ASAIO transactions最新文献_第2页

Myocardial mechanics and energetics revisited. 心肌力学与能量学重述。

ASAIO transactions Pub Date : 1991-10-01

J Y Kresh

引用次数: 0

Can our society afford mechanical hearts? 我们的社会负担得起机械心脏吗?

ASAIO transactions Pub Date : 1991-10-01

V L Poirier

{"title":"Can our society afford mechanical hearts?","authors":"V L Poirier","doi":"","DOIUrl":"","url":null,"abstract":"Congestive heart failure afflicts 4 million people in the United States, with 400,000 deaths annually. Very little can be done for individuals with this condition, which is increasing in prevalence. The only hope is the promise of intervention with permanent circulatory support systems. Can we as a society afford the $3.1 billion that would be required to support every patient needing such a system? This cost represents an increase of 1/2 of 1% of the $662 billion per year expended for medical care. Fortunately, circulatory support systems do not necessarily represent an expense, but rather an investment that has a reasonable payback period. An investment in an individual of $100,000 for the device and implantation cost, coupled with an ongoing maintenance cost of $4,000 per year, can return to society an income greater in value than the investment. The payback period is strongly dependent on the earning power of the individual, as well as the amount of medical attention or complications experienced. An individual with an annual salary of $40,000 per year becomes a positive financial force in our society and increases the gross national product (GNP) within 5 years. The same individual with extensive medical complications and intermittent loss of salary can extend the payback period by an additional 2 years. Circulatory support systems have the potential of increasing our GNP, leading to a higher standard of living for the populace.","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 4","pages":"540-4"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12932315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reuse of "highly permeable" dialyzers with peroxyacetic acid as sole cleansing and disinfecting agent. 以过氧乙酸作为唯一清洁和消毒剂的“高渗透性”透析器的重复使用。

ASAIO transactions Pub Date : 1991-10-01

B Canaud, Q V Nguyen, L J Garred, R Nicolle, C Mion

{"title":"Reuse of \"highly permeable\" dialyzers with peroxyacetic acid as sole cleansing and disinfecting agent.","authors":"B Canaud, Q V Nguyen, L J Garred, R Nicolle, C Mion","doi":"","DOIUrl":"","url":null,"abstract":"In the past few years, dialyzer reuse has gained increased clinical acceptance. This has been due both to the availability of automated reconditioning machines and powerful chemical cleaning and disinfecting agents. In this study the authors evaluated the effectiveness of a newly available peroxyacetic acid solution (PAS) (Dialox) as the dual cleaning and disinfecting agent in the reuse of highly permeable dialyzers. An in vivo study was conducted with ten patients already involved in our center's reuse program using the Renatron reprocessing machine and PAS at various dilutions. One hundred forty dialyzers of three different brands and membrane types (HF80 used for hemodiafiltration [HDF], Filtral 16 used for hemodialysis [HD], and FH88 used for hemofiltration [HF]) were employed for a total of 1182 treatments, giving an average 8.4 uses per module. Significantly more uses were obtained with the HF80 and Filtral 16 dialyzers (9.7 and 9.4, respectively) than for the FH88 modules used by the HF patients (6.7 uses per module). Compromised cleaning by backfiltration due to the lack of a second dialysate port on the FH88 may be a possible explanation. Greater membrane plugging due to higher ultrafiltration rates in HF may be another factor. Patient variability was found to be another factor in dialyzer reuse. The cleaning effectiveness of various dilutions of PAS was also tested in this study. The number of uses achieved was not found to vary significantly with PAS strength; however, a greater frequency of second or third reprocessing was required with more dilute cleaning solution. The authors found the dilution achieved on the Renatron reprocessing machine using the currently marketed PAS concentrate to be the most cost effective.","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 4","pages":"653-7"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12930715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Skeletal surveys in renal osteodystrophy. 肾性骨营养不良的骨骼调查。

ASAIO transactions Pub Date : 1991-10-01

R Mohini, F Dumler, D S Rao

{"title":"Skeletal surveys in renal osteodystrophy.","authors":"R Mohini, F Dumler, D S Rao","doi":"","DOIUrl":"","url":null,"abstract":"The authors reviewed the clinical usefulness of routine comprehensive skeletal surveys in monitoring renal osteodystrophy in 66 patients on chronic maintenance hemodialysis. Only fourteen (22%) of the 66 patients had roentgenographic evidence of hyperparathyroid bone disease. There were no significant differences in serum calcium, phosphate, or aluminum levels between patients with and without evidence of phalangeal subperiosteal bone resorption in the hands. However, serum levels of parathyroid hormone (PTH) (both intact and mid-molecule) and alkaline phosphatase values were significantly higher in the group with subperiosteal bone resorption (p less than 0.01 and p less than 0.02, respectively). Serum intact PTH correlated with alkaline phosphatase better than the mid-molecule assay. Neither intact nor mid-molecule PTH values correlated with serum calcium, phosphate, or aluminum. Hand roentgenograms were most sensitive in detecting early changes of hyperparathyroidism; symphysis pubis was the next best. Other skeletal roentgenographic findings were less revealing, and in a subset of 20 patients, roentgenograms correlated poorly with bone histology. During this study the authors found an 8% prevalence of vertebral compression fractures; all in postmenopausal white women.","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 4","pages":"635-7"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12930783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The influence of dialysis treatment modality on the decline of remaining renal function. 透析治疗方式对剩余肾功能下降的影响。

ASAIO transactions Pub Date : 1991-10-01

M J Lysaght, E F Vonesh, F Gotch, L Ibels, M Keen, B Lindholm, K D Nolph, C A Pollock, B Prowant, P C Farrell

{"title":"The influence of dialysis treatment modality on the decline of remaining renal function.","authors":"M J Lysaght, E F Vonesh, F Gotch, L Ibels, M Keen, B Lindholm, K D Nolph, C A Pollock, B Prowant, P C Farrell","doi":"","DOIUrl":"","url":null,"abstract":"A retrospective investigation was undertaken in which the rate of decline of residual renal function (RRF), estimated from creatinine clearance, was compared in 55 continuous ambulatory peritoneal dialysis (CAPD) and 57 hemodialysis (HD) patients for whom a minimum of four (mean of 7.6) well-spaced historic measurements of residual clearance were available. Because of the intrinsic variability that attends such data, specialized nonlinear, growth curve statistical methods were employed. Residual function was found to decline exponentially after the onset of therapy in both cohorts. The rate of decline in the HD group was twice that of the CAPD group (5.8% +/- 0.4% per month for HD vs 2.9% +/- 0.3% per month for CAPD; difference significant at p less than 0.0001). This difference remained highly significant (p less than 0.01) when corrected for other potential risk factors such as age, gender, hypertensive status, and use of angiotensin converting enzyme inhibitors in patients with diabetic or other forms of glomerular nephropathy. Differences between cohorts were not significant for patients with other diagnoses (p greater than 0.1) although the size of some of these subsets was very small. The physiologic mechanism for the more rapid fall-off of RRF on HD remains speculative, but could be related to renal ischemia secondary to intratreatment hypovolemia and/or to nephrotoxic effects of the inflammatory mediators of extracorporeal circulation.","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 4","pages":"598-604"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12930885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Platelet preservation during cardiopulmonary bypass with iloprost and Duraflo-II heparin-coated surfaces. 体外循环中伊洛前列素和durafo - ii肝素包被表面的血小板保存。

ASAIO transactions Pub Date : 1991-10-01

G M Palatianos, M K Dewanjee, W Smith, S Novak, L C Hsu, M Kapadvanjwala, G N Sfakianakis, G A Kaiser

{"title":"Platelet preservation during cardiopulmonary bypass with iloprost and Duraflo-II heparin-coated surfaces.","authors":"G M Palatianos, M K Dewanjee, W Smith, S Novak, L C Hsu, M Kapadvanjwala, G N Sfakianakis, G A Kaiser","doi":"","DOIUrl":"","url":null,"abstract":"To test the hypothesis that temporary platelet inhibition during cardiopulmonary bypass (CPB) with surface heparinized systems may result in platelet preservation, nine Yorkshire pigs were placed on CPB for 3 hours. Platelet labeling was done in all pigs with Indium-111 tropolone. CPB was instituted with a roller pump, a hollow fiber membrane oxygenator (Bentley CM-50 [Baxter-Bentley Laboratories, Irvine, CA]), and an arterial filter. The extracorporeal perfusion systems were surface-coated with the Duraflo-II heparin complex. Group A pigs (n = 5) were systemically heparinized (activated coagulation time longer than 400 sec). Group B pigs (n = 4) were placed on CPB without systematic heparinization, but have received the stable prostacyclin-analog Iloprost (ZK36374) at 1 ng/kg/min i.v. from 30 min before and during CPB. Platelet counts declined in group A pigs at 5 min, 1 hr, 2 hr, and 3 hr of CPB to 79.8% (mean), 66.5%, 71.3%, and 69.0% of pre-CPB values, respectively (p less than 0.05). In group B pigs, mean platelet count during CPB was higher than 90% of control value. Percentage of injected radioactivity detected in the oxygenator was 2.82% in group A pigs versus 0.73% in group B pigs (p = 0.0541). Surface heparinization with the Duraflo II heparin coating complex in combination with Iloprost-induced temporary platelet inhibition resulted in platelet count preservation during CPB in the pig model.","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 4","pages":"620-2"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12886254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Illness in hemodialysis patients after exposure to chloramine contaminated dialysate. 接触氯胺污染透析液后血液透析患者的疾病。

ASAIO transactions Pub Date : 1991-10-01

M A Tipple, N Shusterman, L A Bland, M A McCarthy, M S Favero, M J Arduino, M H Reid, W R Jarvis

{"title":"Illness in hemodialysis patients after exposure to chloramine contaminated dialysate.","authors":"M A Tipple, N Shusterman, L A Bland, M A McCarthy, M S Favero, M J Arduino, M H Reid, W R Jarvis","doi":"","DOIUrl":"","url":null,"abstract":"In September 1987, patients at an outpatient dialysis center were exposed to chloramine contaminated dialysate when the carbon filter in a recently modified water treatment system failed. Forty-one patients required transfusion to treat the resultant hemolytic anemia. Epidemiologic investigation demonstrated that the mortality rate among dialysis center patients increased during the 5 months after chloramine exposure when compared with the 12 months before chloramine exposure, but no deaths could be attributed to the exposure. Chloramine is commonly used as a disinfectant in municipal water supplies, and has previously been reported to cause hemolytic anemia in patients undergoing dialysis. Hemodialysis centers in cities that use chloramine in water supplies must design water treatment systems with adequate means for removing chloramine and must monitor processed water closely to ensure that chloramine contamination does not occur. Dialysis centers that make changes in their water processing systems should evaluate all components of the system before changes are made, and must ensure that after modifications are made, processed water meets the standards set by the Association for Advancement of Medical Instrumentation.","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 4","pages":"588-91"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12930883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost and reimbursement rates for investigational circulatory support. 研究循环支持的费用和偿还比率。

ASAIO transactions Pub Date : 1991-10-01

M T Swartz, J E Reedy, D Lohmann, T Bennett, L R McBride, D G Pennington

引用次数: 0

Continuous pH and HCO3 monitoring during hemodiafiltration without blood sampling. 血液滤过期间连续监测pH和HCO3而不采血。

ASAIO transactions Pub Date : 1991-10-01

P M Ghezzi, R Gervasio, J Botella

引用次数: 0

Renal allograft outcome in the cyclosporine era: comparison between intermediate-term failure and long-term survival. 环孢素时代的同种异体肾移植结果:中期失败和长期生存的比较。

ASAIO transactions Pub Date : 1991-10-01

N Sumrani, V Delaney, J H Hong, P Daskalakis, E A Friedman, B G Sommer

引用次数: 0