ID | 110961 |
タイトル別表記 | 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
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著者 |
Takeuchi, Risa
The University of Tokushima
Noda, Yasuhiro
The University of Tokushima
Makino, Tomomi
The University of Tokushima
Chikata, Yusuke
The University of Tokushima
Hann, Michael
Naval Medical Center San Diego
吉本, 咲耶
The University of Tokushima
小野, 広幸
The University of Tokushima
上田, 紗代
The University of Tokushima
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キーワード | Prepump arterial pressure
Hemolysis
pressure pillow
Dialysis
Blood flow
Vacuum monitor
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資料タイプ |
学位論文
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抄録 | 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.
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掲載誌名 |
Artificial Organs
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ISSN | 0160564X
15251594
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cat書誌ID | AA00551950
AA11616446
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出版者 | International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
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巻 | 39
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号 | 7
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開始ページ | 627
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終了ページ | 634
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発行日 | 2015-05-01
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備考 | 内容要旨・審査要旨・論文本文の公開
本論文は, 著者Eriko Shibataの学位論文として提出され, 学位審査・授与の対象となっている。 |
EDB ID | |
出版社版DOI | |
出版社版URL | |
フルテキストファイル | |
言語 |
eng
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著者版フラグ |
博士論文全文を含む
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文科省報告番号 | 甲第3117号
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学位記番号 | 甲医第1352号
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学位授与年月日 | 2017-10-26
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学位名 |
博士(医学)
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学位授与機関 |
徳島大学
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部局 |
医学系
病院
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