Journal
HEMODIALYSIS INTERNATIONAL
Volume 21, Issue 2, Pages 168-172Publisher
WILEY
DOI: 10.1111/hdi.12474
Keywords
Hemodialysis; gas embolies; clots
Categories
Funding
- Vasterbottens Lans Landsting (ALF support)
- Norrlands Njurforening
- Vinnova
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During preparation of the hemodialysis (HD) extracorporeal circuit (ECC) a priming solution is used to remove air from the tubes and dialyzer. Ultra sound techniques have verified micro embolic signals (MES) in the ECC that may derive from clots or gas embolies. In vitro studies could clarify that embolies of air develop within the ECC and also pass the safety systems such as air traps and enter the venous line that goes into the patient. Clinical studies have confirmed the presence of MES within the ECC that pass into the returnvenousline during conventional HD without inducing an alarm. In addition, studies confirmed that such MES were present within the AV fistula and subclavian vein, but also detected within the carotid artery. Autopsy studies revealed the presence of gas embolies surrounded by clots within the lung but also brain and myocardial tissue. This review will focus on how the MES develop and measures of how the exposure can be limited.
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