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Edgar V. Lerma 🇵🇭
@edgarvlermamd
, 8 tweets, 8 min read Read on Twitter
Hemodialysis 101: Apparatus
📌 From the patient, blood is pumped via the vascular access thru an ARTERIAL blood line (INFLOW) to the dialyzer
📌 Blood is returned to the patient from the dialyzer via a VENOUS blood line (OUTFLOW)
#Nephpearls #DialysisDirector
Redsense sensor is used to detect blood leakage at the site of potential line separation
📌 For those who are at high risk for line separation
#Nephpearls #DialysisDirector
👉🏼 redsensemedical.com/index.php/cont…
The VENOUS PRESSURE can be used to monitor the state of coagulation.
It is a function of:
📌 BFR
📌 Blood viscosity
📌 Downstream access (needle or catheter) resistance
#Nephpearls #DialysisDirector
Hollow fiber dialyzer
📌 Blood flows into a chamber (HEADER) at one end of the cylindrical shell; from there, blood enters thousands of capillaries tightly bound in a bundle
♦️Blood flows thru the fibers
♦️Dialysate flows around the outside
#Nephpearls #DialysisDirector
Hollow fiber dialyzer
📌 COUNTERCURRENT flow: Blood and dialysate flow in opposite directions to maximize the concentration gradient between blood and dialysate in all parts of the dialyzer
#Nephpearls #DialysisDirector
The presence of recirculation during HD decreases dialysis effectiveness, & generally occurs if the vascular access of the patient cannot deliver the required BFR
#Nephpearls #DialysisDirector
👉🏼 basicmedicalkey.com/hemodialysis-a…
Blood Circuit
📌Inflow blood line
♦️Prepump segment
♦️Roller pump segment
♦️Postpump segment (ARTERIAL)
Dialyzer
Dialysis Fluid Circuit
📌Outflow blood line (VENOUS)
♦️ Airtrap and pressure monitor
#Nephpearls #DialysisDirector
👉🏼 basicmedicalkey.com/hemodialysis-a…
Hemodialysis membranes from @croncoIRRIV @NatRevNeph #Nephpearls #DialysisDirector
👉🏼 ncbi.nlm.nih.gov/m/pubmed/29730…
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More from @edgarvlermamd see all

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Edgar V. Lerma 🇵🇭
@edgarvlermamd
FRANCIS: Hemolytic Uremic Syndrome
#NKFClinicals 🇺🇸 #Nephpearls
Clinical and laboratory manifestations of atypical HUS (aHUS)
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👉🏼 openurologyandnephrologyjournal.com/contents/volum…
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👉🏼 sciencedirect.com/science/articl…
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🇹🇷 MYWAY 🇹🇷
@mywayTurkey
Yıl 1878'di..
Afyon'a bağlı Beyköy'de bir tarlada 10 metre uzunluğunda kireç taşından yapılmış bir yazıt bulundu..
Üzerinde bir takım şekiller vardı..
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Okuyalım☺️
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Bölgede kazı yapan Fransız arkeolog George Perrot buna karşı çıksa da, köylülere derdini anlatamadı..
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Aisha Shaikh
@aishaikh
💥’Physical Examination of the Dialysis Vascular Access’ - Tweetorial

Let’s first review the:
⚡️Anatomy of the Vascular Access
⚡️Vascular Access-related
complications
1/
@ASDINNews
@RenalFellowNtwk
#VascularAccessPearls
💥 A dialysis vascular access is a ‘circuit’ and NOT just a ‘connection’ between an artery & a vein

⚡️The circuit consists of:
☄️ Pump (heart)
☄️ Inflow (artery)
☄️ Conduit (body of the access)
☄️ Outflow (vein)
2/
💥 There are 3 basic types of vascular access:
⚡️AVF (arterio-venous fistula)
⚡️AVG (arterio-venous graft)
⚡️CVC (central venous catheter)

☄️AVF: created by a direct connection b/w an artery & a vein
☄️AVG: graft is interposed b/w an artery & a vein👇🏽
3/
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