Physiological Principles of Hemodialysis - Solve The Crosswords

Views:
 
Category: Others/ Misc
     
 

Presentation Description

To download the lecture please contact me on drgawad@gmail.com //// visit www.NephroTubeCNE.com for more educational Nephrology lectures

Comments

By: fedail (28 month(s) ago)

great work Dr Mohammed . can i have acopy from the TTP presentation sanosii46@gmail.com

Presentation Transcript

Physiological Principles of Hemodialysis Solve the Crosswords:

Physiological Principles of Hemodialysis Solve the Crosswords Mohammed Abdel Gawad Nephrology Specialist Kidney & Urology Center (KUC) Alexandria – EGY drgawad@gmail.com 12 th KUC Club – March 2015

To download the powerpoint with full animations please contact me on email drgawad@gmail.com:

To download the powerpoint with full animations please contact me on email drgawad@gmail.com Visit www. N ephro T ube CNE .com for more lectures

Slide3:

Solve the Crosswords

Talk Outline:

Talk Outline Diffusion – Convection Concept Concept of Clearance

Slide8:

=

Slide9:

Dialysis Solute composition of a solution A (Blood), is altered by exposing solution A to a second solution B (Dialysate) , through a semipermeable membrane (Filter - Dialyzer) Dialyzer A B

Slide10:

Dialyzer

Slide11:

Dialysis Solute composition of a solution A (Blood), is altered by exposing solution A to a second solution B (Dialysate) , through a semipermeable membrane (Filter - Dialyzer) Dialyzer A B B A Dialyzer

Slide12:

Dialysis Solute composition of a solution A (Blood), is altered by exposing solution A to a second solution B (Dialysate) , through a semipermeable membrane (Filter - Dialyzer) B A Dialyzer Water molecules and LMW solutes in the two solutions can pass through the membrane pores L arger solutes (such as proteins) cannot pass through the semipermeable barrier

Slide13:

Dialysis Solute composition of a solution A (Blood), is altered by exposing solution A to a second solution B (Dialysate) , through a semipermeable membrane (Filter - Dialyzer) B A Dialyzer Water molecules and LMW solutes in the two solutions can pass through the membrane pores L arger solutes (such as proteins) cannot pass through the semipermeable barrier Diffusion Ultra-Filtration (Convection) Hydrostatic Osmotic

Slide14:

Blood Dialyzate

Diffusion:

Diffusion Blood Dialyzate M ovement of solutes from a compartment in which they are in high concentration to one in which they are in lower concentration The larger the MW of a solute, the slower the diffusion

Slide16:

Large solutes can’t pass

Slide17:

Dialysis Solution consists of sodium , potassium, calcium, magnesium, chloride, bicarbonate , and dextrose added to highly purified water

Water Treatment Unit:

Water Treatment Unit Dialysis Solution consists of sodium , potassium, calcium, magnesium, chloride, bicarbonate , and dextrose added to highly purified water

Slide19:

Blood Dialyzate

Ultrafiltration (Convection) Hydrostatic UF:

Ultrafiltration (Convection ) Hydrostatic UF Blood Dialyzate S olutes are swept through the membrane pores along with the water (a process called “ solvent drag ”) in response to a transmembrane pressure gradient . Water + Solute (Solvent Drag)

Ultrafiltration (Convection) Hydrostatic UF:

Transmembrane (Hydrostatic) Pressure Hydrostatic pressure gradient between the blood and dialysate compartments Ultrafiltration (Convection ) Hydrostatic UF

Ultrafiltration (Convection) Hydrostatic UF:

Ultrafiltration (Convection ) Hydrostatic UF

Ultrafiltration Coefficient (KUF):

Ultrafiltration Coefficient ( K UF ) Number of milliliters of fluid per hour that will be transferred across the membrane per mmHg pressure gradient across the membrane 1 mmHg 0 mmHg 1 Hour ?? ml of water K UF Vary and is a function of membrane thickness and pore size

Ultrafiltration Coefficient (KUF):

Ultrafiltration Coefficient ( K UF)

Slide25:

Blood Dialyzate

Ultrafiltration (Convection) Osmotic UF:

Ultrafiltration (Convection ) Osmotic UF

Slide27:

Blood Dialyzate Different types of Dialysis

Slide28:

Hemodialysis Hemofiltration Diffusion (mainly) + Convection (ultrafiltration) removing water accumulated during the interdialytic period Convection (ultrafiltration) large amount of ultrafiltration + higher removal of larger, poorly diffusible solutes CRRT: CVVHD CRRT: CVVHF

Slide29:

Hemodialysis Hemofiltration Diffusion (mainly) + Convection (ultrafiltration) removing water accumulated during the interdialytic period Convection (ultrafiltration) large amount of ultrafiltration + higher removal of larger, poorly diffusible solutes Hemo dia filtration Diffusion (HD) + High Convection (ultrafiltration) (HF) CRRT: CVVHD CRRT: CVVHF

Slide30:

Hemo dia filtration Diffusion (HD) + High Convection (ultrafiltration) (HF) CRRT: CVVHDF If ultrapure dialysate produced by the dialysis machine as replacement fluid Online HDF (OL HDF )

Slide31:

CRRT: SCUF Hemofiltration, CRRT: CVVHF

CRRT:

CRRT

Talk Outline:

Talk Outline Diffusion – Convection Concept Concept of Clearance

Extraction ratio:

Extraction ratio The extraction ratio is the percentage reduction of urea (or any other solute) across the dialyzer

Extraction Ratio Effect of Erythrocytes:

Extraction Ratio Effect of Erythrocytes Plasma RBC U U U U U U Dialysis Machine Plasma RBC U U Urea equilibrate quickly Increased Ht % will minimally or not affect Urea ER C C C C C C C C Cr and Phosphate equilibrate slowly Increased Ht % decreases ER

Extraction Ratio Effect of Blood Flow Rate (Qb):

Extraction Ratio Effect of Blood Flow Rate (Qb) Low flow, More time to be cleaned Per one Cycle Flow rate over time length of HD session is more important

Dialyzer Clearance is “KD”:

Dialyzer Clearance is “ K D” The extraction ratio for molecules larger than urea will be less than that of urea

Dialyzer Clearance is “KD”:

Dialyzer Clearance is “ K D”

Dialyzer Clearance is “KD”:

Dialyzer Clearance is “ K D” At very high Qb, the clearance will plateau → theoretical maximum clearance of a dialyzer at infinite blood and dialysate flow rates ( ) Removal efficiency falls at higher Qb, and so the clearance does not increase with Q B in a 1:1 ratio

Mass Transfer Area Coefficient “ ” :

Mass T ransfer A rea C oefficient “ ” The theoretical maximum clearance of a dialyzer (for a given solute) at infinite blood and dialysate flow rates ( mL/min) the permeability coefficient of the dialyzer membrane for a given solute the total effective surface area of the membrane in the dialyzer I ncreased by making the membrane thinner, by adjusting its porosity & other factors

Mass Transfer Area Coefficient “ ” :

Mass Transfer Area Coefficient “ ” when Q B is low (~200 mL/min), dialyzers in the 800–1,600mL/min K 0 A range have ~ similar clearances

Slide42:

Dialyzer efficiency T he ability of a dialyzer to remove small solutes. R epresented by K 0 A for urea Dialyzer flux The ability of a dialyzer to remove very large molecules such as β2 - microglobulin

Slide43:

Dialyzer flux The ability of a dialyzer to remove very large molecules such as β2 - microglobulin W ater permeability ( K UF ) is used to specify the flux H igh-flux dialyzers will have a water permeability > 15–20 mL/ hr / mm Hg

Slide44:

Dialyzer flux The ability of a dialyzer to remove very large molecules such as β2 - microglobulin

Slide45:

Dialyzer flux The ability of a dialyzer to remove very large molecules such as β2 - microglobulin

Slide46:

Adsorption

Concept of Clearance:

Concept of Clearance Dialyzer Flux

Slide48:

Solve the Crosswords 1 A method of RRT that uses diffusion parallel with high volume of ultrafiltration as a main mechanism for solute transport with a replacement fluid 2 Approved filter by FDA to treat dialysis related amyloidosis 3 A method of RRT that uses diffusion as a main mechanism for solute transport 5 Movement of solutes from a compartment in which they are in high concentration to another compartment in which they are in lower concentration 7 The ability of a dialyzer to remove large sized molecules and it is specified by water flux 9 Qb X Extraction ratio 10 A method of RRT that uses convection as a main mechanism for solute transport with a replacement fluid 8 A mechanism by which solutes are swept through the membrane pores along with the water in response to a transmembrane pressure gradient or osmotic pressure 11 Molecule that its extraction ration is affected by changes in Ht % level 12 The percentage reduction of urea (or any other solute) across the dialyzer 17 The ability of a dialyzer to remove small solutes, represented by K0A for solute 18 Modality of CCRT that uses convection as a main mechanism for solute transport without replacement fluid (abbreviation) 4 Molecule that its extraction ration is slightly or not affected at all by changes in Ht % level 6 Movement of water from area of solute low concentration gradient to an area of higher concentration gradient of the same solute 13 The pressure in the blood compartment minus the pressure in the dialysate compartment (abbreviation) 14 A method of RRT that uses diffusion parallel with high volume of ultrafiltration as a main mechanism for solute transport with an ultrapure dialysate produced by the dialysis machine as replacement fluid (abbreviation) 15 The theoretical maximum clearance of a dialyzer (for a given solute) at infinite blood and dialysate flow rates (mL/min) (abbreviation) 16 Number of milliliters of fluid per hour that will be transferred across the membrane per mmHg pressure gradient across the membrane (abbreviation)

www.NephroTubeCNE.com:

www. N e phro T ube CNE .com

To download the powerpoint with full animations please contact me on email drgawad@gmail.com:

To download the powerpoint with full animations please contact me on email drgawad@gmail.com Visit www. N ephro T ube CNE .com for more lectures

Slide51:

Gawad Thank You

authorStream Live Help