Periodic monitoring of vascular access flow as
recommended by K/DOQI Guidelines.
Results in fewer failures & surgical revisions
Transonic's gold-standard vascular access flow
measurement is used as a baseline of the function of new or recently revised vascular accesses. PatientTrace Plus software integrates serial measurements into a patient's access flow history. The report trends results and allows for easy identification of accesses that are indanger of failure.
K/DOQI Guidelines: flow < 600 ml/min for
grafts and fistulas of flow below 1000 ml/minthat has decreased by 20% of its orginal value within a four month period.
This protocol first confirms that the
prescribed deliverd flow is delivered to the patient. Recirculation measurements identify inadvertently reversed dialysis lines.
This simple Flow-QC testing performed during dialysis fulfills the
K/DOQI guideline: "Detailed Error Analysis for Deficiencies in Delivered Kt/V or URR" [Am J Kidney Disease Vol 30 No 3 Suppl 2 pp S59-S63] and takes full
advantage of the diagnostic ease of Transonic Flow-QC technology.
Cardiac Output is measured using Transonic's proprietary ultrasound
indicator dilution method. Cardiac Output and the patient parameters, Cardiac Index, Peripheral Resistance and Central Blood Volume are reported for an on-site
assessment of a patient's cardiac function.
Simple Steps for Flow-QC Monitoring
Similar measurement steps are used for each protocol. During routine dialysis a nurse clips ultrasonic/dilution sensors onto a patient's dialysis
blood lines. A bolus of saline is then introduced into the blood line (either by opening the patient's saline bag for several seconds, or via an injection into a blood
line port). This initiates a testing sequence which measures the selected diagnostic parameter. The protocols are easily implemented into a clinic's patient management
program to meet DOQI recommendations.
One sensor is clipped onto the venous line (blue sensor) and one onto
the arterial line (red sensor). These sensors measure flow & dilution with ultrasound transit-time (described below).
0.9% NaCl is infused into the venous blood line or a 10 ml injection
can be made into the venous bubble trap.
The saline indicator dilutes the blood and the resulting change in
concentration is detected as it passes by the venous sensor producing a concentration curve.
If recirculation is present, a portion of the bolus will immediately
pass by the sensor on the arterial line. This produces a second concentration curve.
Results are calculated automatically and are displayed on the
computer screen within minutes.
For access flow measurements a similar procedure is followed with the
dialysis lines reversed.
