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Doris H Fuertinger, Franz Kappel, Hanjie Zhang, Stephan Thijssen, Peter Kotanko
Anemia commonly occurs in people with chronic kidney disease (CKD) and is associated with poor clinical outcomes. The management of patients with anemia in CKD is challenging, due to its severity, frequent hypo-responsiveness to treatment with erythropoiesis stimulating agents (ESA) and common hemoglobin cycling. Nonlinear dose-response curves and long delays in the effect of treatment on red blood cell population size complicate predictions of hemoglobin (Hgb) levels in individual patients. A comprehensive physiology based mathematical model for erythropoiesis was adapted individually to 60 hemodialysis patients treated with ESAs by identifying physiologically meaningful key model parameters from temporal Hgb data...
2018: PloS One
Falk Leichsenring, Christiane Steinert, Paul Crits-Christoph
BACKGROUND: There is a growing body of evidence for the efficacy of psychodynamic therapy. Some representatives of other approaches, however, have repeatedly questioned its efficacy. Recently, another line of argumentation emerged, claiming that psychodynamic therapy may work, but that the mechanisms of change underlying its effects were not clear or even could not be tested empirically at all. OBJECTIVE: The present article critically reviews these allegations...
March 2018: Zeitschrift Für Psychosomatische Medizin und Psychotherapie
Michio Mineshima
Many kinds of technologies have been introduced and successfully developed for therapeutic apheresis. During the DFPP treatments, the patient's blood volume (BV) often decreases with time due to albumin loss induced by inadequate albumin infusion in a supplementation fluid. We examined the change of BV by a continuous hematocrit (HCT) monitor, CRIT-LINE™, during an in vivo study for nine patients. As a result, albumin loss was fairly occurred in some DFPP treatments. The decrease of patient's BV was induced by an oncotic pressure drop due to albumin loss and often resulted in a blood pressure drop...
August 30, 2017: Transfusion and Apheresis Science
Line Toft Tengberg, Nicolai Bang Foss, Morten Laksafoss Lauritsen, Janne Orbæk, Morten Hulvej Rod, Tine Tjørnhøj-Thomsen, Lena Veyhe, Morten Bay-Nielsen
INTRODUCTION: Undergoing acute high-risk abdominal (AHA) surgery is associated with reduced survival and a great risk of an adverse outcome, especially in the elderly. The primary aim of this study was to investigate the residential status and quality of life in elderly patients undergoing AHA surgery. METHODS: From 1 November 2014 to 30 April 2015, consecutive patients (≥ 75 years) undergoing AHA surgery were included for follow-up after six months. The patients included answered a health-related quality-of-life questionnaire and a supplemental questionnaire regarding residential status...
June 2017: Danish Medical Journal
Giannis Alexiadis, Stelios Panagoutsos, Stefanos Roumeliotis, Ilias Stibiris, Angelos Markos, Konstantia Kantartzi, Ploumis Passadakis
PURPOSE: Control of hydration status is an important constituent of adequate and efficient hemodialysis (HD) treatment. Nevertheless, there are no precise clinical indices for early recognition of small changes in fluid status of patients undergoing chronic hemodialysis therapy. This study aimed to evaluate and compare the widely used and reliable method of indexed inferior vena cava diameter (IVCDi) with established and more recently available techniques (bioelectrical impedance analysis [BIA], continuous blood volume monitoring [Crit-line], and the B-line score [BLS] with lung ultrasonography) for estimating the hydration status of patients on HD...
March 2017: International Urology and Nephrology
Steven A Frost, Mari-Cris Alogso, Lauren Metcalfe, Joan M Lynch, Leanne Hunt, Ritesh Sanghavi, Evan Alexandrou, Kenneth M Hillman
BACKGROUND: Health care-associated infections (HAI) have been shown to increase length of stay, the cost of care, and rates of hospital deaths (Kaye and Marchaim, J Am Geriatr Soc 62(2):306-11, 2014; Roberts and Scott, Med Care 48(11):1026-35, 2010; Warren and Quadir, Crit Care Med 34(8):2084-9, 2006; Zimlichman and Henderson, JAMA Intern Med 173(22):2039-46, 2013). Importantly, infections acquired during a hospital stay have been shown to be preventable (Loveday and Wilson, J Hosp Infect 86:S1-70, 2014)...
November 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
(no author information available yet)
In the October In Our Unit article by Cooper et al, “Against All Odds: Preventing Pressure Ulcers in High-Risk Cardiac Surgery Patients” (Crit Care Nurse. 2015;35[5]:76–82), there was an error in the reference citation on page 82. At the top of that page, reference 18 cited on the second line should be reference 23, which also should be added to the References list: 23. AHRQ website. Prevention and treatment program integrates actionable reports into practice, significantly reducing pressure ulcers in nursing home residents...
February 2016: Critical Care Nurse
Aurelio A de los Reyes V, Doris H Fuertinger, Franz Kappel, Anna Meyring-Wösten, Stephan Thijssen, Peter Kotanko
An assessment of fluid status can be obtained by monitoring relative blood volume (RBV) during hemodialysis (HD) treatment. The dynamics of RBV is determined by fluid removal from the intravascular compartment by ultrafiltration (UF) and vascular refill from the interstitium. To characterize this dynamics, a two-compartment model describing the short-term dynamics of vascular refilling and UF is developed. Fluid movement between the compartments is governed by lymphatic and microvascular fluid shifts. Further, protein flux is described by convection, diffusion and the lymphatic protein flux...
February 7, 2016: Journal of Theoretical Biology
Paul Balter, Linda H Ficociello, Patrice B Taylor, Len Usvyat, Dixie-Ann Sawin, Claudy Mullon, Jose Diaz-Buxo, Paul Zabetakis
BACKGROUND: Inadequate removal of extracellular volume markedly increases blood pressure and contributes to high morbidity and mortality in hemodialysis patients. Advances in fluid management are needed to improve clinical outcomes. The aim of this quality improvement project was to examine the advantages of using a hematocrit-based, blood volume monitor (Crit-Line * ) for 12 months, as part of a clinic-wide, fluid management program in one dialysis facility. METHODS: Forty-five individuals were receiving hemodialysis at one facility at project initiation and are included in this analysis...
2015: Current Medical Research and Opinion
Rouba Garro, Scott Sutherland, Liz Bayes, Steven Alexander, Cynthia Wong
BACKGROUND: The national average for achieving the KDOQI-recommended hemoglobin (Hgb) target level of 11-12 g/dL is low with the current anemia management protocol of measuring Hgb levels every 2-4 weeks to guide intervention. The objective of this study was to correlate initial Hgb readings from the CRIT-LINE monitor with actual serum Hgb levels in pediatric patients on hemodialysis (HD). METHODS: Data were collected from pediatric HD patients who had Hgb tests ordered for routine and/or clinical reasons...
June 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Paul Balter, Mikhail Artemyev, Paul Zabetakis
The Crit-Line™ monitor measures relative changes in intravascular blood volume during hemodialysis. The device is also used to monitor hematocrit and oxygen saturation. Using this device to decrease fluid volume has yielded inconsistent results on outcome measures such as hospitalization rates, erythropoietin utilization, and blood pressure reduction. Through a year-long deployment of the Crit-Line™ monitor, the Renal Research Institute (RRI) has shown that outcomes can be improved even in a busy dialysis clinic with attention to the details of how the device is utilized...
2015: Blood Purification
M A Butlitsky, B B Zelener, B V Zelener
A two-component plasma model, which we called a "shelf Coulomb" model has been developed in this work. A Monte Carlo study has been undertaken to calculate equations of state, pair distribution functions, internal energies, and other thermodynamics properties. A canonical NVT ensemble with periodic boundary conditions was used. The motivation behind the model is also discussed in this work. The "shelf Coulomb" model can be compared to classical two-component (electron-proton) model where charges with zero size interact via a classical Coulomb law...
July 14, 2014: Journal of Chemical Physics
Scott P Sibbel, Linda H Ficociello, Michael Black, Mayuri Thakuria, Claudy Mullon, Jose Diaz-Buxo, Thomas J Alfieri
BACKGROUND: The Crit-Line® monitor (CLM) is a device for monitoring hematocrit, oxygen saturation and change in intravascular blood volume during hemodialysis. Prior studies have evaluated CLM use in dialysis patients, but not specifically in those new to dialysis. METHODS: In this retrospective analysis, 199 patients initiating dialysis at 8 facilities routinely using CLM were compared with 796 propensity score-matched non-CLM patients initiating dialysis at facilities not using CLM...
2014: Blood Purification
Hiroshi Yamada, Minako Saeki, Junko Ito, Kazuhiro Kawada, Aya Higurashi, Hiromi Funakoshi, Kohji Takeda
The pulse CO-Oximeter (Radical-7; Masimo Corp., Irvine, CA) is a multi-wavelength spectrophotometric method for noninvasive continuous monitoring of hemoglobin (SpHb). Because evaluating the relative change in blood volume (ΔBV) is crucial to avoid hypovolemia and hypotension during hemodialysis, it would be of great clinical benefit if ΔBV could be estimated by measurement of SpHb during hemodialysis. The capability of the pulse CO-Oximeter to monitor ΔBV depends on the relative trending accuracy of SpHb...
February 2015: Journal of Clinical Monitoring and Computing
Gia Oh, Cynthia Wong, Brandy Begin, Kari Salsbery, Scott Sutherland, Abanti Chaudhuri
BACKGROUND: We hypothesized that the percent change in resistance (%RΔ) from bioimpedance analysis (BIA) measurements during hemodialysis (HD) can provide information on pediatric HD patients' hydration status. METHODS: Whole-body single-frequency BIA measurements were obtained before HD, each hour on HD, and after HD during two HD sessions. Pre-and post-HD weights, blood pressures, Crit-Line® measurements, and intradialytic symptoms were collected on the day of the BIA measurements...
August 2014: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Naoki Sugano, Keitaro Yokoyama, Naohiko Kato, Yoichiro Hara, Satoshi Endo, Jun Mitome, Taisei Kin, Goro Tokudome, Satoru Kuriyama, Tatsuo Hosoya, Takashi Yokoo
BACKGROUND: Bioelectrical impedance analysis (BIA) is a non-invasive method to estimate total body water (TBW) and extracellular water (ECW) volume. Crit-Line(®) (CL), on the other hand, assesses intravascular water (IVW) volume. We evaluate continuous changes in body water composition during hemodialysis (HD) with concurrent use of BIA and CL. METHODS: BIA at the start and the end of the HD session was measured using a BIA device. To investigate the shifting pattern of body water composition, patients were subjected to simultaneous monitoring of BIA with CL...
December 2014: Clinical and Experimental Nephrology
Sonika Puri, Jun-Ki Park, Frank Modersitzki, David S Goldfarb
Accurate assessment of blood volume (BV) may be helpful for prescribing hemodialysis (HD) and for reducing complications related to hypovolemia and volume overload. Monitoring changes in relative BV (RBV) using hematocrit, e.g., Crit-Line Monitor (CLM-III), an indirect method, cannot be used to determine absolute BV. We report the first study of BV measurement for assessing volume status in HD patients using the indicator dilutional method. Ten adult HD patients were enrolled in this prospective observational study...
April 2014: Hemodialysis International
Amanda Stavinoha, Vinai Modem, Raymond Quigley
Maintaining a dialysis patient's hemoglobin (Hgb) within a very narrow range can be challenging. Relying on Hgb measurements only once or twice a month can cause large fluctuations in their measurements. Utilizing the Hgb measurement from noninvasive modalities has been studied in adult populations. Our study focused on a pediatric hemodialysis population where blood volumes are much smaller to see if these measurements would adequately work for adjusting erythropoietin dosages. We reviewed our patients' data over a 6-month time period and collected simultaneous measurements of Hgb performed in the laboratory, as well as the initial Crit-Line measurement...
October 2013: Hemodialysis International
Hala Moukhachen, Prabalini Rajendram, Sanjay Chawla, Nina Raoof, Kaye Hale, Louis Voigt, Stephen Pastores, Neil Halpern
SESSION TYPE: Cardiovascular Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Pulmonary veno-occlusive disease (PVOD) is an uncommon variant of primary pulmonary artery hypertension (PAH) and is a rare but fatal complication of hematopoeitic stem cell transplant (HSCT). It often goes unrecognized antemortem.CASE PRESENTATION: 63-year-old man with history of Burkitt's lymphoma s/p chemotherapy in 2003 followed by autologous HSCT in 2005. In January 2011, he was diagnosed with MDS and received chemotherapy followed by an allogeneic HSCT...
October 1, 2012: Chest
Yundong Zhang, Xuenan Zhang, Ying Wang, Ruidong Zhu, Yulong Gai, Xiaoqi Liu, Ping Yuan
We theoretically propose and experimentally perform a novel dispersion tuning scheme to realize a tunable Fano resonance in a coupled-resonator-induced transparency (CRIT) structure coupled Mach-Zehnder interferometer. We reveal that the profile of the Fano resonance in the resonator coupled Mach-Zehnder interferometers (RCMZI) is determined not only by the phase shift difference between the two arms of the RCMZI but also by the dispersion (group delay) of the CRIT structure. Furthermore, it is theoretically predicted and experimentally demonstrated that the slope and the asymmetry parameter (q) describing the Fano resonance spectral line shape of the RCMZI experience a sign reversal when the dispersion of the CRIT structure is tuned from abnormal dispersion (fast light) to normal dispersion (slow light)...
April 8, 2013: Optics Express
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