The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

Nadeem E. Moghal - One of the best experts on this subject based on the ideXlab platform.

Rasheed A Balogun - One of the best experts on this subject based on the ideXlab platform.

  • unusual placement of a Dialysis Catheter persistent left superior vena cava
    American Journal of Kidney Diseases, 2004
    Co-Authors: Tamil S Kuppusamy, Rasheed A Balogun
    Abstract:

    Many nephrologists perform clinical procedures, and perhaps the most common is placement of a noncuffed Dialysis Catheter to obtain vascular access necessary for immediate hemoDialysis therapy. The right internal jugular vein frequently is the site of choice for placement of such Catheters in most patients, but placement in the left internal jugular vein would not be unusual; for example, if another central Catheter is present in the right internal jugular vein or there has been a failed attempt at that site. Nephrologists who place hemoDialysis Catheters in the left internal jugular vein should be aware of the existence of an anatomic variant, a persistent left superior vena cava, to prevent alarming misinterpretation and inappropriate clinical responses to routine chest radiographs taken to confirm adequate placement of such Catheters.

Rajesh G. Krishnan - One of the best experts on this subject based on the ideXlab platform.

Frank J M F Dor - One of the best experts on this subject based on the ideXlab platform.

  • laparoscopic versus open peritoneal Dialysis Catheter insertion a meta analysis
    PLOS ONE, 2013
    Co-Authors: Sander M Hagen, Jan N M Ijzermans, Jeffrey A Lafranca, Ewout W Steyerberg, Frank J M F Dor
    Abstract:

    Background: Peritoneal Dialysis is an effective treatment for end-stage renal disease. Key to successful peritoneal Dialysis is a well-functioning Catheter. The different insertion techniques may be of great importance. Mostly, the standard operative approach is the open technique; however, laparoscopic insertion is increasingly popular. Catheter malfunction is reported up to 35% for the open technique and up to 13% for the laparoscopic technique. However, evidence is lacking to definitely conclude that the laparoscopic approach is to be preferred. This review and meta-analysis was carried out to investigate if one of the techniques is superior to the other. Methods: Comprehensive searches were conducted in MEDLINE, Embase and CENTRAL (the Cochrane Library 2012, issue 10). Reference lists were searched manually. The methodology was in accordance with the Cochrane Handbook for interventional systematic reviews, and written based on the PRISMA-statement. Results: Three randomized controlled trials and eight cohort studies were identified. Nine postoperative outcome measures were meta-analyzed; of these, seven were not different between operation techniques. Based on the meta-analysis, the proportion of migrating Catheters was lower (odds ratio (OR) 0.21, confidence interval (CI) 0.07 to 0.63; P = 0.006), and the one-year Catheter survival was higher in the laparoscopic group (OR 3.93, CI 1.80 to 8.57; P = 0.0006). Conclusions: Based on these results there is some evidence in favour of the laparoscopic insertion technique for having a higher one-year Catheter survival and less migration, which would be clinically relevant.

  • laparoscopic versus open peritoneal Dialysis Catheter insertion the loci trial a study protocol
    BMC Surgery, 2011
    Co-Authors: Sander M Hagen, Arjan M Van Alphen, Jan N M Ijzermans, Frank J M F Dor
    Abstract:

    Background Peritoneal Dialysis (PD) is an effective treatment for end-stage renal disease. It allows patients more freedom to perform daily activities compared to haemoDialysis. Key to successful PD is the presence of a well-functioning Dialysis Catheter. Several complications, such as in- and outflow obstruction, peritonitis, exit-site infections, leakage and migration, can lead to Catheter removal and loss of peritoneal access. Currently, different surgical techniques are in practice for PD-Catheter placement. The type of insertion technique used may greatly influence the occurrence of complications. In the literature, up to 35% Catheter failure has been described when using the open technique and only 13% for the laparoscopic technique. However, a well-designed randomized controlled trial is lacking.

Jeanne Louw - One of the best experts on this subject based on the ideXlab platform.

  • a randomized trial of Catheters of different lengths to achieve right atrium versus superior vena cava placement for continuous renal replacement therapy
    American Journal of Kidney Diseases, 2012
    Co-Authors: David J R Morgan, Kwok M Ho, Conor Murray, Hugh Davies, Jeanne Louw
    Abstract:

    Background The aim was to assess whether inserting a longer soft silicone short-term Dialysis Catheter targeting tip placement in the right atrium could improve dialyzer circuit life span compared with inserting a shorter Dialysis Catheter targeting tip placement in the superior vena cava. Study Design Randomized unblinded controlled study. Setting & Participants A tertiary multidisciplinary intensive care unit enrolling 100 critically ill patients requiring continuous renal replacement therapy (CRRT). Intervention Placement of longer (20-24 cm) versus shorter Dialysis Catheters (15-20 cm) within one of the major thoracic veins for initiation of CRRT. Outcomes The primary study outcome was duration of Dialysis circuit life span. Secondary outcomes included delivered daily Dialysis dose, incidence and cause of CRRT circuit failure, complications potentially related to the position of the short-term Dialysis Catheter, mortality, and patient length of stay. Results Placing the longer Dialysis Catheters was associated with an increased average dialyzer life span of 6.5 hours (24 hours [25th-75th percentile, 11-32] vs 17.5 hours [25th-75th percentile, 8-23]; P = 0.001), improved delivered daily Dialysis dose (91% [25th-75th percentile, 85%-100%] vs 81% [25th-75th percentile, 72%-97%]; P P = 0.04) or circuits taken down due to vascular access problem (0.19 vs 0.53; P = 0.04) per patient compared with placing shorter Dialysis Catheters. The incidence of atrial arrhythmias was similar between groups (28% vs 21%; P = 0.6) and the only mechanical complication was the malposition of one Dialysis Catheter tip in the longer Dialysis Catheter group. Limitations Single-center study design. Conclusions The use of longer soft silicone short-term Dialysis Catheters targeting right atrial placement appeared to be safe and could improve dialyzer life span and daily Dialysis dose of CRRT delivered compared with the use of shorter Catheters targeting superior vena cava placement.