Therapeutic apheresis (TA) is an extracorporeal procedure for various diseases as primary treatment or as an adjunct therapy in which large quantities of plasma are removed and replaced by FFP (Fresh Frozen Plasma), albumin and saline. Requirement of replacement fluid during therapeutic apheresis is to prevent hemodynamic instability due to volume depletion and decreased oncotic […]
PREFERRED TEMPORARY DIALYSIS CATHETER LOCATION FOR DIALYSIS THERAPY BY DR JIGAR SHRIMALI CVCs should preferably be inserted into the right jugular vein, as It carries the lowest risk of thrombosis and stenosis Straight course into the superior vena cava or right atrium reduces the risk of malposition and allows high blood flow Gives more chance to […]
First of all, let’s have 2 cases to discuss where catheter tip was not in ideal position, but was in anterior mediastinum. 1) INNOMINATE VEIN PERFORATION 40-year-old female with K/C/O HTN and CKD STAGE 5D, started on MHD through right IJV temporary DLC. She had poor calibre vessels for AVF creation. She developed […]
PORT/CLAMP FRACTURE OF TUNNELLED DIALYSIS CATHETER BY DR VEERABHADRA GUPTHA, DR JIGAR SHRIMALI As tunnelled dialysis catheters are used for long term, wear and tear is an issue, majorly affecting port or clamp as they are repeatedly manipulated. Due to this we see a fractured port or clamp as a common issue for tunnelled dialysis […]
ROLE OF VENOUS PRESSURE AND ARTERIAL PRESSURE IN DETECTION OF NEEDLE DISLODGEMENT Venous pressure: All dialysis machines must be equipped with a functioning venous pressure alarm, which stops the blood pump and clamps the blood lines in case of a venous pressure outside the alarm limits. An acute decrease in dialysis venous pressure should theoretically […]
48-year-old female patient, HTN CKD STAGE 5D, was on thrice a week MHD, through left BC AVF. One day she had venous needle dislodgement due to an unintentional limb moment. This led to excessive bleeding which was timely detected and stopped by the dialysis technician. Here we can see the oozing of blood from the […]
AIR DETECTION ALARM TROUBLESHOOTING DR JIGAR SHRIMALI 62 year old male, who is k/c/o DM, HTN, CAD, CKD STAGE 5D on thrice a week MHD. At the end of the dialysis, as per nephrologist’s prescription intravenous 7% Amino Acid solution was started at the end of dialysis. This solution when came to end, the technician […]
CASE DISCUSSION 33 years old female, K/C/O HTN, CKD STAGE 3, loss to follow up for 1 year, admitted with A/CKD with H/O alternate drug intake. She had complaints of nausea, vomiting and breathlessness with serum creatinine value of 12.4 mg/dl and metabolic acidosis. She was started on haemodialysis with right IJV temporary DLC. She […]
Dialysis therapy is dependent on diffusion and convection through a large amount of water, so during that patient gets exposed to temperature changes of water directly. Malfunction of the heating element in the dialysis machine can result in the production of excessively cool or hot dialysis solution. Use of cool dialysis solution (down to 35°C) […]
32-year-old male, who is k/c/o HTN, DM, CVA, CKD Stage 5D on thrice a week MHD with left BC AVF. He was posted for right carotid endarterectomy. For that, pre-op heparin free dialysis was planned. After dialysis, the next morning the patient’s blood pressure was 70/52 mm of Hg. On evaluation found to have severe […]
