By Allen R. Nissenson MD FACP, Richard E. Fine MD
Here is an in-depth, quick-reference, problem-solving source for these keen on the care of dialysis sufferers. greater than one hundred twenty world-class professionals talk about dialysis thoughts, mechanical concerns, and problems relating to quite a few illnesses for either pediatric and grownup sufferers. chosen annotated references and perfect cross-referencing among chapters assist you locate solutions speedy, and greater than a hundred photographs, drawings, charts, and tables, normally in colour, make clear complicated themes. supplying sensible, instantly precious instructions that may be utilized on to sufferer care, this ebook is a "must-have" for all dialysis caregivers.
- Presents the practice-proven event of most sensible specialists within the box of dialysis treatment.
- Offers dialysis tips for either grownup and pediatric sufferers in a single handy source.
- Features a readable hands-on procedure, permitting you to speedy assessment the complex ideas of dialysis.
- Includes important annotated bibliography lists in each one part for additional in-depth examine on any subject.
- Explains advanced dialysis thoughts via plentiful diagrams, images, line drawings, and tables.
- Features a brand new 4-color layout, allowing you in finding the tips you would like extra quickly.
- Includes assurance of convective dialytic remedies and the result of contemporary scientific trials.
- Ensures that you just continue present on pediatric dialysis matters prevention and therapy with new chapters together with prevention and remedy of bone illness, administration of anemia, assessing caliber of existence in pediatric sufferers present process dialysis, and immunizations in teenagers present process dialysis.
Read Online or Download Handbook of Dialysis Therapy, 4e PDF
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Additional resources for Handbook of Dialysis Therapy, 4e
Example text
30 Temporary Vascular Access for Hemodialysis The malfunctioning lumen only may be infused, or routinely both lumens may be infused regardless of which is malfunctioning. The drug is usually left to dwell for 20 to 60 minutes, but dwells of 1 to 4 days have been described. During the dwell, active drug can be periodically advanced toward the tip with saline. 2). A direct comparison of urokinase with t-PA to treat catheter malfunction in oncology suggests that t-PA may be more effective. , right atrial thrombus).
Prevention of Catheter-Related Infections Duration of use is the strongest risk factor for infection. Therefore, minimizing the duration of use is the best method of preventing infection. The NKF-K/DOQI recommends that temporary femoral catheters remain in place for a maximum of 7 days, and that internal jugular vein catheters remain in place for a maximum of 3 weeks. If a catheter is still required, a tunneled cuffed catheter should be considered. There is no data to support the routine changing of other types of central venous catheters and this is generally not recommended.
Nevertheless, some interventionalists insist on negative blood cultures. If no exit-site or tunnel infection is present, the same exit site and tunnel can be used. This technique eradicates infection 80 to 100% of the time. When an exit-site or tunnel infection is present, the catheter should be tunneled out through a new exit site. The success rate decreases to 64% with this technique. 79). Catheters should not be left in place and treated with antibiotics because there is only a 32% chance the infection will be eradicated.