Although central venous catheters are prone to thrombosis and infection, many patients undergoing hemodialysis have catheters either to initiate hemodialysis or for permanent hemodialysis delivery. KDOQI Guidelines define central venous catheter dysfunction as failure to attain and maintain blood flow sufficient to perform hemodialysis without significantly lengthening hemodialysis treatment. The Guidelines recommend blood flow in catheters be maintained at more than 300 mL/min for adequate hemodialysis.
“There are only two types of catheters: those that are infected and those that will be infected.” Gerald Schulman, MD Professor of Medicine, Vanderbilt University
Within the hemodialysis community, central venous catheters (CVC) are considered the least desirable type of vascular access because they are prone to infection. At one hemodialysis convention a respected nephrologist simply stated, “Catheters kill.” He followed saying that he would hope to see the day when they are no longer used at all.
The success of the Centers for Medicare and Medicaid Services (CMS) Fistula First Break-through Initiative has transformed a hemodialysis access in the United States from a “graft-oriented culture” to a “fistula-oriented culture” in less than 10 years. When the Fistula First Initiative took off in 2005, The United States lagged far behind their European counterparts in utilizing a fistula as a vascular access of choice for appropriate hemodialysis patients. An arteriovenous fistula (AVF) is the optimal vascular access for hemodialysis because it is associated with longer survival, fewer infections, lower hospitalization rates, and reduced costs. Now more than 60% of American hemodialysis patients have AV fistulas. The Fistula First goal is to reach 68%.
Transonic ’s Gold Standard Hemodialysis optimizes dialysis adequacy by:
- Identifying a Discrepancy Between Pump Setting & Delivered Blood Flow as a result of:
- Effects of negative pump pressure effects;
- Condition of access;
- Needle size & placement;
- Kinked or occluded tubing;
- Calibration of the dialysis machine;
- Change in type of dialysis tubing,
- Calibration of Flow/dilution Sensors.