A new blood access system for hemodialysis (HD) addresses the major shortcomings of current accessing techniques and helps overcome patient adversity with available choices. The system uses new methods, devices and compositions comprising several novel elements: (1) totally implanted port, elementally simple in design, small and robust with improved safety features, (2) engineered transcutaneous tissue tract (TTT) to precisely guide a tubular conduit to engage the implanted port, (3) viscoelastic gel prophylaxis for internal passages and surface interfaces of the port and TTT, (4) the tool kit aligns the TTT with the port and initiates TTT formation at the time of port placement, (5) an integrated external bloodline circuit comprising the interface between the implanted port and HD machine which can be reused for several treatment sessions. The system provides bloodless, painless, and fail-safe connections with redundant sealing along the complete blood path.
View Article and Find Full Text PDFBackground: Data generated with the body composition monitor (BCM, Fresenius) show, based on bioimpedance technology, that chronic fluid overload in hemodialysis patients is associated with poor survival. However, removing excess fluid by lowering dry weight can be accompanied by intradialytic and postdialytic complications. Here, we aim at testing the hypothesis that, in comparison to conventional hemodialysis, blood volume-monitored regulation of ultrafiltration and dialysate conductivity (UCR) and/or regulation of ultrafiltration and temperature (UTR) will decrease complications when ultrafiltration volumes are systematically increased in fluid-overloaded hemodialysis patients.
View Article and Find Full Text PDFCatheters are widely used for blood purification, parenteral nutrition, and for the infusion of drugs. Previous work on catheter lock spillage has focused on the theory and in vitro demonstration of catheter lock spillage caused by the laminar flow profile and by fluid exchange caused by density differences. This work describes an in vitro test with a method that potentially allows measurement of catheter lock spillage in vivo without sampling.
View Article and Find Full Text PDFBackground: The locking anticoagulant plays a decisive role in the patency of central venous catheters (CVCs) used for haemodialysis. During injection, the hydraulic effects inevitably cause lock solution to spill into the systemic circulation. Density differences between whole blood (WB) and the lock solution cause further gravity-induced seepage of lock solution.
View Article and Find Full Text PDFIn this chapter, unanswered questions regarding the safety and usability of the wearable artificial kidney (WAK) are discussed. This will cover issues such as safe blood access, risks related to the operation of the WAK, temporary disconnection or separation during sleep, and reloading dialysate regeneration cartridges.
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