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Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Hemodialysis II: Procedure and Complications01:24

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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
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Peritoneal Dialysis I: Introduction and Procedure01:30

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Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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Continuous Renal Replacement Therapy01:30

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Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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Dialysis01:27

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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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A Murine Model of Hemodialysis Access-Related Hand Dysfunction
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Pediatric hemodialysis access.

P Stephen Almond1, Mohammad A Emran2, Shannon M Koehler2

  • 1Division of Pediatric Surgery, Bruce M. Henderson Chair in Pediatric Surgery, Head, Divisions of Pediatric Surgery, Urology and Transplantation, Surgical Director, Pediatric Surgery and Transplantation, Driscoll Children's Hospital, 3533 S. Alameda St, Suite 302, Corpus Christi, TX 78411, USA.

Seminars in Pediatric Surgery
|December 21, 2021
PubMed
Summary

Creating effective pediatric hemodialysis access is challenging, with high complication rates. A multidisciplinary pediatric hemodialysis access team improves decision-making and patient outcomes.

Keywords:
Arteriovenous fistulaArteriovenous graftCatheter related blood stream infectionsComplicationsHemodialysisOutcomesPediatricVascular access

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Pediatric Medicine

Background:

  • Pediatric hemodialysis access procedures are technically demanding and infrequent.
  • These procedures are associated with high complication and failure rates, impacting future access and transplant sites.
  • Optimizing vascular access is critical for long-term pediatric hemodialysis management.

Purpose of the Study:

  • To review the current literature on pediatric hemodialysis access.
  • To offer technical suggestions for improving outcomes in pediatric hemodialysis access procedures.
  • To emphasize the benefits of a multidisciplinary approach in pediatric hemodialysis access.

Main Methods:

  • Literature review of pediatric hemodialysis access.
  • Analysis of factors influencing access success and complications.
  • Synthesis of technical recommendations for improved outcomes.

Main Results:

  • Pediatric hemodialysis access presents unique challenges due to infrequent, complex procedures.
  • High rates of complications and failures negatively impact subsequent interventions.
  • Multidisciplinary team involvement simplifies access choices and enhances outcomes.

Conclusions:

  • A multidisciplinary pediatric hemodialysis access team is crucial for improving decision-making and outcomes.
  • Implementing technical suggestions can mitigate complications and failure rates.
  • Optimized access strategies are essential for effective pediatric hemodialysis.