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INTRODUCTIONHemodialysis removes wastes and water by circulating blood outside the body through an external filter, called a dialyzer, that contains a semi permeable membrane. The blood flows in one direction and the dialysate flows in the opposite. The counter-current flow of the blood and dialysate maximizes the concentration gradient of solutes between the blood and dialysate, which helps to remove more urea and creatinine from the blood. The concentrations of solutes (for example potassium, phosphorus, and urea) are undesirably high in the blood, but low or absent in the dialysis solution, Dialysis is an increasingly common type of treatment.The dialysis solution has levels of minerals like potassium and calcium that are similar to their natural concentration in healthy blood.
PURPOSE:When the nephrons in the kidneys are failure or not working properly, the ions like potassium, creatinine etc we go through dialysis.Diseases of renal failure are NephrotoxinsDiabetic Nephropathy Hypertension GlomerulonephritisCystic kidney Disease
DEFINITION:The Hemodialysis name it self contains hemo means blood and dialysis means thediffusionofsolutemoleculesthroughasemi permeable membrane,normallypassingfromthesideofhigherconcentrationtothat of lower. Semi membraneisonethatallowsthepassageofcertainsmallermoleculesofsuchcrystalloidsasglucoseandurea,but preventspassageoflargermoleculessuchasthecolloidalplasmaproteins andprotoplasm.Hemodialysis,also spelledhaemodialysis, commonly calledkidney dialysisor simplydialysis, is a process of purifying the blood of a person whosekidneysare not working normally. It is a method that is used to achieve the extracorporeal removal of waste products such ascreatinine andureaand free water from thebloodwhen thekidneysare in a state ofrenal failure. Hemodialysis is one of threerenal replacement therapies (the other two beingrenal transplant andperitoneal dialysis). An alternative method for extracorporeal separation of blood components such as plasma
PRINCIPLE:The principle of Hemodialysis is the same as other methods ofdialysis; it involvesdiffusion of solutes across a semi permeable membrane. Hemodialysis utilizescounter current flow, where the dialysate is flowing in the opposite direction toblood flow in the extracorporealcircuit. Counter-current flow maintains the concentration gradient across the membrane at a maximum and increases the efficiency of the dialysis.It involves diffusion,osmomis and ultra filtration.
DESCRIPTION:Hemodialysis is diffusion across a semi permeable membrane (one that allows only certain molecules to pass through it). The semi permeable membrane is used to remove the wastes from the blood and at the same time correct the level of electrolytes in the blood. Before Hemodialysis can be performed, a surgeon must make a way for the blood to be pumped out of the body and then be returned after it has been cleansed. To do this, the surgeon uses an artery and a vein in the forearm. Arteries (which have muscles in their walls) bring oxygenated blood to the body from the heart, and veins return blood to the heart, which needs to have oxygen. The surgeon connects the radial artery in the forearm to a large vein called the cephalic vein. This connection is called an arterio venous shunt. A shunt carries something from one place to another. In this case it carries blood from an artery to a vein. After this shunt is made, the veins in the forearm get big and eventually form muscles in their walls like arteries. They are now strong and can be punctured many times for dialysis.
Description condtDIALYSIS: There are two different kinds of dialysis used in medicine: Hemodialysis and peritoneal dialysis. The methods for performing dialysis may be different, but the goal of the treatment is the same, that is, to remove waste products. These wastes are composed mainly of nitrogen in the form of urea, uric acid, and creatinine. TYPES OF DIALYSIS: There are five types of dialysis.Hemodialysis.Peritoneal Dialysis.Hemofiltration.Hemodiafiltration.Intestinal dialysis.
FRONT VIEW:1. Monitor2. Blood Pressure Cuff3. Extracorporeal blood circuit module4. Concentrate connectors5. Brake6. Shunt interlock for the dialyzer connecting lines7. IV pole8. Status indicator
BACK VIEW:1. Monitor2. Sampling value3.Bracket for the dialyzer connection lines4. Dialysate outlet tube5. Dialysate inlet tube6. Disinfection connector7. Filter8. CDS (red) option9. Drain10. Water connector (permeate)11. DIASAFE plus12. Vent tubing13. Power supply unit
PARTS AND FUNCTIONS:S.NO PARTSFUNCTION1Dialysis Machine Blood Pump and TubingA blood pump simply pumps the blood from the body into the machine through specially made tubes. 2SyringeThe syringe contains a drug called Heparin whichprevents the blood from clotting in the tubes.3DialyzerThe dialyzer is a large canister containing thousands of small fibers through which patient blood is passed. The dialyzer is the key part of a dialysis machinewhere the cleaning of the blood takes place. 4Alarmsin order to protect the patient from any errors in functioning. The things that are monitored with alarms include:Blood pressure within the machineBlood pressure of the patientBlood flowTemperatureDialysate mixture
1S.NOPARTSFUNCTION5Pressure monitor Arterial pressure monitor: Detects the pressure between the blood access and the blood pump. Venous pressure monitor: It normally detects positive pressures. If the venous pressure goes low, it probably due to disconnection/low blood flows in the circuit. 6Air Leakage DetectorThe detector is settled in the venous blood line and detects as well as in the purpose of avoiding air embolus
7Data InterfacesDialysis machines can include USB, Ethernet, and a variety of serial interfaces to legacy hospital information systems. Wireless interfaces (such as Wi-Fi) may also be included for direct connection to the hospital wireless networks. Data card slots are also available on some designs. 8ValvesSeveral valves with electronic actuation are needed in the machine to allow variable mixing ratios. Various implementations are possible from simple opened/closed valves driven by solenoids to precision variable-position valves driven by stepper motors.
9SensorsDialysis machines require many different types of sensorsto monitor various parameters. Blood pressure at various points in the extracorporeal circuit, dialysate pressure, temperature, O2saturation, motor speed, dialyzer membrane pressure gradient, and air are all monitored for proper values during dialysis.
Step by step procedure:After the dialysis procedure has been done to a patient, the machine should get ready for another new patient, we should clean the disposable tubing's and filter with sterilizing fluid and should checked with a type of litmus test.When the patient arrives, the parameters like weight, blood pressure and temperature are measured.For fistula procedure we have to connect to veins of arms or legs. For catheter procedure we have to connect to large veins at chest.Then the patient is connected to the machine with complete loop, then the timer and pump are started.Hemodialysis is under process.Periodically for every half hour, the blood pressure is taken. If, low blood pressure can cause cramping, nausea, shakes, dizziness, lightheadedness, and unconsciousness .The amount of fluid to be removed is set by the dialysis nurse according to the patient's "estimated dry weight."
Procedure condt8. At the end of the procedure time, the patient is disconnected from the plumbing. Needle wounds are bandaged with gauze, held for up to 1 hour with direct pressure to stop bleeding, and then taped in place. 9. Temperature, standing and sitting blood pressure, and weight are all measured again. Temperature changes may indicate infection. BP discussed above. Weighing is to confirm the removal of the desired amount of fluid. 10.Care staff verifies that the patient is in condition suitable for leaving. The patient must be able to stand, to maintain a reasonable blood pressure, and be coherent.
RISKS: Anemia: due to the procedure associated blood losses and mild effect on oxygen transporting function.Hematocrit (Hct): It levels, a measure of red blood cells, are typically low in ESRD patients. This deficiency is caused by a lack of the hormone erythropoietin. Cramps, nausea, vomiting, and headaches: Some patients experience cramps and flu-like symptoms during treatment. These can be caused by a number of factors, including the type of dialysate used, composition of the dialyzer membrane, water quality in the dialysis unit, and the ultra filtration rate of the treatment.Hypotension: Because of the stress placed on the cardiovascular system with regular Hemodialysis treatments, patients are at risk for hypotension, a sudden drop in blood pressure. This can often be controlled by medication and adjustment of the patient's dialysis prescription.Infection: Patients can also get infections through surroundings. The room and area used for patients must be kept clean. Infectious diseases: There is a great deal of blood exposure involved in dialysis treatment, a slight risk of contracting hepatitis B and hepatitis C exists. The hepatitis B vaccination is recommended for most patients.
ADVANTAGES:Low mortality rateBetter control of blood pressure and abdominal crampsLess diet restrictionBetter solute clearance effect for the daily hemo dialysis: better tolerance and fewer complications with more frequent dialysis
DISADVANTAGES:Restricts independence, as people undergoing this procedure cannot travel around because of supplies' availabilityRequires more supplies such as high water quality and electricityRequires reliable technolo