effect of increasing blood flow rate on dialysis adequacy in hemodialysis patients

One of the morbidity and mortality determinants of the dialysis patients is inadequacy of dialysis. Increasing the dialysis efficacy improves patient's prognosis. The aim of this study was to assess the effect of increasing blood flow on the adequacy of dialysis in dialysis department of Ekbatan hospital of Hamadan. This before-after design study was performed on 42 patients First, data was collected about the following parameters: patient's weigh; before and after hemodialysis. ultrafiltration, urea before and after hemodialysis, the time of dialysis, percentage of filter clearance and speed of dialysate. Then the patient was attached to the dialysis machine and a sample of blood was taken. The pumpage of dialysis machine in the first session was put on 200 ml/min and in the second session on 250 ml/min. During the hemodialysis, the hemodynamic status and vital signs of patient's were controlled. When hemodialysis finished a blood sample was taken from the artery set, in a section before dialyzer [4 blood sample for each patients], weight was controlled again and the sample was sent to a laboratory for urea control. Then the efficiency of dialysis was determined. Descriptive and analytical statistics were used for analysis of the data. Results showed the mean KT/V [K=Clearance dialyzer T= Time V=Volume of distribation of urea] of patients whose pumping cycle were 200 ml/min, had 0.943 +/- 0.335 and URR [Urea Reduction Ratio] 53.3 +/- 13.5 wereas mean KT/V patients with 250 pumping cycle had 1.195 +/- 0.45 and URR 60.17 +/- 10.47. Paired t-test with%95 confidence interval showed that there was a significant difference in dialysis efficiency between the two groups [p<0.05]. Our data suggests that increasing blood flow rate by 25% of previous flow rate is effective in achieving higher dialysis adequacy in hemodialysis patients

[ effect of sterile gauze bandage on preventing of phlebitis and local infections due to using intravenous catheter]

Background and Objective: one of the most current aggressive methods to access to blood vessels intravenous peripheral catheters that contains excess complications and prevention of it is one of important medical goals. Therefore, this study was done to determining influence dressing with gauze sterile using in complication appearance rate of side effects patients in CCU and having venous catheter

Materials and Methods: this clinical trial accomplished on 64 patient's hospitalization in CCU and post CCU of Malayer Hospital. 32 of patients in the experimental group [Use of dressing with gaze sterile] and 32 of patients shelled in the control group [Routine] randomly. For data collecting was used checklist and laboratory reports, the method was according to following

Form: in beginning, questionnaire which contained demographic information completed and then venous catheter was enclosed sterility in patient's hand by one person, after the catheter was replaced, placed the gauze sterile on catheter site for the experimental group [Routine] then every 12 hours considered the place in aspect of phlebitis and infection to 72 hours duration, since phlebitis appearing and or finished 72 hours, the angiocat plastical tip detached from trunck by sterile bisturi and transferred to laboratory tube containing nutritive materials and sent the laboratory during minumm time possible time it was cultured in a culture environment growing 15 colony number on every platelet was considered as positive

Results: 65% of 2 groups are among 61-70 years old 53.1% of both group are illiterate. The majority of both groups [59.4%] had myocardial ischemic heart disease. Catheter situation in the experimental group 53.7% was in the left hand and the control group 63.1% was in the right hand in aspect of type of used drug 44.1% individuals of the 2 groups used 2 drugs heparin and vasodilators. Study's result about phlebitis with [P<0.05] showed that the gauze sterile dressing has effected in preventing of it's appearance, therefore statistical fisher test showed that gauze sterile dressing is not effected in preventing of venous catheter's local infection

Conclusion: the use of the sterile gauze dressing can effect in preventing of phlebitis and colonization