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AV Fistula Repair and Maintenance

Measurement

Vascular Access Flow

Benefits of Measurement

The flow inside the AV access (AV fistula or AV graft) is used to determine if the flow can support the hemodialysis prescription and if the access is developing a clinically significant stenosis

Technology Utilized

Ultrasound Dilution Technology

Measurement Highlights

Transonic Transit- Time ultrasound (TTU) flow measurement 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

Bubble Detection

Benefits of Measurement

Reduces microembroli leading to fewer embolisms and improved clinical outcomes

Technology Utilized

Transit-time ultrasound

Measurement Highlights

Transonic's transit-time ultrasound (TTU) flow measurement through sterile tubing is the gold standard for blood flow verification, and has the capability of detecting bubbles that are 20% or larger of the inner diameter of the tubing being used. Wide beam ultrasonic illumination of transit-time ultrasound flowsensors measure the velocity of fluid across the entire vessel lumen to derive volume flow in mL/min or L/min., and in the process can register the presence of bubbles.

Measurement

Blood Volume

Benefits of Measurement

Provides CBV index to help avoid hypovolemic collapse

Technology Utilized

Ultrasound Dilution Technology

Measurement Highlights

Ultrasound Dilution Tethodology (UDT), pioneered by Nikolai Krivistki PhD, DSc, uses body temperature saline, an innocuous indicator, injected into a patientís peripheral vascular access. The indicator is injected into the venous line, travels through the heart and lungs and returns via the arterial system where a Flow/dilution Sensor records the diluted blood concentration. Software converts the data into conventional dilution curves. Classic Stewart-Hamilton equations are used to calculate cardiac function and central hemodynamic parameters including Cardiac Output (CO).