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Recent developments have spurred a renewed interest in novel solutions to access the patient circulation, mainly concentrating on vascular access for renal replacement therapies and on peritoneal dialysis access.Starting with the epidemiology, the focus then shifts to the evolution of new techniques and monitoring procedures with regard to hemodialysis, which are discussed and evaluated. Attention is also paid to the new biomaterials available, concentrating on their improved biocompatibility and surface characteristics. As developments in the field of peritoneal dialysis have taken a similar turn, new devices providing access to the peritoneal cavity which have recently been made available are introduced next. Last but not least, the management of complications and the continuous maintenance and care of the access with regard to both hemodialysis and peritoneal dialysis are highlighted.This book provides a complete overview of the devices, catheters and methods currently available to ensure successful vascular and peritoneal access. Taking into account both the physiology of the extracorporeal circulation and the mechanisms of peritoneal dialysis with regard to the most adequate access techniques, this is a unique resource for clinicians, investigators and researchers in the field of renal replacement therapy.
This updated volume covers the basic principles and practice of dialysis access management. To cover the latest trends and evidence from clinical trials, new chapters on the management of cephalic arch stenosis and swing zone stenosis, the role of drug eluting balloon in dialysis access interventions, the management of central vein stenosis, endovascular creation of AVF, and the management of steal syndrome have been included. Dialysis Access Management gives readers a step-by-step guide to endovascular interventions with special emphasis on the principles and rationale behind these approaches. This book is an essential text for residents, fellows, and physicians who are learning or practicing in dialysis, especially in the fields of nephrology, radiology, surgery, and vascular medicine.
The book is an on-the-spot reference for residents and medical students seeking diagnostic radiology fast facts. Its question-and-answer format makes it a perfect quick-reference for personal review and studying for board examinations and re-certification. Readers can read the text from cover to cover to gain a general foundation of knowledge that can be built upon through practice or can use choice chapters to review a specific subspecialty before starting a new rotation or joining a new service. With hundreds of high-yield questions and answer items, this resource addresses both general and subspecialty topics and provides accurate, on-the-spot answers. Sections are organized by subspecialty and body area, including chest, abdomen, and trauma, and chapters cover the anatomy, pathophysiology, differential diagnosis, hallmark signs, and image features of major diseases and conditions. Key example images and illustrations enhance the text throughout and provide an ideal, pocket-sized resource for residents and medical students.
For more than a generation haemodialysis has been the principal method of treating patients with both acute and chronic renal failure. Initially, developments and improvements in the system were highly technical and relevant to only a relatively small number of specialists in nephrology. More recently, as advances in therapy have dem onstrated the value of haemofiltration in the intensive therapy unit and haemoperfusion for certain types of poisoning, the basic principles of haemodialysis have been perceived as important in many areas of clinical practice. In this volume, the potential advantages of bicarbonate haemo dialysis are objectively assessed, the technical and clinical aspects of both haemofiltration and haemoperfusion discussed and the con tinuing problems associated with such extra corporeal circuits analysed. All the chapters have been written by recognized experts in their field. The increasing availability of highly technical facilities for appropriately selected patients should ensure that the information contained in the book is relevant not only to nephrologists but to all practising clinicians. ABOUT THE EDITOR Dr Graeme R. D. Catto is Professor in Medicine and Therapeutics at the University of Aberdeen and Honorary Consultant Phy sician/Nephrologist to the Grampian Health Board. His current inter est in transplant immunology was stimulated as a Harkness Fellow at Harvard Medical School and the Peter Bent Brighton Hospital, Boston, USA. He is a member of many medical societies including the Association of Physicians of Great Britain and Ireland, the Renal Association and the Transplantation Society.
This atlas is designed to provide an all-inclusive resource that describes step by step how to perform the essential bedside procedures required to provide optimal care to the critically ill patient. Detailed descriptions of these procedures, with sequential photographs depicting each critical step, provide an in depth understanding of the anatomy, critical technical steps and common pitfalls to both military and civilian trainees. For the advanced professional operator, this atlas will provide a rapid refresher of the critical steps and is an excellent teaching resource, based on the decades of collective experience accumulated by the authors. The top quality photographs of perfused and ventilated cadavers makes this atlas a standard reference for surgeons, critical care physicians, nurses and all critical care professionals.
EMERGENCY MANAGEMENT OF THE HI-TECH PATIENT IN ACUTE AND CRITICAL CARE Emergency Management of the Hi-Tech Patient in Acute and Critical Care helps practitioners stabilize and care for pediatric and adult patients who have specialized medical devices such as prosthetic valves, cochlear transplants, insulin pumps, orthopedic hardware, and ventriculoperitoneal (VP) shunts. Using a step-by-step approach to acute presentations of patients with clinical hardware, this concise yet comprehensive guide provides specific instructions for the initial evaluation and management of numerous clinical scenarios including device malfunctions, infections, trauma, surgical complications, and more. Encompassing management of both the patient and the device, the guide enables emergency and critical care clinicians to rapidly make appropriate treatment decisions without the immediate need for extensive research, extended discussions with subspecialists, or recalling complex diagnostic and therapeutic algorithms. Clear, concise, and easy-to-follow chapters—written by a panel of highly experienced experts across specialties—include numerous algorithms, figures, tables, diagrams, and color illustrations and clinical images. An invaluable resource for improving the quality of care for the unique hi-tech patient population, this advanced practical manual: Provides algorithms for the most common clinical scenarios of device malfunction and related complications Covers management of patients who have undergone major operations such as organ transplantation or complex congenital heart disease repair Presents detailed management plans for a wide range of hardware types and medical conditions Offers expert guidance to practitioners in settings where not all specialties are readily available, such as rural and remote areas or community hospitals Features contributions from a team of experts in various areas of adult and pediatric emergency and critical care medicine Emergency Management of the Hi-Tech Patient in Acute and Critical Care is a must-have clinical reference and guide for pediatric and adult emergency medicine physicians, general pediatricians, internists, general practitioners, critical care specialists, and allied health practitioners.
This comprehensive reference details the techniques for establishing vascular access for hemodialysis and other acute and chronic conditions that require access to the circulation along with peritoneal dialysis access methods. Includes over 960 references and more than 160 tables, figures, and photographs. Vascular Access in Clinical
Interventional Nephrology: Principles and Practice describes a very direct approach to clinical problems encountered by the community of care providers who treat chronic kidney disease and dialysis patients. Practical scenarios faced on a day-to-day basis are presented by experts in the field utilizing the latest scientific information. In addition to internal medicine residents, nephrology fellows and practitioners, this comprehensive and useful resource is a must-have for the allied health professionals taking care of patients with hemodialysis and peritoneal dialysis access problems.
The buttonhole method for the cannulation of the arteriovenous fistula was discovered more than 40 years ago and was soon adopted on a wide scale due to its obvious benefits of decreased puncture pain and extension of the life of the arteriovenous fistula. Following reports of complications such as a higher incidence of access-related infections, the method has lately been the subject of intense scrutiny; recent research has focused on the mechanisms of buttonhole access-related infections and newer techniques that may have bearing on the future use of the buttonhole method. This book presents an easily accessible overview of information relevant to the subject, including history, benefits and the latest research results related to the buttonhole cannulation method. It aims to rekindle an awareness of the advantages of this method and to encourage a critical analysis of possible techniques to overcome current barriers that prevent a wider spread of the technique.
While continuous ambulatory peritoneal dialysis (CAPD) has been the standard peritoneal procedure since the seventies, different schedules of automated peritoneal dialysis (APD) have emerged during the eighties. Today, APD is considered a valuable tool in the management of ESRD patients, together with CAPD and hemodialysis. However, despite its frequent use, APD has not yet been well assessed, and most pathophysiological and clinical studies on PD refer to CAPD. In this book, major experts in the field therefore discuss and evaluate the insights gained on APD up to now, presenting a comprehensive review of all experimental, technical and clinical aspects related to the various treatments grouped under the definition of APD. The recent developments presented are divided into four sections: membrane permeability, transport mechanisms and kinetic modeling applied to APD; prescription and adequacy of different APD treatment schedules; dialysis machines and solutions for APD, and, lastly, different clinical aspects such as the possibility to maintain APD program and residual renal function. Physicians involved in ESRD care, renal fellows and scientists both in the academic world and in the hospital setting will undoubtedly profit from this timely publication.