Abstract The rapidly expanding realm of extracorporeal circulation has created a veritable kaleidoscope of new theory and practice within the scope of modern medicine. Competent surgeons, suddenly confronted with the need to apply a new technique with little precedent, experience a sensation of frustration. The problem is compounded by differences of opinion and incomplete descriptions of methods. It is the purpose of this paper to discuss the surgical techniques involved in artificial hemodialysis and indicate a preference for modified venovenous exchange based on experiences with six dialyses in three patients. To understand the technical problems involved in linking a patient to an artificial kidney three questions must be answered: 1. What volume of blood must traverse the dialyzing circuit per unit of time? 2. What expendable vessels are available that will satisfy these requirements? 3. What are the causes of technical failure and how are these avoided? With the answers to References 1. This complication was observed in a case in which dialysis repeated over several weeks was unavailing and the patient died. This is not reported here as it was not a personal case. 2. In 10 cc. of saline 1 mg. of heparin is adequate. However, the patient must be heparinized anyway (2-3 mg/kg. of body weight, so the amount may be quite variable). 3. Kolff, W. J.: Directions for Using the Kolff Disposable Artificial Kidney: A Manual, Germantown Hospital, November 1957.
Archives of Surgery – American Medical Association
Published: Jul 1, 1960
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