scholarly journals Why Does Vascular Access Dysfunction Occur despite Brachial Artery Blood Flow Being Higher than Preset Blood Flow?

2022 ◽  
Vol 2 (1) ◽  
pp. 38-43
Author(s):  
Jun-ichi Ono ◽  
Takushi Oiwa ◽  
Yasuo Ogasawara ◽  
Seiichi Mochizuki
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Vascular Access ◽  
Brachial Artery ◽  
Pure Water ◽  
Blood Flow Rate ◽  
Path Model ◽  
Artery Blood Flow ◽  
Recirculation Rate ◽  
Model Fluid

Background: In recent years, many reports have investigated the usefulness of brachial artery blood flow (BAF) measured by ultrasonography as an evaluation index for the vascular access (VA) stenosis of hemodialysis patients. However, the mechanism of VA dysfunction, despite BAF being higher than the preset blood flow, has not been clarified to date. Methods: The relationship between actual blood-removal flow and recirculation rate with decreasing VA flow was examined using a VA flow path model and pure water as a model fluid. The blood-flow rate was set at 180 mL/min, and the set VA flow rate was lowered stepwise from 350 to 50 mL/min. VA flow rate, blood-removal flow rate, and flow waveform measured between two needle-puncture sites were recorded, and then the actual blood-removal flow rate and recirculation rate were calculated. Results: Recirculation was observed at a VA flow rate < 300 mL/min. The recirculation was due to the VA flow rate, which was transiently reduced to the level below the blood-removal flow rate, resulting in backflow. In contrast, no decrease in the actual blood-removal flow rate was observed. Conclusion: It is suggested that the mechanism of the VA dysfunction, despite the BAF being higher than the preset blood-flow rate, was due to the diastolic BAF being lower than the blood-removal flow rate.

Optimizing dialysis dose by increasing blood flow rate in patients with reduced vascular-access flow rate

2001 ◽  
Vol 38 (5) ◽  
pp. 948-955 ◽  
Author(s):  
Daxenos R.M. Hassell ◽  
Frank M. van der Sande ◽  
Jeroen P. Kooman ◽  
Jan P. Tordoir ◽  
Karel M.L. Leunissen
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Vascular Access ◽  
Blood Flow Rate ◽  
Dialysis Dose

Five Years of Vascular Access Stenosis Surveillance by Blood Flow Rate Measurements during Hemodialysis Using the Delta-H Method

2012 ◽  
Vol 13 (3) ◽  
pp. 321-328 ◽  
Author(s):  
Ramón Roca-Tey ◽  
Rosa Samon ◽  
Omar Ibrik ◽  
Empar Roda ◽  
Juan Carlos González-Oliva ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Vascular Access ◽  
Blood Flow Rate ◽  
Vascular Access Stenosis

CNP causes receptor-mediated positive dromotropic effects in anesthetized dog hearts

1998 ◽  
Vol 275 (2) ◽  
pp. H717-H720 ◽  
Author(s):  
Masamichi Hirose ◽  
Yasuyuki Furukawa ◽  
Yusuke Miyashita ◽  
Fumio Kurogouchi ◽  
Koichi Nakajima ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Natriuretic Peptide ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Natriuretic Peptide Receptor ◽  
Artery Blood Flow ◽  
Peptide Receptor ◽  
Av Conduction ◽  
Anesthetized Dogs

No data are available for the direct effect of C-type natriuretic peptide (CNP) on atrioventricular (AV) conduction in mammalian hearts. Thus we studied the dromotropic effects of CNP-22 injected into the AV node artery in autonomically decentralized hearts in open-chest, anesthetized dogs. CNP decreased AV interval (AV conduction time) in a dose-dependent manner with increase in coronary artery blood flow rate in six anesthetized dogs. Isosorbide dinitrate did not affect AV interval, but it increased coronary artery blood flow rate. A guanylyl cyclase-linked natriuretic peptide receptor antagonist, HS-142–1, inhibited the decreases in AV interval and the increases in coronary blood flow rate in response to CNP, whereas propranolol did not affect the positive dromotropic response to CNP. These results demonstrate that CNP decreases AV interval and increases coronary artery blood flow rate mediated by a guanylyl cyclase-linked natriuretic peptide receptor, but not β-adrenoceptor, in the dog heart.

scholarly journals Feasibility of MRI to assess differences in ophthalmic artery blood flow rate in normal tension glaucoma and healthy controls

2020 ◽  
Author(s):  
Martin Kristiansen ◽  
Christina Lindén ◽  
Sara Qvarlander ◽  
Anders Wåhlin ◽  
Khalid Ambarki ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Ophthalmic Artery ◽  
Blood Flow Rate ◽  
Normal Tension Glaucoma ◽  
Healthy Controls ◽  
Artery Blood Flow

Stellenwert der Duplexsonographie der Brachialarterie zur Überwachung von vaskulären Zugängen bei Hämodialysepatienten

VASA ◽  
2001 ◽  
Vol 30 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Michèle Depairon ◽  
C.P. Ferrier ◽  
P. Tutta ◽  
E. Descombes ◽  
G. van Melle ◽  
...  
Keyword(s):  
Blood Flow ◽  
Sensitivity And Specificity ◽  
Flow Rate ◽  
Vascular Access ◽  
Brachial Artery ◽  
Ultrasound Examination ◽  
Resistance Index ◽  
Duplex Ultrasound ◽  
Screening Tests ◽  
Cross Sectional

Background: Vascular access (VA) stenosis with subsequent thrombosis remains one of the major causes of morbidity and hospitalization in haemodialysis patients. The present cross-sectional study was planned in order to analyze the usefulness of brachial artery duplex ultrasound for detection and prediction of vascular access stenoses. Methods: Color duplex ultrasound (Apogée Cx 200, sectorial probe 7.5 MHz) was used to obtain the anatomical pattern of the VA and flow velocity waveforms of the brachial artery in 77 non-selected VA (47 Ciminio-Brescia fistulae and 30 PTFE grafts). In each VA, the resistance index (RI), the mean blood flow rate (Q) and the blood flow ratio index (QI) (QI = VA flow rate/contralateral flow rate) were calculated at the level of the brachial artery. The sensitivity and specificity of these brachial Doppler parameters were calculated for the detection of VA stenosis. In normal VA, positive (PPV) and negative predictive (NPV) values were calculated for the development of clinical stenotic complications 3 months post ultrasound examination. Results: Thirteen of the 77 VA (17%) were identified as stenosed by duplex ultrasound and confirmed by fistulography and/or during surgical exploration. The best screening tests for VA stenosis detection were a QI threshold < 4.0 with a sensitivity and specificity of 69 and 69% and an RI > 0.55 with a sensitivity and specificity of 62 and 66%, respectively. In the VA considered as normal by ultrasound, the prediction of subsequent stenosis within three months post-ultrasound examination gave a PPV of only 18% and 19% for RI and QI, respectively. NPV for RI and QI were 90% and 88%. Conclusions: While Doppler ultrasound is a useful non-invasive test for the detection of prevalent VA stenosis, our results do not confirm that abnormal brachial Doppler flow parameters can predict short term development of VA stenosis.

scholarly journals P1367THE RELATIONSHIP OF SERUM PHOSPHORUS LEVEL AND ARTERIOVENOUS FISTULA DYSFUNCTION IN MAINTENANCE HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hyung-Jong Kim ◽  
Mi Jung Lee
Keyword(s):  
Blood Flow ◽  
Risk Factor ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Vascular Access ◽  
Univariate Analysis ◽  
Blood Flow Rate ◽  
Dialysis Unit ◽  
The Mean ◽  
The Impact

Abstract Background and Aims It is known that maintenance of function of arteriovenous fistula (AVF) is very important in the management of hemodialysis (HD) patients. Therefore, identifying a risk factor for decreased vascular access flow has a clinical relevance in real world practice. Although hyperphosphatemia plays a crucial role in the pathogenesis of vascular calcification, there is lack of studies evaluating the effect of hyperphosphatemia on AVF. This study investigated the impact of serum phosphorous (P) on vascular access flow in HD patients. Method Sixty-two maintenance HD patients who visited dialysis unit of Bundang CHA Medical Center from November 2016 to December 2017 were included in this study. Serum P levels were determined every month and time-averaged serum P was calculated. All patients had left arm AVF (side to side anastomosis) and vascular access flow was assessed by Transonic HD 03. Decreased vascular access flow was defined as less than 600 mL/min. Results The mean age was 57.9 ± 12.1 years, 32 patients (51.6%) were men. The mean serum P levels were 5.1 ± 1.1 mg/dL and the vascular access flow was 1,071.4 ± 504.2 mL/min. Decreased vascular access flow was observed in 14 of 62 patients (22.6%). In univariate analysis, higher serum P was significantly associated with decreased vascular access flow (odds ratio [OR]=2.089, 95% confidence interval [CI]=1.159-3.766, P=0.014). But there was no significant association of dialysis blood flow rate, ejection fraction on echocardiography and serum calcium (Ca) levels with vascular access flow. Multivariable analysis indicated that higher serum P was independently associated with greater risk of decreased vascular access flow (OR=4.012, 95% CI=1.651-9.711, P=0.002). Old age, reduced EF, low dialysis blood flow rate and higher serum Ca was not associated with vascular access flow. Conclusion This study demonstrated that higher serum P was the independent risk factor for decreased vascular access flow in maintenance HD patients. Serial monitoring of serum P may be helpful to stratify the risk of vascular access dysfunction in these patients.

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