Clotting and bleeding are major causes of mortality and morbidity during high risk ECMO therapy that treats the “sickest of the sick” by infusing patients with oxygen-rich blood drawn from an ECMO circuit. One key component of an ECMO circuit is the oxygenator. As a clot develops in the oxygenator over time, the volume of oxygenated blood decreases and less oxygen-rich blood is delivered to the critically ill patient. If the clot gets large enough, the oxygenator will need to be switched out by the perfusionist as quickly as possible and replaced by one that will continue to oxygenate the blood.
One of the most devastating hurricanes in the history of the United States, Hurricane Katrina caused $75 billion in damage in New Orleans and along the Mississippi coast. Beyond its toll on infrastructure and the lives of the area’s citizens, the hurricane exposed several gaps in emergency preparedness for hemodialysis patients. Many clinics in the area didn’t have sufficient emergency preparedness plans in place; patients didn’t know how to adequately prepare for the storm; and public health officials were unaware of how much of the population was dependent on dialysis.
Otsuka Acquires Visterra
Otsuka has acquired antibody therapy maker Visterra for $430 million. Otsuka hopes to take advantages of Visterra’s therapies for CKD and other conditions.
DaVita Profits Decline 15 Percent for Q3
The loss can be attributed to higher than expected medical costs and the underperforming managed care business. Net loss for the quarter was $214 million. As of the end of September, DaVita provided services to 218,200 patients.
As a dialysis provider, you know that healthcare settings and patient conflict go hand in hand. But unresolved patient conflict creates more stress for your staff, decreases productivity and teamwork and harms your clinic’s ability to safely deliver top-quality dialysis care.
Despite these consequences, providers often shy away from confronting challenges with patients because conflict is almost always uncomfortable. Experts call this avoidance a lack of “conflict competence,” and cite it as a major reason for dysfunctional dialysis units.
How a patient feels during his or her dialysis treatments often affects whether he or she will return to your clinic for further treatment. The National Kidney Foundation recommends patients evaluate the staff of a dialysis clinic before choosing a provider. The organization advises patients to see if the staff makes them feel welcome, if they were helpful, knowledgeable and were able to answer their questions. Patients also are encouraged to notice if clinic staff listens to them and addresses their needs.
Patients want to feel understood and at ease, and if your clinic is struggling to retain patients, this could be a contributing factor to patient retention.
Thankfully, a few changes in the way your staff communicates can improve patient experience at your dialysis clinic.
Fresenius Medical Care Acquires NxStage Medical
The deal was for about $2 billion, or $30 per common share. The deal is expected to close in 2018. Fresenius hopes the acquisition will help it accelerate growth within the home dialysis markets.
Clinicians at a Fort Worth vascular access center wanted to ascertain the effects of banding their patients with high-flow arteriovenous fistulas. It is known that patients with high flow of more than 2 L/min are more likely to experience cardiac symptoms. Therefore, the nephrologists set a goal of reducing flow in the high-flow fistulas of 12 patients to between 600 and 1200 mL/min and then retrospectively analyzing the results.
Largest Dialysis Providers Ranked
Fresenius Medical Care (No. 1) and DaVita (No. 2) ranked as the top dialysis providers in the USA. Fresenius saw 192,964 patients this year, while DaVita saw 190,500. Coming in third was U.S. Renal Care, seeing 25,120 patients. Fresenius’ bump in volume came from an increase in patients accepted for treatment for acute kidney injury.
Source: Nephrology News & Issues
“The ELSA monitor provides an easy-to-use, non-invasive method to measure recirculation in VV ECMO without blood sampling.” SS Said, MD
The state-of-the-art Transonic® ELSA Monitor helps optimize and safeguard extracorporeal membrane oxygenation (ECMO) therapy in infants, children and adults by:
- Measuring true blood flow in ECMO circuits
- Quantifying recirculation in the ECMO circuit
- Detecting oxygenator clotting
With the ELSA, surgeons can place a cannula so that flow delivery is maximized. By maximizing flow delivery and minimizing recirculation, a perfusionist then has more time to change out the oxygenator if and when the ELSA identifies unacceptably high clot development within the oxygenator.
Knowing actual blood flow through the circuit at all times helps avoid catastrophic circuit failures in fragile ECMO patients. Kinks and circuit blockages can be immediately identified and corrected. When flow delivery is maximized, recirculation is minimized, and optimal cannula placement is achieved, the time a patient must be on ECMO is shortened. This translates into better outcomes and bottom line cost savings for an ECMO program.
Safeguard your ECMO program by using the Transonic ELSA Monitor.
1. Said MM et al, Children’s Hospital, Washington, D.C., “Influence of central hemodynamics on VV ECMO oxygen delivery in neonatal animal model,” J Neonatal Perinatal Med 2017.