COMPLICATIONS OF DIALYSIS - PART 1 pps

[...]... Gynecol Obstet 19 90; 17 1:33–39 McDowell DE, Moss AH, Vasilakis C, Bell R, Pillai L Percutaneously placed dual lumen silicon catheters for long-term hemodialysis Am Surg 19 93; 59:569– 573 Gibson SP, Mosquera D Five years experience with the Quinton Permcath for vascular access Nephrol Dial Transplant 19 91; 6:269–274 Complications of Vascular Access 10 11 12 13 14 15 16 17 18 19 20 21 22 Tesio F, De... (11 7 ,12 2 ,12 4 ,12 5), tissue plasminogen activator (11 9 ,12 0), and urokinase (12 3 ,12 6 12 8) The lytic agent has been given as a continuous infusion (11 7 ,12 6 ,12 8), an initial bolus injection followed by a continuous infusion (12 3 ,12 4), and as intermittent injections (12 5 ,12 7) Treatment times have ranged from 2 to 72 hours The patients have generally been admitted to the intensive care unit The rate of success... Permcath Nephrol Dial Transplant 19 92; 7 :11 11 11 15 Shusterman NH, Kloss K, Mullen JL Successful use of double-lumen, silicon rubber catheters for permanent hemodialysis access Kidney Int 19 89; 35:887– 890 Blake PG, Huraib S, Wu G, Uldall PR The use of dual lumen jugular venous catheters as definitive long term access for hemodialysis Int J Artif Organs 19 90; 13 :26– 31 Trerotola SO, Johnson MS, Harris... evaluation of the graft-vein circuit and angioplasty of any stenotic lesion that was found Using this method, Valji et al (12 9) reported 96% success with only a 3% rate of minor 13 complications They were able to accomplish lysis within a mean time of 86 minutes Subsequently these investigators adopted a modification of their technique that they referred to as the pulse-spray method of PMT (11 9 ,12 9 ,13 1) This... C Graft Infection Infection of the PBG is a serious complication It has been reported to account for 20% of all dialysis access complications (14 7) and to be the second leading cause of graft loss Infection has been reported to occur at a frequency of 1. 3 episodes per 10 0 dialysis- months and to be associated with bacteremia at a rate of 0.7 cases per 10 0 dialysis- months (14 8) S aureus is the most common... low of 14 .3% (12 4) to a high of 10 0% (12 6) Complication rates have ranged from none to 85.7% Although most of these complications have been local due to bleeding at needle puncture sites, some have been more serious In one report, 6.3% of the patients experienced an embolus to the peripheral artery (12 2), and in another 12 % of the cases required blood transfusions (12 8) Because of the large doses of. .. superior to any other type of vascular access In spite of its obvious advantage, the relative number of AVFs being created has been decreasing Patients starting dialysis had a 70% greater chance of receiving a PBG instead of an AVF in 19 90 than they did in 19 86 (17 8) In 19 96 only 17 .9% of hemodialysis patients were using an AVF 60 days after the intiation of therapy (2) The complications associated with... therapy of venous stenosis in this setting have ranged from 80 to 94% (69 ,10 5 10 7) The highest rate of technical failure has occurred in the treatment of central lesions Long-term success rates have ranged from 41 to 76% at 6 months and 31 to 45% at one year (69 ,10 5 10 9) Treatment of central lesions has been met with poor long-term success In a series of 50 cases of central vein stenosis, a 6-month... $12 ,740 (n = 75) for surgical thrombectomy Vesely et al (14 6) discovered charges of $6,062 (n = 10 ) for thrombolysis and $5,580 (n = 10 ) for surgery in their institution When Marston et al (11 2) reviewed their cost data, they found that thrombolysis charges ranged from $3 ,10 4 to $11 ,646 (n = 15 ) and surgical treatment ranged from $6, 711 to $11 ,430 (n = 15 ) They concluded that there were no significant differences... in MT studies (11 4 ,12 1 ,13 3 13 5) Beathard et al (11 4) reported finding multiple small perfusion defects in five of six patients undergoing lung scans These cleared by 2 weeks with no adverse sequelae The occurrence of small emboli is not unique to MT These occur with removal of central venous catheters, percutaneous catheter stripping (26,29), surgical thrombectomy of dialysis access (13 3), and pharmacological . Distribution Marcel Dekker AG Hutgasse 4, Postfach 812 , CH-40 01 Basel, Switzerland tel: 4 1- 6 1- 2 6 1- 8 482; fax: 4 1- 6 1- 2 6 1- 8 896 World Wide Web http://www.dekker.com The publisher offers discounts on this book when. Reserved. ISBN: 0-8 24 7-8 87 1- 0 This book is printed on acid-free paper. Headquarters Marcel Dekker, Inc. 270 Madison Avenue, New York, NY 10 016 tel: 21 2-6 9 6-9 000; fax: 21 2-6 8 5-4 540 Eastern Hemisphere. isolate in cases of CRB has been Staphylococcus aureus (10 ,33). In a se- ries of 10 1 cases of CRB, we observed gram-negative organisms in 29%. Multiple organisms were isolated in 17 % of these cases. b.