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Renal Replacement / Hemodialysis

Measurement

Vascular Access Flow

Benefits of Measurement

The flow inside the AV access (AV fistula or graft) helps determine if the hemodialysis prescription can be supported, if the access is developing a clinically significant stenosis, or access flow is dangerously high

Technology Utilized

Ultrasound Dilution Technology (UDT)

Measurement Highlights

Transonic Transit- Time Ultrasound Flow Measurement (TTFM) through sterile tubing is the gold standard for blood flow verification. Transonic ultrasound dilution access measurement by the ‘Krivitski Method’ is the recognized gold standard technology for dialysis patient access flow measurement. The Krivitski Method calls for the temporary reversal of arterial and venous blood lines at their respective needle connections to create mixing conditions conducive for an indicator dilution flow measurement when a bolus of isotonic saline is injected into the blood circuit. Classical dilution equations are used to calculate vascular access flow.

Measurement

Delivered Flow

Benefits of Measurement

Confirmation of dialysis dose delivery

Technology Utilized

Transit-Time Ultrasound Flow Measurement (TTFM)

Measurement Highlights

Effective dialysis depends on the delivery of the dialysis prescription from the dialysis machine to the patient. When a patient begins hemodialysis, a baseline dialysis adequacy flow study confirms dialysis delivery and can be used to set vascular access parameters. Often, Transonic’s accurate flow measurements expose issues with calibration of the hemodialysis pump itself; Transonic measurements on board a hemodialysis machine allows for the ultimate guarantee that your device is working optimally.

Measurement

Cardiac Function

Benefits of Measurement

Provides proactive cardiac index tracking to help avoid cardiac collapse

Technology Utilized

Ultrasound Dilution Technology (UDT)

Measurement Highlights

For patients on dialysis, Transonic’s indicator dilution technology tracks the dilution of body temperature saline throughout the cardiovascular circuit to determine key cardiovascular functions such as Cardiac Index, Total Ejection Fraction, Central Blood Volume Index, etc. Knowing cardiac parameters can help staff identify high flow access that could cause cardiac overload, identify early cardiovascular issues, provide alerts to double check dry weight and medications, indicate fluid volume overload and avoid sudden cardiac collapse.

Measurement

Recirculation

Benefits of Measurement

Identifies vascular access recirculation, a late indicator of access dysfunction, allowing for on-the-spot correction of inadvertent reversal of bloodlines, if necessary

Technology Utilized

Ultrasound Dilution Technology (UDT)

Measurement Highlights

To measure vascular access recirculation, flow/dilution sensors monitor the blood's ultrasound velocity (1560-1590 m/sec). The greater the protein concentration in the blood, the faster ultrasound will travel. When a bolus of isotonic saline (velocity in blood is 1533 m/sec.). is injected into the blood, the blood protein concentration is diluted. Flow/dilution sensors detect the reduced ultrasound velocity. When recirculation occurs, the saline indicator returns immediately to the arterial line where the diluted blood is detected by the arterial sensor. Flow-QC software converts the data into conventional dilution curves from which recirculation can be calculated.