Arterial line pressure control enhanced extracorporeal blood flow prescription in hemodialysis patients
| Autor: | Nelly Flores, Alfonso Mariscal, Guadalupe De-La-Cruz, Franklin Mora-Bravo, Salvador Magaña, Héctor Pérez-Grovas, Laura Rosales, Martha Franco, Juan P Herrera–Felix |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Blood Pressure lcsh:RC870-923 Extracorporeal Renal Dialysis Internal medicine medicine Humans Prospective cohort study Dialysis business.industry Middle Aged lcsh:Diseases of the genitourinary system. Urology Surgery Catheter Treatment Outcome Blood pressure Quartile Nephrology Therapy Computer-Assisted Anesthesia Kidney Failure Chronic Arterial line Female Hemodialysis business Blood Flow Velocity Research Article |
| Zdroj: | BMC Nephrology BMC Nephrology, Vol 9, Iss 1, p 15 (2008) |
| ISSN: | 1471-2369 |
| DOI: | 10.1186/1471-2369-9-15 |
| Popis: | Background In hemodialysis, extracorporeal blood flow (Qb) recommendation is 300–500 mL/min. To achieve the best Qb, we based our prescription on dynamic arterial line pressure (DALP). Methods This prospective study included 72 patients with catheter Group 1 (G1), 1877 treatments and 35 arterio-venous (AV) fistulae Group 2 (G2), 1868 treatments. The dialysis staff was trained to prescribe Qb sufficient to obtain DALP between -200 to -250 mmHg. We measured ionic clearance (IK: mL/min), access recirculation, DALP (mmHg) and Qb (mL/min). Six prescription zones were identified: from an optimal A zone (Qb > 400, DALP -200 to -250) to zones with lower Qb E (Qb < 300, DALP -200 to -250) and F (Qb < 300, DALP > -199). Results Treatments distribution in A was 695 (37%) in G1 vs. 704 (37.7%) in G2 (P = 0.7). In B 150 (8%) in G1 vs. 458 (24.5%) in G2 (P < 0.0001). Recirculation in A was 10.0% (Inter quartile rank, IQR 6.5, 14.2) in G1 vs. 9.8% (IQR 7.5, 14.1) in G2 (P = 0.62). IK in A was 214 ± 34 (G1) vs. 213 ± 35 (G2) (P = 0.65). IK Anova between G2 zones was: A vs. C and D (P < 0.000001). Staff prescription adherence was 81.3% (G1) vs. 84.1% (G2) (P = 0.02). Conclusion In conclusion, an optimal Qb can de prescribed with DALP of -200 mmHg. Staff adherence to DLAP treatment prescription could be reached up to 81.3% in catheters and 84.1% in AV fistulae. |
| Databáze: | OpenAIRE |
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