scholarly journals Biomechanics Perspective for the Design and Manufacture of Continuous Ambulatory Peritoneal Dialysis Connectors

2021 ◽  
Vol 11 (4) ◽  
pp. 1502
Author(s):  
Mario Alberto Grave-Capistrán ◽  
Luis Antonio Aguilar-Pérez ◽  
Juan Carlos Paredes-Rojas ◽  
Carlos De la Cruz-Alejo ◽  
Christopher René Torres-SanMiguel

Chronic kidney disease (CKD) progressively and irreversibly affects the kidneys and is considered a catastrophic disease on a global scale. Continuous ambulatory peritoneal dialysis (CAPD) is one of the most used methods of treatment, involving infusion and draining bags and a transfer line. Patients receiving this treatment have a catheter that is placed during surgery; this depends on having the same catheter supplies, as they are not compatible with other market brands. This research shows the comparison between connector brands used at the outlet of the Tenckhoff® catheter. The methodology shows the design of two connectors using the 3D printing technique. Numerical simulations were carried out to establish the flow patterns through each of the designs; the maximum values of velocity reached 74 mm/s inside the PISA to Baxter (PB) connector, while the pressure and vorticity were controlled and did not represent failures inside the connectors and threads connections. An experimental testbed was designed to verify the connections between the manufactured devices and the market brand elements. The results show numerical and experimental comparisons of the developed titanium-ELI connectors with no leaks at the connection points due to the lack of commercial supplies. These connectors can be used in the treatment of CAPD.

Author(s):  
William J. Lamoreaux ◽  
David L. Smalley ◽  
Larry M. Baddour ◽  
Alfred P. Kraus

Infections associated with the use of intravascular devices have been documented and have been reported to be related to duration of catheter usage. Recently, Eaton et al. reported that Staphylococcus epidermidis may attach to silastic catheters used in continuous ambulatory peritoneal dialysis (CAPD) treatment. The following study presents findings using scanning electron microscopy (SEM) of S. epidermidis adherence to silastic catheters in an in vitro model. In addition, sections of polyvinyl chloride (PVC) dialysis bags were also evaluated by SEM.The S. epidermidis strain RP62A which had been obtained in a previous outbreak of coagulase-negative staphylococcal sepsis at local hospitals was used in these experiments. The strain produced surface slime on exposure to glucose, whereas a nonadherent variant RP62A-NA, which was also used in these studies, failed to produce slime. Strains were grown overnight on blood agar plates at 37°C, harvested from the surface and resuspended in sterile saline (0.85%), centrifuged (3,000 rpm for 10 minutes) and then washed twice in 0.1 M phosphate-buffered saline at pH 7.0. Organisms were resuspended at a concentration of ca. 106 CFU/ml in: a) sterile unused dianeal at 4.25% dextrose, b) sterile unused dianeal at 1.5% dextrose, c) sterile used dialysate previously containing 4.25% dextrose taken from a CAPD patient, and d) sterile used dialysate previously containing 1.5% dextrose taken from a CAPD patient.


Mycoses ◽  
2002 ◽  
Vol 45 (3-4) ◽  
pp. 120-122 ◽  
Author(s):  
S. Cinar ◽  
A. Nedret Koc ◽  
H. Taskapan ◽  
A. Dogukan ◽  
B. Tokgoz ◽  
...  

2009 ◽  
Vol 27 (1) ◽  
pp. 59-61
Author(s):  
E Indhumathi ◽  
V Chandrasekaran ◽  
D Jagadeswaran ◽  
M Varadarajan ◽  
G Abraham ◽  
...  

1990 ◽  
Vol 10 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Paul Nikolaidis

Newer fluoroquinolones such as ciprofloxacin, pefloxacin, ofloxacin, enoxacin, and fleroxacin are potent antimicrobial agents against many gram-negative bacteria, including Pseudomonas aeruginosa species and staphylococci-sensitive or resistant to methicillin. They are almost completely absorbed when given orally, reaching therapeutic plasma and dialysate concentrations, and their long half lives permit infrequent dosing intervals. Clinical studies on fluoroquinolones efficacy in continuous ambulatory peritoneal dialysis (CAPD) infections, although not extensive, demonstrate good results. They are well tolerated and the adverse reactions, consisting mainly of gastrointestinal disturbance, were uncommon, mild, and reversible. The fluoroquinolones offer a promising alternative to standard parenteral treatments in CAPD patients, while their good oral bioavailability makes them attractive and convenient for both patients and hospital staff. However, they must be used with caution until we have more information and gain further experience.


1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 367-371 ◽  
Author(s):  
Erich Keller

Staphylococci are the leading pathogens In continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis. Vancomycin appears to be an outstanding antistaphylococcal drug because resistance to It Is nearly absent. The pharmacokinetics of vancomycin and clinical cure rates of peritonitis with different dosing guidelines have been studied extensively. Different dosing guidelines with IP or IV loading doses followed or not followed by IP maintenance doses are used successfully, despite the fact that some of the dosing schemes produce apparently suboptimal drug levels referring to In vitro data like the MIC value (minimum Inhibitory concentration). Alternatively, amlnoglycosldes, cephalosporlns, Isoxazolyl penicillins, and broad-spectrum penicillins combined with betalactamase Inhibitors may be used for the treatment of gram-positive peritonitis. For the above panicillins pharmacokinetic data are scarce, and clinical experience is limited. Rifampin has excellent Intracellular antistaphylococcal activity and should be used In combination with other antibiotics. Although pharmacokinetic data are lacking, rifampin dosages do not require adaptation to renal function or replacement therapy.


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