Severity: Warning
Message: fopen(/var/lib/php/sessions/ci_sessionmr0ekpb9ta4g5lmece1kmvit3ackak8e): Failed to open stream: No space left on device
Filename: drivers/Session_files_driver.php
Line Number: 177
Backtrace:
File: /var/www/html/index.php
Line: 316
Function: require_once
Severity: Warning
Message: session_start(): Failed to read session data: user (path: /var/lib/php/sessions)
Filename: Session/Session.php
Line Number: 137
Backtrace:
File: /var/www/html/index.php
Line: 316
Function: require_once
Severity: Warning
Message: file_get_contents(https://...@gmail.com&api_key=61f08fa0b96a73de8c900d749fcb997acc09&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 197
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 197
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 271
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3145
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Millions of patients with kidney failure rely on hemodialysis (HD) central venous catheters (CVC) for their life-sustaining dialysis treatments. CVC dysfunction necessitates removal of up to 20% of CVCs and is an important problem for patients with kidney failure. Thrombosis and fibrin sheath formation are the most common mechanisms of CVC dysfunction beyond the first week after insertion. Factors such as female sex, left-sided CVC placement and prior CVC dysfunction increase the risk of dysfunction. Patient specific factors contribute substantially to variation in the number of CVC dysfunction events. Weekly thrombolytic locks have been shown to improve CVC blood flow rates, prevent infection and reduce dysfunction requiring removal. However, routine administration may not be cost-effective in HD units with low infection rates, and targeted use among patients with established CVC dysfunction has not been studied. Concentrated heparin lock (e.g., 5000 vs. 1000 IU/ml) have been associated with lower requirements for therapeutic CVC thrombolysis but increased systemic bleeding risks and costs. Citrate 4% was non-inferior to standard heparin locks to prevent thrombosis, may cause less bleeding, and is less costly in some countries. Tunneled CVCs with a symmetrical tip have been associated with a lower risk of CVC dysfunction compared to those with a step tip. Multifaceted CVC care interventions can reduce the incidence of dysfunctional CVCs by 33% compared to usual care. Future research to identify patients at high risk of CVC dysfunction will inform individualized vascular access plans, targeted use of preventive strategies, and enrolment criteria for future clinical trials.
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Source |
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http://dx.doi.org/10.1681/ASN.0000000666 | DOI Listing |
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