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Characterizing sleep disorders in chronic hemodialysis patients. 慢性血液透析患者睡眠障碍的特征。
ASAIO transactions Pub Date : 1991-07-01
J L Holley, S Nespor, R Rault
{"title":"Characterizing sleep disorders in chronic hemodialysis patients.","authors":"J L Holley,&nbsp;S Nespor,&nbsp;R Rault","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Forty-eight chronic hemodialysis (HD) patients (pts) completed questionnaires that used linear analogue scales (LAS), yes/no responses, and demographic data collection to characterize sleep disorders. Twenty-five pts (52%) reported problems sleeping. These pts graded sleep problems significantly higher than those without sleep problems (6.5 +/- 3 vs. 1.8 +/- 2, p less than 0.001 by LAS). Those with sleep disorders were more likely to smoke cigarettes (13/25 vs. 6/23, p less than 0.05) and have bone pain (14/25 vs. 6/23, p less than 0.05). No differences among pts with and without sleep problems were seen in age, gender, time on dialysis, caffeine intake, pruritus, feelings of sadness, worry, or anxiety, or Kt/V values (1.5 +/- 0.2 vs. 1.4 +/- 0.2, p less than 0.13). Restless legs (84%), onset insomnia (76%), and nighttime (76%) and early A.M. waking (72%) characterized the sleep disorders; symptoms suggesting nocturnal myoclonus were less common (20%). We conclude that sleep disorders are common in HD pts and may be exacerbated by tobacco use, bone pain, and restless legs. Kt/V does not correlate with sleep disorders. Further examination of this problem, including formal sleep studies, is needed.</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M456-7"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12913764","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
Continuous measurement of pressure in internal arteriovenous fistulae and prevention of symptomatic hypotension during hemodialysis. 血液透析中动静脉内瘘压力的持续测量与症状性低血压的预防。
ASAIO transactions Pub Date : 1991-07-01
K Nakane, T Shinzato, K Maeda
{"title":"Continuous measurement of pressure in internal arteriovenous fistulae and prevention of symptomatic hypotension during hemodialysis.","authors":"K Nakane,&nbsp;T Shinzato,&nbsp;K Maeda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To continuously monitor the blood pressure (BP) in an internal arteriovenous fistula, the blood tubing wall was punctured with a long, fine needle (25 gauge), and the needle tip was advanced into the fistula vein through the lumen of the outflow blood access puncture needle. It was found that the intrafistula BP thus measured varied in parallel with the systemic arterial BP during hemodialysis (HD). When the intrafistula BP fell to 60% of the level at the start of HD, 50 ml of saline was administered. As a result, hypotension was prevented completely in 60 HD in five patients who often showed symptomatic hypotension during HD.</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M232-4"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12914264","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
Simultaneous heparin extracorporeal LDL precipitation and hemodialysis. First clinical experience. 同时肝素体外LDL沉淀和血液透析。第一次临床经验。
ASAIO transactions Pub Date : 1991-07-01
T Eisenhauer, U Müller, P Schuff-Werner, V W Armstrong, T Bosch, J Thiery, H Gurland, D Seidel
{"title":"Simultaneous heparin extracorporeal LDL precipitation and hemodialysis. First clinical experience.","authors":"T Eisenhauer,&nbsp;U Müller,&nbsp;P Schuff-Werner,&nbsp;V W Armstrong,&nbsp;T Bosch,&nbsp;J Thiery,&nbsp;H Gurland,&nbsp;D Seidel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Simultaneous heparin extracorporeal LDL precipitation (HELP)-dialysis was carried out at weekly intervals in six patients with end-stage renal failure, associated hyperlipidemia, and a high risk of premature atherosclerosis. Evaluating 135 single treatments, a mean acute total cholesterol/LDL reduction of 31% and 39%, respectively, was found, while clearance of urinary substances was comparable to that in regular hemodialysis treatment. Treatment tolerance was excellent and no derangements in albumin, hemodialysis parameters, or blood coagulation were detected.</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M494-6"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12914276","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
Long-term anticalcification effect of Fe3+ in rat subdermal implants of glutaraldehyde preserved bovine pericardium. 铁3+对大鼠戊二醛保存牛心包皮下植入物的长期抗钙化作用。
ASAIO transactions Pub Date : 1991-07-01
M T Baldwin, B L Ciesliga, L D Barkasi, C L Webb
{"title":"Long-term anticalcification effect of Fe3+ in rat subdermal implants of glutaraldehyde preserved bovine pericardium.","authors":"M T Baldwin,&nbsp;B L Ciesliga,&nbsp;L D Barkasi,&nbsp;C L Webb","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fe3+ preincubation has been shown to inhibit pathologic calcification of glutaraldehyde preserved bovine pericardium (GPBP) in the short-term rat subdermal model (21 days). This study was designed to test the long-term anticalcification efficacy of Fe3+ in the same model. Glutaraldehyde preserved bovine pericardium was preincubated (1 hr, 25 degrees C) in 0.1M FeCl3, 0.01M FeCl3, or 0.05M HEPES, then implanted subdermally in weanling male rats (40-60 gm) for 21, 60, 90, and 120 days. At explant, Fe3+ and Ca2+ levels were measured by atomic absorption spectroscopy. Fe3+ effectively inhibited calcification in both experimental groups compared to control through the longest implant (Ca2+ levels, 120 day implant: 0.1M FeCl3 = 46.85 +/- 17.45 micrograms/mg; 0.01M FeCl3 = 17.31 +/- 7.38 micrograms/mg; control = 258.04 +/- 15.71). Measurement of explanted GPBP Fe3+ levels showed that tissue Fe3+ levels of at least 7.28 +/- 0.70 micrograms/mg were required to effectively inhibit calcification after a 120-day implant. There was no evidence of Fe3+ impairment of rat growth. In conclusion, Fe3+ pretreatment of GPBP significantly inhibited calcification after long-term (120 day) rat subdermal implant.</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M170-2"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12914538","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
Blood compatibility of the jellyfish valve without anticoagulant. 无抗凝血剂海蜇瓣膜的血液相容性。
ASAIO transactions Pub Date : 1991-07-01
K Imachi, K Mabuchi, T Chinzei, Y Abe, K Imanishi, M Suzukawa, T Yonezawa, A Kouno, T Ono, H Nozawa
{"title":"Blood compatibility of the jellyfish valve without anticoagulant.","authors":"K Imachi,&nbsp;K Mabuchi,&nbsp;T Chinzei,&nbsp;Y Abe,&nbsp;K Imanishi,&nbsp;M Suzukawa,&nbsp;T Yonezawa,&nbsp;A Kouno,&nbsp;T Ono,&nbsp;H Nozawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The blood compatibility of the jellyfish valve was studied. Artificial heart (AH) blood pumps incorporating jellyfish valves were connected to 18 goats as total artificial hearts (TAHs) and pumped for 1 to 125 days without anticoagulant or antiplatelet drugs. No thrombus was formed on the valve membrane or around the valve seat. Scanning electron microscopy showed almost no platelet deposition or microfibrin clot formation on the valve membrane, including its central region; the spokes of the valve seat were also free from platelet and microfibrin clots. No calcification was observed during these tests, and plasma free hemoglobin was between 2 and 7 mg/dl. The jellyfish valve revealed good blood compatibility, even without anticoagulant use.</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M220-2"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12914785","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
A unique, efficient, implantable, electromechanical, total artificial heart. 一个独特的，高效的，可植入的，机电的，全人工心脏。
ASAIO transactions Pub Date : 1991-07-01
S Takatani, M Shiono, T Sasaki, I Sakuma, J Glueck, M Sekela, G Noon, Y Nose, M DeBakey
{"title":"A unique, efficient, implantable, electromechanical, total artificial heart.","authors":"S Takatani,&nbsp;M Shiono,&nbsp;T Sasaki,&nbsp;I Sakuma,&nbsp;J Glueck,&nbsp;M Sekela,&nbsp;G Noon,&nbsp;Y Nose,&nbsp;M DeBakey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A completely implantable, one piece electromechanical total artificial heart (TAH) intended for permanent human use was developed. It consisted of left and right conically shaped pusher-plate blood pumps sandwiching a thin centerpiece with a compact, efficient electromechanical actuator. The actuator consisted of a direct current brushless motor; a planetary roller screw fit the space between the two conically shaped pusher-plates. The rotational motion of the motor was converted to the rectilinear motion of the rollerscrew to displace the left and right pusher-plates in the left master alternate mode. The diameter of the assembled TAH was 97 mm, with a central thickness of 82 mm. The overall weight was 620 g, with a displaced volume of 510 ml. The pump provided flows of 3-8 L/min with a preload of 1-15 mmHg against an afterload of 100 mmHg. The net efficiency ranged from 15% to 18%. This model showed good fit in the pericardial space of heart transplant recipients (body weight, 77 kg).</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M238-40"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12914789","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
Peripheral circulation during nonpulsatile systemic perfusion in chronic awake animals. 慢性清醒动物非搏动性全身灌注时的外周循环。
ASAIO transactions Pub Date : 1991-07-01
Y Taenaka, E Tatsumi, M Sakaki, E Sasaki, T Masuzawa, T Nakatani, H Akagi, M Goto, Y Matsuo, K Inoue
{"title":"Peripheral circulation during nonpulsatile systemic perfusion in chronic awake animals.","authors":"Y Taenaka,&nbsp;E Tatsumi,&nbsp;M Sakaki,&nbsp;E Sasaki,&nbsp;T Masuzawa,&nbsp;T Nakatani,&nbsp;H Akagi,&nbsp;M Goto,&nbsp;Y Matsuo,&nbsp;K Inoue","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Peripheral circulation (PC) during nonpulsatile (NP) perfusion is not satisfactorily understood, although it is known that animals can survive with chronic NP flow. In awake goats, PC was analyzed by hemodynamic and hormonal parameters, tissue blood flow of the ear measured by a noninvasive laser Doppler flowmeter, and distribution of the body surface temperature monitored by thermography. An NP systemic circulation was established in five 40-64 kg goats with a centrifugal pump (MD-10, Iwaki Pump, Japan) that replaced a pulsatile ventricular assist device 2 weeks postoperatively; this was done without anesthesia. Nonpulsatile total left heart bypass was obtained, with flow rates of 78-165 ml/kg/min. Systemic vascular resistance and blood adrenalin and noradrenalin levels were not affected by the depulsation. Tissue blood flow during NP perfusion was well maintained and showed comparable values to those during pulsatile systemic circulation. Vasomotion of 10-20 cycles/min was obvious in the tissue blood flow pattern, indicating adequate PC at each sampling point. Thermography before and after depulsation indicated no change of temperature distribution, and displayed warm peripheral areas. In conclusion, PC of animals on chronic NP systemic perfusion is adequately maintained.</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M365-6"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12914795","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
Experimental study on limitations of anastomotic endothelialization of vascular prostheses. 血管假体吻合口内皮化局限性的实验研究。
ASAIO transactions Pub Date : 1991-07-01
S Niu, T Matsuda, T Oka
{"title":"Experimental study on limitations of anastomotic endothelialization of vascular prostheses.","authors":"S Niu,&nbsp;T Matsuda,&nbsp;T Oka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We studied the effect of endothelial cell (EC) senescence on proliferation, migration, and endothelialization in vitro using a culture model. Two generations of cultured bovine aortic ECs were used. The results showed that 1) the senescent ECs had much reduced rates of proliferation, migration, and endothelialization in vitro, and 2) that the young ECs at the leading edge gradually developed morphology similar to that of the senescent ECs as endothelialization proceeded. Computerized videomicroscopic observation revealed that the ECs at the leading edge had higher motile activity than the ECs at the back. This suggests that the ECs at the leading edge, and circumvented from contact inhibition, may proliferate much more frequently than the ECs at the back. Localized cellular aging may result in decelerated or incomplete endothelialization, as found clinically.</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M468-9"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12913763","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
High venous urea concentrations in the opposite arm. A consequence of hemodialysis-induced compartment disequilibrium. 对臂静脉尿素浓度高。血液透析引起的腔室不平衡的结果。
ASAIO transactions Pub Date : 1991-07-01
T A Depner, S Rizwan, A Y Cheer, J M Wagner, L A Eder
{"title":"High venous urea concentrations in the opposite arm. A consequence of hemodialysis-induced compartment disequilibrium.","authors":"T A Depner,&nbsp;S Rizwan,&nbsp;A Y Cheer,&nbsp;J M Wagner,&nbsp;L A Eder","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Resistance to urea diffusion among body fluid compartments diminishes the therapeutic effectiveness of hemodialysis. Cell membrane or capillary wall resistance is thought to be responsible for hemodialysis-induced urea disequilibrium. The authors examined the possibility that reduced blood flow might contribute to urea disequilibrium in the arm opposite the blood access site. Blood samples were taken simultaneously from a vein in the arm opposite the access site and from the arterial port after occluding the access graft between the needle sites for 1 min. Venous urea nitrogen levels from the opposite arm averaged 10% higher after 5 min, 26% higher after 60 min, and 36% higher after 120 min of dialysis. A three-compartment model of urea kinetics that includes a blood flow term accurately predicted all measured urea nitrogen concentrations in both arms. These data suggest that the opposite arm often behaves as a compartment with high resistance to urea diffusion. Slow diffusion from this compartment is partially due to reduced blood flow/compartment volume, and results in a delayed fall in venous blood urea nitrogen (BUN).</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M141-3"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12913941","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
Transcatheter placement of an intraluminal prosthesis for the thoracic aorta. A new approach to aortic dissections. 经导管置入胸主动脉腔内假体。主动脉夹层的新方法。
ASAIO transactions Pub Date : 1991-07-01
H Yoshida, T Kakino, M Kajitani, K Goh, T Gohda, K Yasuda, T Tanabe
{"title":"Transcatheter placement of an intraluminal prosthesis for the thoracic aorta. A new approach to aortic dissections.","authors":"H Yoshida,&nbsp;T Kakino,&nbsp;M Kajitani,&nbsp;K Goh,&nbsp;T Gohda,&nbsp;K Yasuda,&nbsp;T Tanabe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A new aortic prosthesis (SAP, shape memory aortic prosthesis) was developed with its transfemoral placement system to treat aortic dissection with minimal invasion. The SAP consists of a Nitinol stent and polyurethane tube, and it is designed in such a configuration that it can be compressed inside a 14 Fr catheter when cold. It regains its original shape when warmed to 30 degrees C. From the results of intra-aortic sutureless placement of SAP in 10 mongrel dogs, we concluded that a SAP of proper diameter could be implanted safely for more than 3 months. The transfemoral placement system is composed of a delivery catheter, pushing rod, catching catheter, and pulling wire. Using these devices, transfemoral placement of SAP was demonstrated successfully in three dogs and one sheep. The original SAP and delivery system can be used as an emergency procedure for aortic dissections, such as Stanford type B. The advantages of the procedure are minimal invasion of acutely ill patients and prompt application in the catheter laboratory.</p>","PeriodicalId":77493,"journal":{"name":"ASAIO transactions","volume":"37 3","pages":"M272-3"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12913950","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
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