Cardiovascular Disorders in Hemodialysis: 14th International by Mohammed S. Razzaque, Takashi Taguchi PDF

By Mohammed S. Razzaque, Takashi Taguchi

ISBN-10: 1423796756

ISBN-13: 9781423796756

ISBN-10: 3805579381

ISBN-13: 9783805579384

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Extra resources for Cardiovascular Disorders in Hemodialysis: 14th International Course on Hemodialysis, Vicenza, May 2005 (Contributions to Nephrology)

Example text

However, to determine the thermal effects of the whole extracorporeal circulation blood temperatures must be determined at the level of the vascular access. In quiet air, arterial and venous access temperatures can be estimated from arterial and venous bloodline measurement when room temperature, blood flow, and insulation characteristics as well as the distance of the measuring site from the access are known [11]. This is done in the blood temperature monitor (BTM, Fresenius Medical Care, Germany).

The substances that are exchanged are water-soluble organic substances, electrolytes and dissolved gases. Under fault condition (machine or system malfunction or user error) the patient and/or the user is exposed to hazards that in a worst-case condition may result in death or serious injury. In order to reduce the likelihood of such events, hemodialysis machines contain additional monitors, so-called ‘protective systems’. The minimum requirements for safety of hemodialysis machines are described by standards (AAMI RD5 [1] for the US and IEC601–2-16 [2] for the rest of the world).

Modern dialysis machines usually allow adjustment of dialysate sodium (Naϩ) and dialysate bicarbonate concentrations. The other electrolytes (Kϩ, Caϩϩ, Mgϩϩ) are changed proportionally to Naϩ. Three-concentrate mixing machines allow choice of Kϩ, Caϩϩ and Mgϩϩ independent of Naϩ by using ‘individual’ bags. 5% for sodium and Ϯ6% for potassium, calcium and magnesium. This estimate results from the addition of the allowed tolerances of concentrates [6] and calibration accuracy of mixing systems. Under worst-case conditions the deviation can be higher.

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Cardiovascular Disorders in Hemodialysis: 14th International Course on Hemodialysis, Vicenza, May 2005 (Contributions to Nephrology) by Mohammed S. Razzaque, Takashi Taguchi


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