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Hemodialysis heparin

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https://www.readbyqxmd.com/read/29782356/acute-neurologic-complications-during-extracorporeal-membrane-oxygenation-a-systematic-review
#1
Raoul Sutter, Kai Tisljar, Stephan Marsch
OBJECTIVES: We determine the frequency, risk factors, and mortality of neurologic complications in adults on extracorporeal membrane oxygenation and propose an algorithm for preventive strategies. DATA SOURCES: PubMed, Embase, and Cochrane databases. STUDY SELECTION: Screening was performed using predefined search terms to identify cohort studies reporting neurologic complications in adults during extracorporeal membrane oxygenation from 1990 to 2017...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29745004/heparin-free-renal-replacement-therapy-for-chronic-hemodialyzed-patients-at-high-risk-for-bleeding-a-comparison-of-on-line-predilution-hemodiafiltration-with-conventional-hemodialysis
#2
Vincent Brunot, Jean-Emmanuel Serre, Georges Mourad, Kada Klouche, Vincent Pernin
BACKGROUND: In chronic hemodialysis patients with high risk of bleeding, optimal anticoagulation of the extracorporeal circuit is challenging. Heparin-free hemodialysis (HD) with heparin-coated AN69ST dialyzer is now considered as a good option and recommended by experts. Predilutional hemodiafiltration (HDF) may represent also a feasible alternative but has been poorly investigated. In this study, our aim was to evaluate the performance of on-line automated predilution heparin-free HDF as compared to conventional heparin-free HD with a heparin-coated membrane...
May 10, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29744595/synthesis-and-biocompatibility-of-an-argatroban-modified-polysulfone-membrane-that-directly-inhibits-thrombosis
#3
Xiao Fu, Jian-Ping Ning
Anticoagulation therapy plays a vital role in the prevention of blood clot formation during hemodialysis and hemofiltration, especially for critical care patients. Here, we synthesized a novel argatroban (Arg)-modified polysulfone (PSf) membrane for anticoagulation. Arg was grafted onto the PSF membrane via chemical modification to increase membrane hydrophilicity. Protein adsorption, coagulation, as well as activation of platelets and complement systems were greatly reduced on the Arg-modified PSf membrane...
May 9, 2018: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/29579885/intraoperative-heparinization-during-simultaneous-pancreas-kidney-transplantation-is-it-really-necessary
#4
A Arjona-Sánchez, L Rodríguez-Ortiz, J M Sánchez-Hidalgo, J Ruiz Rabelo, J J Salamanca-Bustos, A Rodríguez-Benot, P Campos-Hernández, J Briceño-Delgado
INTRODUCTION: The use of intraoperative sodium heparin during simultaneous pancreas-kidney transplantation (SPKT) remains as a routine practice in some referral centers to minimize pancreatic graft thrombosis rate. One of its disadvantages is the theoretical increased risk of postoperative bleeding. In our center, we have abandoned its use since 2011. MATERIALS AND METHODS: We performed a retrospective analysis among 198 SPKTs performed in our center between the years 1989 and 2017...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29578404/priapism-and-hemodialysis-case-report-and-literature-review
#5
Weiwen Vivian Shih, Cynthia Wong
BACKGROUND: Priapism is a known but rarely described complication of patients on dialysis. The incidence of priapism in the general population is estimated at 1.5 in 100,000 patients and 2.9 in 100,000 patients in males over 40 years of age; however there is little current literature describing priapism in adult dialysis patients and no current literature in pediatric dialysis patients [1]. We describe two pediatric patients who developed priapism concurrent with hemodialysis, each with differing severity and therapeutic management...
March 26, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29561271/convectively-dominated-heparin-leakage-from-multiple-catheter-designs-an-in-vitro-experimental-study
#6
Michael Coleman Barbour, Kenneth W Gow, Alberto Aliseda
Central venous catheters (CVCs) are routinely filled with a heparin lock while not in use to avoid thrombus formation near the tip. However, heparin leakage is known to occur, and the lock effectiveness remains in question. It was recently shown that convective fluxes from the blood flow in the host vein transport the majority of locking solution away from the tip of hemodialysis catheters immediately after instillation. Combined with the low diffusivity of heparin, this results in concentrations of heparin at the catheter tip that are orders of magnitude lower than at instillation for the majority of the interdialytic phase, diminishing the antithrombotic effectiveness of the lock...
March 16, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29477675/factors-associated-with-early-thrombosis-after-arteriovenous-fistula-creation
#7
Abraham Korn, Hamid Alipour, Joshua Zane, Ali Shahverdiani, Timothy J Ryan, Amy Kaji, Nina Bowens, Christian de Virgilio
BACKGROUND: Arteriovenous fistulas (AVF) are the preferred modality for hemodialysis access. Early thrombosis hampers development of a working AVF. We endeavored to determine the incidence and identify factors associated with early thrombosis of AVF and to determine salvage rates following thrombosis, at a high-volume hemodialysis access center. METHODS: Retrospective review of autologous AVF was created between November 2014 and July 2016 at a single center. Early thrombosis was defined as thrombosis that occurred within 30 days of surgery...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29472415/cluster-randomized-trial-of-devices-to-prevent-catheter-related-bloodstream-infection
#8
Steven M Brunelli, David B Van Wyck, Levi Njord, Robert J Ziebol, Laurie E Lynch, Douglas P Killion
Central venous catheters (CVCs) contribute disproportionately to bloodstream infection (BSI) and, by extension, to infection-related hospitalization, mortality, and health care costs in patients undergoing dialysis. Recent product advancements may reduce BSIs, but a sufficiently powered comparative-effectiveness study is needed to facilitate evidence-based patient care decisions. In a 13-month, prospective, cluster-randomized, open-label trial, we compared BSI rates in facilities using ClearGuard HD antimicrobial barrier caps (ClearGuard group) with those in facilities using Tego hemodialysis connectors plus Curos disinfecting caps (Tego+Curos group)...
April 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29422067/predictors-of-hospital-mortality-in-adult-trauma-patients-receiving-extracorporeal-membrane-oxygenation-for-advanced-life-support-a-retrospective-cohort-study
#9
Meng-Yu Wu, Pin-Li Chou, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Using extracorporeal membrane oxygenation (ECMO) to provide advanced life support in adult trauma patients remains a controversial issue now. The study was aimed at identifying the independent predictors of hospital mortality in adult trauma patients receiving ECMO for advanced cardiopulmonary dysfunctions. METHODS: This retrospective study enrolled 36 adult trauma patients receiving ECMO due to advanced shock or respiratory failure in a level I trauma center between August 2006 and October 2014...
February 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29419934/evaluation-of-nafamostat-mesilate-as-an-alternative-anticoagulant-during-intermittent-hemodialysis-in-healthy-beagle-dogs
#10
Joon-Hyuk Choi, Seok-Yeong Byun, Aryung Nam, Sei-Myoung Han, Kyu-Pil Lee, Kun-Ho Song, Hwa-Young Youn, Kyoung-Won Seo
OBJECTIVE: To evaluate nafamostat mesilate (NM) as an alternative anticoagulant agent for intermittent hemodialysis (IHD). DESIGN: Prospective randomized study. SETTING: University teaching hospital. ANIMALS: Eighteen healthy Beagle dogs. INTERVENTIONS: In group 1 (n = 6), NM was administered at a dose of 0.5 mg/kg/h during IHD for 5 hours. In group 2 (n = 6), NM was administered at a low dose of 0...
March 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29391103/predictors-of-steal-in-hemodialysis-access
#11
Abraham Korn, Hamid Alipour, Joshua Zane, Kelsey Gray, Timothy Ryan, Amy Kaji, Christian De Virgilio, Nina Bowens
Pathological steal is an uncommon but devastating complication after the creation of arteriovenous access for hemodialysis. In this study, we sought to assess predictors of clinically significant steal syndrome and to further evaluate the outcome of differing surgical treatment approaches. A retrospective analysis was performed of 282 consecutive patients undergoing hemodialysis access at a single center from November 2014 to April 2016. Adequate follow-up to assess for the development of steal was obtained in 237 patients...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29390544/anesthetic-management-of-primary-hyperparathyroidism-during-pregnancy-a-case-report
#12
Hong Zeng, Zhengqian Li, Xiaoqing Zhang, Ning Wang, Yang Tian, Jun Wang
RATIONALE: Primary hyperparathyroidism (PHPT) during pregnancy is rare. Nevertheless, hypercalcemia secondary to gestational PHPT may be masked by physiological changes in calcium homeostasis during pregnancy. Gestational PHPT constitutes a serious danger to mother and fetus. Surgery is the only curative treatment when conservative treatment could not control the condition. Due to the lack of guidelines concerning PHPT during pregnancy, the optimal anesthetic management of PHPT during pregnancy needs to be individualized...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29354913/-effects-of-auricular-plaster-therapy-on-quality-of-life-in-uremia-patients-after-parathyroidectomy-plus-autograft
#13
Li Li, Jin Wang, Yanlin Li
OBJECTIVE: To observe the effects of auricular plaster therapy on quality of life in uremia patients after parathyroidectomy plus autograft (PTX+AT). METHODS: A total of 34 uremia patients complicated with secondary hyperparathyroidism (SHPT) who received PTX+AT were randomly divided into an observation group and a control group, 17 cases in each one. The patients in the control group were treated with calcium supplementation after surgery, 1 to 2 mg/kg an hour; one day after surgery, the patients were treated with oral administration of calcium carbonate before meals, 1...
September 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29335321/effectiveness-and-cost-of-weekly-recombinant-tissue-plasminogen-activator-hemodialysis-catheter-locking-solution
#14
Brenda R Hemmelgarn, Braden J Manns, Steven D Soroka, Adeera Levin, Jennifer MacRae, Karthik Tennankore, Jo-Anne S Wilson, Robert G Weaver, Pietro Ravani, Robert R Quinn, Marcello Tonelli, Mercedeh Kiaii, Paula Mossop, Nairne Scott-Douglas
BACKGROUND AND OBJECTIVES: Evidence to guide hemodialysis catheter locking solutions is limited. We aimed to assess effectiveness and cost of recombinant tissue plasminogen activator (rt-PA) once per week as a locking solution, compared with thrice weekly citrate or heparin, in patients at high risk of complications. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used a prospective design and pre-post comparison in three sites across Canada. Pre-post comparisons were conducted using multilevel mixed effects regression models accounting for cluster with site and potential enrollment of patients more than once...
March 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29276299/safety-and-efficacy-of-enoxaparin-compared-with-unfractionated-heparin-for-venous-thromboembolism-prophylaxis-in-hemodialysis-patients
#15
Melissa S Green, Katie B Tellor, Amanda R Buckallew
Background: Enoxaparin, a low-molecular-weight heparin approved for prophylaxis in patients at risk for venous thromboembolism (VTE), offers several advantages compared with unfractionated heparin (UFH). Enoxaparin is primarily excreted through renal elimination and is currently not recommended in patients receiving hemodialysis (HD) due to potential increased bleeding complications. To date, there are limited safety and efficacy data supporting the use of enoxaparin in this patient population for VTE prophylaxis...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29223499/a-comparison-of-standard-versus-low-dose-heparin-on-access-related-complications-after-coronary-angiography-through-radial-access-a-meta-analysis-of-randomized-controlled-trials
#16
Khagendra Dahal, Sharan Sharma, Adil Yousuf, Juyong Lee, Michael Azrin, Enrique Jimenez, Kalgi Modi, Neeraj Tandon
BACKGROUND: Transradial access (TRA) is preferred for coronary angiography (CA) or percutaneous coronary intervention due to reduced access-related complications, and mortality especially for patients with ST elevation myocardial infarction. Radial artery occlusion (RAO) is a known complication of TRA, and precludes its use as a future access site, conduit for coronary artery bypass grafting or for hemodialysis fistula placement. Although a standard dose (SD) heparin of 5000 Units is used during TRA, the risks of RAO and hematoma compared to lower dose (LD) remain unclear...
November 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29214504/postmarketing-experience-with-neutrolin%C3%A2-taurolidine-heparin-calcium-citrate-catheter-lock-solution-in-hemodialysis-patients
#17
Bruce E Reidenberg, Christoph Wanner, Bruce Polsky, Mariana Castanheira, Alla Shelip, Dirk Stalleicken, Antony E Pfaffle
Catheter-related bloodstream infections (CRBSI) are major complications for patients with life-threatening conditions requiring chronic vascular catheterization. The wide range of etiologic microbes and the ongoing development of resistance to antimicrobials with specific mechanisms of action make this an appropriate target for applying a nonspecific antimicrobial therapeutic. Taurolidine hydrolyzes into two antimicrobial moieties, formaldehyde and methylene glycol, which react with microbial surfaces. Neutrolin® (taurolidine, heparin, calcium citrate) was recently introduced in Germany as an antimicrobial catheter lock solution...
December 6, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29192725/viabahn-stent-for-hemodialysis-shunt-efficacy-long-segment-recanalization-and-prognostic-factors-for-reintervention
#18
Giancarlo Salsano, Matteo Trezzi, Matteo Barattini, Franca Puccianti, Nicola Romano, Tito Zattera, Nadia Chiappini, Francesco Londrino, Davide Rolla, Teseo Stefanini
INTRODUCTION: The study evaluated the Heparin Bioactive Surface (HBS) Viabahn Stent (W.L. Gore & Associates, -Flagstaff, Arizona) efficacy in the maintenance or re-establishment of hemodialysis. MATERIALS AND METHODS: Fifty HBS Viabahn stents deployed in 37 consecutive patients with hemodialysis dysfunction from January 2008 to May 2016 were evaluated in a single-institution retrospective review.Outcomes were stent patency intended as primary circuit patency (PP), assisted primary patency (APP), target lesion primary patency (TLPP) and secondary patency (SP)...
November 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29191576/-comparison-of-citrate-4-and-heparin-as-tunneled-catheters-locking-solution-in-chronic-hemodialysis
#19
Guillaume Chazot, Manolie Mehdi, Christie Lorriaux, Patrik Deleaval, Brice Mayor, Guillaume Jean, Charles Chazot, Sylvain Lechevallier, Oriane Moncel, Cyril Vo-Van, Jean-Marc Hurot
INTRODUCTION: Citrate 4% is an alternative to heparin as catheter-locking solution in chronic hemodialysis patients. We compared catheter dysfunction episodes, dialysis adequacy, plasminogen-tissular activators use and costs according to catheter-locking solution in our centre. METHODS: Prospective, monocentric, cohort study (NephroCare Tassin-Charcot) on 49 prevalent patients in chronic hemodialysis. Two main groups were formed according to the prescription of catheter-locking solution at the beginning of the study (03/02/2016) and followed until 05/10/2016: heparin (n=26) and citrate (n=22)...
February 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29171099/regional-citrate-anticoagulation-for-intermittent-hemodialysis-in-dogs
#20
T Francey, A Schweighauser
BACKGROUND: The traditional systemic heparinization used for anticoagulation in extracorporeal therapies may cause fatal complications in animals at risk of bleeding. HYPOTHESIS/OBJECTIVES: To develop and validate a protocol of regional citrate anticoagulation (RCA) for intermittent hemodialysis in dogs. ANIMALS: A total of 172 dogs treated with hemodialysis for acute kidney injury. METHODS: In vitro titration was performed, adding trisodium citrate and calcium chloride to heparinized canine blood...
January 2018: Journal of Veterinary Internal Medicine
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