<img height="1" width="1" style="display:none" src="https://www.facebook.com/tr?id=875423625897521&amp;ev=PageView&amp;noscript=1">

Sensing Savvy

Deborah Brouwer-Maier RN, CNN

Deborah Brouwer-Maier is a nephrology nurse for more than 30 years. Her area of expertise is hemodialysis vascular access. She served on the KDOQI Vascular Access Work Groups in 1997, 2000 and 2006. She also served in various volunteer roles for the Fistula Frist Initiates since the formation of the initial Work Group. She is the support for the Hemodialysis Circle of Care Transonic products to support access creation, surveillance and preservation.

Recent Posts

Rule of Sixes Key to Successful HD Cannulation

Posted by Deborah Brouwer-Maier RN, CNN on Jun 26, 2017 7:00:00 AM

The KDOQI Work Group and Dr. Michelle L. Robbin from the University of Alabama at Birmingham, offer valuable guidelines for successful hemodialysis cannulation of fistulas in end-stage-renal-disease (ESRD) patients. It is recommended that a 4 mm or greater vessel diameter and flow of 500 mL/min or greater is needed to support successful hd cannulation and dialysis blood flow rates. Ultrasound is not needed for cannulation. Also suggested is the following Rule of Sixes:

Read More

Topics: Hemodialysis

Endovascular Catheter Is Valuable for Measuring Access Flow

Posted by Deborah Brouwer-Maier RN, CNN on Jun 14, 2017 7:00:00 AM

Dr. Lymaris GarcÌa-Medina and colleagues from the Universitario Reina Sofia General Hospital in Murcia, Spain analyzed the flow values measured by the Transonic ReoCath® Flow Catheter to determine whether the ReoCath’s measurements were more reliable than angiographic and clinical findings for planning and determining the outcome of invasive radiologic treatments of hemodialysis fistulas.

Read More

Topics: Catheter Adequacy, VA Flow & Patency

Fistulography, Intra-access Blood Flow Measurement Correlations

Posted by Deborah Brouwer-Maier RN, CNN on Jun 12, 2017 6:30:00 AM

The success of percutaneous transluminal angioplasty (PTA) in stenotic hemodialysis prosthetic grafts and autogenous fistulas is traditionally assessed by the post-intervention vessel diameter of the grafts or fistulas. Interventionalists at the University of San Diego sought to compare this traditional measure of success (vessel diameter), and pre- and post-intervention real-time intra-access blood flow rates with access blood flow measured during hemodialysis.

Read More

Topics: Blood Flow Measurement

Is Timing a Factor In Flow Measurements Performed During Hemodialysis?

Posted by Deborah Brouwer-Maier RN, CNN on Jun 7, 2017 6:30:00 AM

NKF-KDOQI guidelines recommend that the vascular access flow assessment be performed during the first 90 minutes of hemodialysis to eliminate error caused by decrease in cardiac output or blood pressure related to ultrafiltration and/or hypotension. This measurement time restriction to within the first 90 minutes limits the number of measurements that can be performed by one operator, which is a significant issue in clinical practice.

Read More

Topics: Hemodialysis

Hemodialysis in Children: Dedicated Pediatric Vascular Access Clinics Are Key to Success

Posted by Deborah Brouwer-Maier RN, CNN on Jun 7, 2017 6:30:00 AM

Children undergoing hemodialysis present unique challenges for dialysis providers. Hemodialysis in children presents challenges: Little is known about their ideal vein and artery sizes, maturation times and expected volume flow rates to achieve a functioning fistula.

After clinicians at London’s Great Ormond Street Hospital for Children reviewed the outcomes of 25 children who received an arteriovenous fistula (AVF), they found that five had primary AVF failure, and three had secondary AVF failure.

Read More

Topics: Hemodialysis

Which Is Better, Percutaneous Transluminal Angioplasty or Surgical Repair?

Posted by Deborah Brouwer-Maier RN, CNN on May 31, 2017 6:30:00 AM

Two of the most common options for treating a vascular access stenosis in hemodialysis patients are percutaneous transluminal angioplasty (PTA) and fistula reconstruction/revision surgery. Because it is more convenient, PTA has become preferable to surgical revision.

To examine the efficacy of and compare percutaneous transluminal angioplasty or surgical repair, clinicians from three hospitals in Taiwan investigated the duration of fistulas and maintenance costs for dialysis patients. Their study was published in the 2017 February issue of the Journal of Vascular Access.

In the study, charts were reviewed retrospectively from 544 hemodialysis patients from two dialysis units in a teaching hospital in the southern area of Taiwan. Researchers analyzed the frequency of PTA or revascularization surgery and the use of related medical resources.

Read More

Topics: Hemodialysis

Your Hemodialysis Access: A Lifeline for a Lifetime

Posted by Deborah Brouwer-Maier RN, CNN on May 29, 2017 7:00:00 AM

It only takes minutes to save your hemodialysis access, your lifeline. All you have to do is look, listen, feel and then also measure.

Read More

Topics: Hemodialysis

Kidney Care News to Know

Posted by Deborah Brouwer-Maier RN, CNN on May 24, 2017 7:00:00 AM

DaVita Appoints Robert Lang President of International Market

Before joining DaVita, Lang led the international markets business at insurance provider Bupa. He has experience working in Europe, the Middle East, Asia and Latin America.

Read More

Topics: Hemodialysis

Create a Culture of Patient Safety at Your Dialysis Clinic

Posted by Deborah Brouwer-Maier RN, CNN on May 8, 2017 7:30:00 AM

Do Dialysis Patients Feel Safe?

According to data from the 2007 Renal Physicians Association (RPA) Health and Safety Survey Project, nearly half of dialysis patients surveyed said they “sometimes, usually or always worry that someone will make a medical mistake during one of their dialysis treatments.” Not only that, 87 percent of staff indicated a mistake had been made in a patient’s treatment over the last three months.

Read More

Topics: Hemodialysis, dialysis patients

Kidney Care News to Know from April

Posted by Deborah Brouwer-Maier RN, CNN on May 4, 2017 6:30:00 AM

Ashfaq Named Senior VP of OPKO Health Renal Division

Dr. Akhtar Ashfaq has been named senior vice president of clinical research and development of OPKO Health’s renal division. He will support the adoption of Rayaldee extended-release capsules by healthcare professionals caring for patients with stage 3 or 4 kidney disease.

He’ll also lead the development of the drug to treat secondary hyperparathyroidism (SHPT) in adults on hemodialysis with vitamin D insufficiency as well as the development of Alpharen for the treatment of hyperphosphatemia in adults with stage 5 kidney disease.

Source: Nephrology News & Issues

Read More

Topics: kidney care

Healthcare Insights to Improve Results

Sensing Savvy provides you with the news and information you need to stay up to date on the latest medical and surgical news, techniques, products and more. Start advancing your outcomes. Subscribe today.

Get Articles and Insights by Email

Close Window
Subscribe Today