Reducing Door-In to Door-Out Time for Patients Receiving a Mechanical Thrombectomy Using AutoLaunch Protocol.

Background: Door-in to door-out (DIDO) time for large vessel occlusion (LVO) stroke is an emerging stroke performance measure. Initial presentation at a non-Comprehensive Stroke Center (CSC) requires a transfer process that minimizes delays. Our objective was to assess whether DIDO time for stroke patients was reduced after implementation of an AutoLaunch protocol for interfacility transfers.

Insulin therapy during peritoneal dialysis: pros and cons of various forms of administration.

Major fluctuations of blood glucose, hyperinsulinemia, and the formation of insulin antibodies can be prevented by intraperitoneal insulin administration during peritoneal dialysis in patients with diabetic nephropathy. The reduction in insulin requirement is most pronounced compared with subcutaneous administration when insulin is instilled into the empty abdominal cavity. If insulin is instilled into the abdominal cavity along with the dialysis fluid, there are losses of activity due to delayed absorption consequential to dilution by the fluid and adsorption to the plastic surface of the dialysis solution delivery systems.

Systematic isolation of circulating human peptides: the concept of peptide trapping.

The structural determination of circulating human peptides is essential to determine their correct posttranslationally processed form. Human hemofiltrate from patients with end stage renal disease is accessible in large quantities and is used as a source for the preparation of circulating peptides. After complete peptide extraction from hemofiltrate, a systematic separation with different chromatographic techniques is achieved.

Fluid balance during haemodialysis and haemofiltration: the effect of dialysate sodium and a variable ultrafiltration rate.

One of the main causes of hypotension during extracorporeal renal replacement therapy is an insufficient substitution of the ultrafiltrated plasma water by tissue water. To investigate the fluid balance and its effects on hypotension in dialysed patients, the following variables were studied: intracellular fluid volume (IFV) and extracellular fluid volume (EFV), blood volume (BV) and blood pressure. IFV and EFV were measured by means of non-invasive electrical conductivity measurements using four electrodes round the leg.

The influence of dialysate sodium and variable ultrafiltration on fluid balance during hemodialysis.

An important factor in the development of hypotension during hemodialysis (HD) is a decrease in blood volume, due to ultrafiltration (UF) and an insufficient refill of the intravascular compartment. This insufficient refill might be caused by a transcellular fluid shift from the extracellular to the intracellular compartment. We studied the influence of dialysate sodium concentration and UF rate on the refill rate, blood volume, intracellular (ICV) and extracellular fluid volume (ECV).

[Determination of the diameter of erythrocytes in the urine in urologic diseases and so-called asymptomatic microhematuria].

In a blind-study with 96 patients analysis of erythrocyte diameters permits to differentiate between renal-parenchymatous and post-renal microhaematuria in 89.9% of the cases. Erythrocytes on renal-parenchymatous microhaematuria are distinctly smaller (Average diameter 3.

Hypertension and cardiovascular risk factors in hemodialyzed diabetic patients.

In a retrospective study, the cause of death and the cardiovascular risk conferred by hypertension and other risk factors were analyzed in 200 diabetic and 200 nondiabetic patients who were matched for age, sex, year of admission, and center of treatment. Total and cardiovascular mortality were considerably higher in diabetics, cardiovascular mortality being 4.8 times higher in patients with type I and 3.

Low molecular weight heparin in hemodialysis and hemofiltration patients.

Low molecular weight (LMW)-heparin was used as the sole anticoagulant during hemodialysis and hemofiltration in a pilot study on 32 patients. A LMW-heparin dose corresponding to 50% of the patients usual unfractionated, standard (UF)-heparin dose was found to produce comparable plasma heparin levels (anti-FXa-activity). No thrombosis of the extracorporal system and no bleeding complications occurred at this LMW-heparin dose.

Optimum dialysis treatment for patients over 60 years with primary renal disease. Survival data and clinical results from 242 patients treated either by haemodialysis or haemofiltration.

An analysis of the data of 180 haemodialysis patients and 62 haemofiltration patients over 60 years of age when commencing treatment, clearly shows that this age group of patients (when suffering from primary renal disease) has a very good chance of surviving many years when treated with either haemodialysis or haemofiltration. This refers also to patients being older than 75 or 80 years, who have survival rates of 50 per cent after five years and three years respectively. The presented data further indicate that chronic haemofiltration seems to be the superior treatment when compared with acetate haemodialysis for the treatment of elderly renal patients, as the survival rates are at any chosen time interval higher with haemofiltration than with haemodialysis.