de la evolución de los riñones obtenidos a partir de donantes en asistolia no controlada.DiseñoCohorte de comienzo retrospectivo de 37 donantes en asistolia, y cohorte de validación de 55 trasplantados de riñón, entre 2013–2017.Ámbitopoblación atendida por el servicio de emergenc...
Source: Medicina Intensiva - Category: Intensive Care Source Type: research
A simpler method for detecting atherosclerosis obliterans is required in the clinical setting. Laser Doppler flowmetry (LDF) is easy to perform and can accurately detect deterioration in skin perfusion. We per...
Source: BMC Nephrology - Category: Urology & Nephrology Authors: Tags: Research article Source Type: research
The Brescia-Cimino arteriovenous fistula (AVF) is the preferred method of providing vascular access for hemodialysis in patients with end-stage renal disease .1 Although uncommon, the dialysis access steal syndrome (DASS) can present as a serious complication of an arteriovenous fistula, characterized by flow dynamic complications that lead to an excess perfusion of the AVF and ischemia of the hand.2 It is frequently associated with the brachial artery fistula which has an incidence rate of 5%.3 Even rarer, however, is its occurrence in the forearm, with incidence rates of 0.25-1.8%.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Case Report Source Type: research
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