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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective clinical trial comparing flushing and ice storage using a new hypertonic citrate solution, with machine preservation by continuous perfusion showed early graft function was similar with each method, and preservation times were comparable. Good early function occurred in half the grafts with preservation times up to 24 hours. Graft survival at three and 12 months was similar with each method of preservation. Graft survival at 12 months was worsened by poor early graft function, whereas patient survival at 12 months was unaffected by early function or by the method of preservation.
Proc Eur Dial Transplant Assoc 1977
PMID:Preservation of cadaveric renal allografts-comparison of flushing and pumping techniques. 34 Nov 31

We reviewed peritonitis (P) experience of four UK units using single use Y (Freeline T.M., Baxter UK)(F) and Twinbag (Solo T.M., Baxter UK) (S) disconnect systems, which incorporate the 'Flush Before Fill' principle. We aim to show clinical achievements, in varying circumstances, in the light of previously published in vitro study results. Each unit recorded P data, i.e., rates, causative organisms, and recurrences (R) over a 12 month period (Sept 89-Aug 90). This data was then analysed by system, by unit and in total. Each unit had similar definitions for P and R, but had varying system selection criteria. Unit 1 had a fairly open criteria for F use, then became more selective at the same time as introducing S. In unit 2, F, and then S, were first choice systems for all (inc. blind diabetics). Unit 3 trains every pt. on non-disconnect System 2, then pt. choice determines if they are retained onto a disconnect system. Unit 4 had a more highly selected population. Results, expressed as episodes/patient month, were as follows: [table: see text] We conclude that it is possible to achieve a low incidence of P, especially that caused by S. epidermidis, particularly with S. It would seem the extent is related to pt. to system selection criteria. The effects of R and ES/TI need to be addressed.
Adv Perit Dial 1992
PMID:CAPD disconnect systems: UK peritonitis experience. 136 13

Presented in February 1989 from this program was data that reflected our departure from the then recommended procedure of Drain/Flush/Fill sequencing with the Delmed Freedom Set. Our procedure was changed to the now accepted Flush/Drain/Fill sequencing in this Y-configured, manual disconnect system. The improvement in the incidence of peritonitis was reflected in the data that demonstrated 1 episode of peritonitis (EOP)/12.4 patient months with the Drain/Flush/Fill (D/F/F) sequencing and the improved incidence of 1 EOP/30.4 patient months Flush/Drain/Fill (F/D/F). Presented here is the cumulative data with an additional 144 patient months experience with the F/D/F sequencing of the Delmed Freedom Set and its Safelock connectology. The incidence of peritonitis remains relatively low, and not significantly different from that initial 1 year data, being 1 EOP/29.6 patient months (current) vs. 1 EOP/30.4 patient months (1 year data).
Adv Perit Dial 1990
PMID:Further experience with the Delmed Freedom Set and the Flush Drain/Fill sequencing. 198 94

The renal preservation ability of a flushing solution (F-M) with fructose-1,6-diphosphate (1 g/dl) and mannitol (2 g/dl) during cold ischaemia was studied with the isolated perfused rat kidney model and compared with the Euro-Collins (EC) and University of Wisconsin (UW) solutions. Kidneys were stored in hypothermia for 4 and 18 h after initial flushing with the solution being tested, and then reperfused at 37 degrees C in an isolated perfusion circuit for 90 min with a Krebs-Henseleit solution containing 4.5% albumin. Forty-four kidneys were studied and divided in a control group and six study groups according to the cold ischaemia time and flushing solution used. Renal functional parameters of plasma flow rate (PFR), renal vascular resistance (RVR), urine flow rate (UFR) glomerular filtration rate (GFR), fractional (FRNa) and net (TNa) sodium reabsortion were assessed during reperfusion. Conventional histology and malondialdehyde tissue levels (MDA) were also evaluated. Our results show that PFR, RVR, and UFR were similar in all study groups. After 4 and 18 h of cold ischaemia, GFR, FRNa and TNa were better, and conventional histology worse in F-M than in EC flushed kidneys. After 4 and 18 h of cold ischaemia, GFR, FRNa and TNa, in fact, were not different between F-M and UW flushed kidneys. After 4 h of cold ischaemia, conventional histology was similar in F-M and UW flushed kidneys. Nevertheless, after 18 h of cold ischaemia, UW flushed kidneys showed worse histological parameters than F-M flushed kidneys. After 4 h of cold ischaemia, MDA was similar in kidneys flushed with three solutions. After 18 h of cold ischaemia MDA was higher in EC than in F-M or UW flushed kidneys. In summary, our newly developed cold storage solution shows promising results in renal preservation and its ability to preserve is at least as good as UW solution assessed in the isolated perfused rat kidney.
Nephrol Dial Transplant 1995
PMID:Evaluation of a preservation solution containing fructose-1,6-diphosphate and mannitol using the isolated perfused rat kidney. Comparison with Euro-Collins and University of Wisconsin solutions. 762 95

Enhanced levels of soluble TNF-receptors (sTNF-R) have been reported in patients with chronic renal failure. The aim of the present study was to evaluate the effects on sTNF-R levels in plasma of haemodialysis patients of the anticoagulation method and of the type of membrane used, as well as the variability of predialysis sTNF-R levels during time. All haemodialysis patients tested (n = 35) showed increased levels of both sTNF-R55 (72.4 +/- 5.7 ng/ml, P < 0.001) and sTNF-R75 (18.2 +/- 2 ng/ml, P < 0.001) before dialysis, as compared with normal healthy controls (< 2.5 ng/ml for both sTNF-R), confirming previous observations. sTNF-R levels were determined before and during haemodialysis at different time intervals in patients receiving either heparin (2500 U, 5000 U, or 10,000 U), low molecular weight heparin, or periodic saline flushing to prevent coagulation of the extracorporal circuit. A transient, small decrease in both sTNF-R levels occurred at the beginning of haemodialysis (t = 15 min) with all anticoagulation methods used. At the end of haemodialysis, sTNF-R55 and sTNF-R75 concentrations were only minimally affected (P > 0.05). Predialysis sTNF-R levels were similar in patients dialysed on either cellulose diacetate or polyacrylonitrile. Finally, there were only minimal variations in predialysis sTNF-R levels in individual patients during the 1 week observation period. Although the biological consequences of the increased TNF-binding ability of serum from haemodialysis patients is still unclear, it could play a role in the complex immunological perturbations of uraemic patients.
Nephrol Dial Transplant 1994
PMID:Increased plasma levels of soluble tumor necrosis factor-receptors in uraemic patients: effects of dialysis, type of membrane, and anticoagulation method. 780 Feb 12

Beraprost sodium, an orally active prostaglandin I2 analog with vasodilatory, cytoprotective, antiplatelet, antithrombotic, and anti-inflammatory effects, 120 microg daily for 8 weeks, decreased plasma D-dimer, a marker of intravascular coagulation, and von Willebrand factor, a marker for endothelial injury, in 100 chronic peritoneal dialysis patients. Total cholesterol, triglycerides, high-density lipoprotein, apolipoprotein A1, apolipoprotein B, albumin, prealbumin, fibrinogen, troponin-T, and high-sensitivity C-reactive protein levels were not changed. Three patients complained of headache and 1 patient experienced facial flushing; however, no serious adverse effects were observed. These results suggest that beraprost sodium is effective in partially reversing the thrombogenic coagulation profile and endothelial injury in chronic peritoneal dialysis patients.
Perit Dial Int
PMID:Effects of beraprost sodium, an oral prostaglandin i2 analog, on hemostatic factors and inflammation in chronic peritoneal dialysis patients. 1929 55

Despite technology advances, prevention of peritonitis remains one of the major challenges in peritoneal dialysis (PD). Several innovative developments have shown an impact on peritonitis rates. Innovative antimicrobial-coated catheter modifications have been introduced, showing promising results in vitro. Topical application of antimicrobial agents such as mupirocin to prevent exit-site infections has been successfully used. New alternative agents for topical exit-site care with reduced potential for antimicrobial resistance are under development. Flushing before fill and avoidance of spiking of solution bags have improved peritonitis rates, as have innovative connectology and double-bag systems. Automated PD seems to be superior with regard to peritonitis rates, although clinical evidence for the benefit is not always conclusive. New PD solutions with neutral pH and low concentrations of glucose degradation products (GDPs) have shown beneficial effects on cell viability and have improved peritoneal host defense. Yet despite advantageous clinical outcomes in some studies, other trials with low-GDP solutions did not show any difference in peritonitis rates. The incidence of peritonitis has markedly improved since the end of the 1980s, but the infection remains a significant complication of chronic PD. Quantifying the role of the many practices and devices in reducing complications is difficult, but their combined effect has clearly improved peritonitis outcomes.
Adv Perit Dial 2010
PMID:Strategies to universally improve peritonitis rates, including use of dialysis solutions with low glucose degradation products. 2134 77

A laparoscopic approach represents an effective alternative to open surgery in patients undergoing peritoneal dialysis (PD). In these patients, conventional thinking provides for removal of the peritoneal catheter during left colon resections because of higher risk of patient contamination and peritonitis. The present paper describes 3 cases of laparoscopic left hemicolectomy for colon cancer performed in PD patients without complications and without peritoneal catheter removal, leading to subsequent early PD resumption.Three normotype PD patients affected by early-stage sigmoid colon adenocarcinoma (T1-T2, M0, N0) underwent integrated surgical and nephrological management to reduce peritoneum stress, infective risk and postoperative complications. The day before surgery, patients were shifted to isovolumetric hemodialysis through tunneled central venous catheter. All patients underwent laparoscopic left hemicolectomy without Tenckhoff catheter removal. The postoperative period was uneventful, with concomitant antibiotic prophylaxis until the fifth day after surgery. Flushing of the PD catheter was performed twice a week postoperatively. Peritoneal dialysis was recovered 4 weeks after surgery in 2 cases with a well-maintained dialytic adequacy. One patient did not proceed to PD due to improvement of renal function after surgery.In selected PD patients, a minimally invasive surgical approach combined with careful nephrological management may represent a valid and safe strategy to treat early-stage colon cancer, avoiding PD drop-out.
Perit Dial Int
PMID:Laparoscopic Left Hemicolectomy for Colon Cancer in Peritoneal Dialysis Patients: A Valid and Safe Surgical Technique to Ensure Peritoneal Dialysis Survival. 2790 56