#ecuimres transcript

Healthcare Social Media Transcript

From: Thu Jan 03 8:30:00 PST 2013
To: Thu Jan 03 12:05:00 PST 2013

What is #ecuimres? Who were the influencers during this time period? #ecuimres analytics


Healthcare Conference  - Healthcare Tweet Chats  -  Healthcare Analytics

nephondemand
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#ecuimres #renal #grandrounds: Optimizing Peritoneal Dialysis Practice in Current Healthcare Setting by J Bargman; live tweets @ 12:30 EST
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: will focus on urgent start pd, adequacy of pd, and reducing peritonitis
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: urgent start pts r pretty much the same @ every institution
nephondemand
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#ecuimres #renal #grandrounds: USRDS 2011 data: most #dialysis starts r w/a catheter (not PD catheter), even those seen by a #nephrologist
nephondemand
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#ecuimres #renal #grandrounds: urgent start PD is needed b/c many pts r reluctant to change 2 a home morality once socialized 2 hemo unit
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: #nephrologists still can place a PD catheter at the BEDSIDE using a peritoneoscope
nephondemand
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#ecuimres #renal #grandrounds: urgent start PD c-indicated 4 pts with recent abdominal surgery, hyperK, pulm edema b/c pd cath may not work
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: @NJ2821 explains that supine PD is used 4 acute starts 2 decr IABP & help w/ wound healing
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: Ghaffari AJKD 2012: urgent start PD pts had lower risk of peritonitis than non urgent starts
nj2821
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#ecuimres incidence of minor leaks more with urgent start PD - rate of infection similar to non urgent PD
nephondemand
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#ecuimres #grandrounds urgent PD prescription is totally flexible: any prescription will work; use small volumes, supine posture w/cycler
nephondemand
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#ecuimres #renal #grandrounds: Rioux CJASN 2011: a dedicated RN 4 acute start PD pts can increase number of pts choosing PD than incenter HD
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: Bargman's division will b implementing bedside PD catheter insertion starting Jan 2013;
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: biggest home limitation is the ability to store ~2 weeks of PD fluid in the home
nephondemand
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#ecuimres #grandrounds: 4 pts on PD who just received a #transplant but have DGF, PD can be done if surgery didn't compromise peritoneum
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: urea is historically the marker 4 adequacy but it is only one of many molecules that cause uremia
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: NEJM 1981:1176 looked @ TAC BUN and dialysis time in a 2x2 factorial design
nj2821
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#ecuimres prepare ahead for PD to allow better healing after PD catheter insertion if patient on steroids eg failing renal transplant
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: NEJM 1981:1176 longest time w/lowest TAC BUN had the least hospitalization rate but time had a p 0.06
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: NEJM 1981:1176 b/c of this study adequacy focused on just BUN & not on time (incorrectly)
nephondemand
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#ecuimres #grandrounds: CANUSA study: RR of death if kT/V increases is 1.00; thus increasing peritoneal kT/V makes no difference in survival
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: ADEMEX: higher kT/v vs lower kT/v: RR 1.00; there is no justification 4 kT/v (urea) targets in PD
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: weekly combined kT/v urea 1.7 is ARBITRAILY chosen; preservation of RRF statistically more important
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: Vanholder KI 2003 lists > 5000 uremic toxins -- Bargman suggests stopping our obsession w/ kT/V urea
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: RRF is very important in PD pts -- hence urgent PD starts is important
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: data show that ACE & ARBs slow GFR decline
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: best way to prevent peritonitis = pt training; new biocompatible solns offer mix results
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: when should u retrain a pt 4 PD? About any time is good!
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: anti fungal ppx decr fungal peritonitis (nystatin swallow) in pts receiving Abx - Restrepo PDI 2010
nephondemand
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#ecuimres #renal #grandrounds 1/3/13: prescribe nystatin PO during duration of ABX + 1 week later
iamdoctord
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RT @nephondemand: #ecuimres #renal #grandrounds 1/3/13: RRF is very important in PD pts -- hence urgent PD starts is important

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