Re-evaluation of Pre-pump Arterial Pressure to Avoid Inadequate Dialysis and Hemolysis : Importance of Prepump Arterial Pressure Monitoring in Hemodialysis Patients

• Material Type: 博士論文
• Title: Re-evaluation of Pre-pump Arterial Pressure to Avoid Inadequate Dialysis and Hemolysis : Importance of Prepump Arterial Pressure Monitoring in Hemodialysis Patients
• Author/Editor: Shibata, Eriko; Nagai, Kojiro; Takeuchi, Risa; Noda, Yasuhiro; Makino, Tomomi; Chikata, Yusuke; Hann, Michael; Yoshimoto, Sakiya; Ono, Hiroyuki; Ueda, Sayo; Tamaki, Masanori; Murakami, Taichi; Matsuura, Motokazu; Abe, Hideharu; Doi, Toshio
• Author Heading: Shibata, Eriko; Nagai, Kojiro; Takeuchi, Risa; Noda, Yasuhiro; Makino, Tomomi; Chikata, Yusuke; Hann, Michael; Yoshimoto, Sakiya; Ono, Hiroyuki; Ueda, Sayo; Tamaki, Masanori; Murakami, Taichi; Matsuura, Motokazu; Abe, Hideharu; Doi, Toshio
• Publication, Distribution, etc.: International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
• Publication Date: 2015-05-01
• Publication Date (W3CDTF): 2015-05-01
• Alternative Title: 至適透析や溶血回避のための血液ポンプ前の動脈圧の再評価 : 血液透析患者における血液ポンプ前の動脈圧モニタリングの重要性; Importance of pre pump arterial pres sure monitoring in hemodialysis patients
• Periodical title: Artificial Organs
• No. or year of volume/issue: 39 7
• Volume: 39
• Issue: 7
• Pages: 627-634
• ISSN (Periodical Title): ISSN : 0160-564X; ISSN : 1525-1594
• Degree grantor/type: 徳島大学
• Date Granted: 2017-10-26
• Dissertation Number: 甲第3117号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Prepump arterial pressure; Hemolysis; pressure pillow; Dialysis; Blood flow; Vacuum monitor
• Target Audience: 一般
• Note (General): Pre-pump arterial pressure (PreAP) is monitored to avoid generating excessive negative pressure. National Kidney Foundation K/DOQI clinical practice guidelines for vascular access recommend that PreAP should not fall below-250 mmHg because excessive negative PreAP can lead to a decrease in the delivery of blood flow, inadequate dialysis, and hemolysis. Nonetheless, these recommendations are consistently disregarded in clinical practice and pressure sensors are often removed from the dialysis circuit.Thus far,delivered blood flow has been reported to decrease at values more negative than -150 mmHg of PreAP. These values have been analyzed by an ultrasonic flowmeter and not directly measured. Furthermore, no known group has evaluated whether PreAP-induced hemolysis occurs at a particular threshold. Therefore, the aim of this study was to clarify the importance of PreAP in the prediction of inadequate dialysis and hemolysis. By using different diameter needles, human blood samples from healthy volunteers were circulated in a closed dialysis circuit. The relationship between PreAP and delivered blood flow or PreAP and hemolysis was investigated. We also investigated the optimal value for PreAP using several empirical monitoring methods, such as a pressure pillow. Our investigation indicated that PreAP is a critical factor in the determination of delivered blood flow and hemolysis,both of which occured at pressure values more negative than -150 mmHg. With the exception of direct pressure monitoring, commonly used monitoring methods for PreAP were determined to be ineffective. We propose that the use of a vacuum monitor would permit regular measurement of PreAP.
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1111/aor.12448
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

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http://repo.lib.tokushima-u.ac.jp/files/public/11/110961/2017120610180447065/k3117_abstract_review.pdf fulltext

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