A study published in PLOS ONE in March 2017 by clinicians from Huazhong University of Science and Technology in Hubei, China, investigated the association between AVF flows and inflammation, cardiovascular events and deaths in Chinese hemodialysis patients who have a radio-cephalic fistula (AVF). They recognized that AVF flows impact dialysis adequacy in hemodialysis patients. But there was limited data for different access flow levels on outcomes related to long-term dialysis Chinese patients.
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:
Fatigue, insomnia, loss of appetite, lack of motivation, forgetfulness, suicidal thoughts … If a patient described these telling symptoms of burnout, you’d take them seriously. As a surgeon, you are 15 times more likely to experience burnout than any other professional, and that number just keeps getting higher. The current medical climate is a landmine for practitioners, and part of the solution lies in understanding burnout, and how medical professionals and hospitals can be proactive in handling it.
In 2011, physicians earned around $206,000, according to Medscape. Now, just six years later, they are earning almost $100,000 more. Find out below what’s behind this salary increase, what your peers in various specialties make and what they like and dislike about their jobs. Here are five interesting things to know about physician compensation in 2017.
Topics: physician compensation
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.
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.
Topics: Blood Flow Measurement
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.
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.
“Not a day goes by when this flowmeter doesn’t solve a problem for me.” - BP Mindich, MD
During coronary artery bypass grafting (CABG), Transonic Flowmeters are used to measure the flow of blood through newly anastomosed bypass grafts.
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.