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HEMODIALYSIS

HEMODIALYSISAGRAVANTES, DENNISELAROYA, DONITAREYES, VALLERIEPRINCIPLES OF HEMODIALYSIS11/21/11Hemodialysis:

>Remove accumulated metabolic waste products

>Correct blood electrolyte composition

>By means of exchange between patients blood & dialysate fluid across a semi-permeable membrane

11/21/11Dialyzer

>The dialyzer consists of a bundle of semi-permeable hollow fibers (tubes) surrounded by a hard plastic casing (shell).

>The fibers are potted into the casing with an impermeable glue at either end.

11/21/11Dialyzer

>Fluid distribution caps are then glued into place

>Blood can then flow into one fluid distribution cap, along the interior of the fiber (tube-side) to the exit distribution cap, and thence out of the dialyzer.

11/21/11Dialyzer

>Dialysate, basically distilled water with an electrolyte and pH composition similar to that of blood plasma, flows counter-current to the blood on the outside of the fibers (shell-side).

11/21/11Dialysis CAN Remove waste products (e.g. urea, creatinine, phosphorus, etc.) Remove excess water Correct high or imbalanced levels of potassium, chloride, sodium, etc. in the blood

Dialysis CANT Automatically regulate blood pressure Produce hormones like Erythropoetin (EPO) Regulate normal calcium levels11/21/11

Electrolyte balance>adding some electrolytes to your dialysate solution excess electrolytes are removed as part of your treatment

>The goal is to get the right amount of the right electrolytes. 11/21/11

Removing excess water

>ultrafiltration.

>the dialysis machine puts pressure on the blood side of the semi permeable membrane in the dialyzer.

>This pressure forces salt and water out of the blood and into the dialysate.

>The used dialysate with the blood wastes and excess fluid is taken away and drained.CURRENT TRENDS

New Dialysis Method Cuts Mortality Risk

Published: Feb 16, 2013ByMichael Smith, North American Correspondent, MedPage Today

HEMODIALYSIS ACCESS11/21/11

ARTERIOVENOUS FISTULA:>An AV fistula requires advance planning

>A surgeon creates an AV fistula by connecting an artery directly to a vein, frequently in the forearm. >As a result, the vein grows larger and stronger, making repeated needle insertions for hemodialysis treatments easier. because a fistula takes a while after surgery to developin rare cases, as long as 24 months.

Connecting the artery to the vein causes more blood to flow into the vein.

1311/21/11

11/21/11ARTERIOVENOUS GRAFT The graft becomes an artificial vein that can be used repeatedly for needle placement and blood access during hemodialysis. often within 2 or 3 weeks.

Compared with properly formed fistulas, grafts tend to have more problems with clotting and infection and need replacement sooner.

A graft doesnt need to develop as a fistula does, so it can be used sooner after placement, However, a well-cared-for graft can last several years.1511/21/11

11/21/11VENOUS CATHETER FOR TEMPORARY ACCESS>A catheter is a tube inserted into a vein in your neck, chest, or leg near the groin. >It has two chambers to allow a two-way flow of blood. >Catheters are not ideal for permanent access.

Once a catheter is placed, needle insertion is not necessary

1711/21/11The most common area:Internal jugular catheter - inserted into the jugular vein on the side of the neck.

Subclavian catheter - placed into the subclavian vein under the collar bone on the chest.

Femoral catheter - placed in the large vein in the leg near the groin.

11/21/11