#ecuimres transcript

Healthcare Social Media Transcript

From: Fri Jan 25 5:00:00 PST 2013
To: Fri Jan 25 7:15:00 PST 2013

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


Healthcare Conference  - Healthcare Tweet Chats  -  Healthcare Analytics

ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Dr Lai presents "Peritoneal Dialysis for the Internist"
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds #peritoneal #Dialysis First reviewing some quiz ques: The number of incident PD pts has increased since 1980s. FALSE
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds #peritoneal #Dialysis Medium for dialysis is capillary to peritoneal space (in HD: blood to dialysate)
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Dr Lai reviewing anatomy of #peritoneal space
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds 2 goals in #peritoneal #dialysis = solute removal (clearance) and fluid removal (ultrafiltration)
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Dialysis in #peritoneal #dialysis is typically dextrose-based which has much higher osmolality (providing gradient)
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Different modalities for #peritoneal #Dialysis include NIPD, CCPD, CAPD
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds NIPD: nightly intermittent #peritoneal #Dialysis good for "rapid transporters"
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds CCPD= continuous cycling #peritoneal #Dialysis
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds CCPD may be a good option for elderly or SNF pt who is unable to manage their own #dialysis
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Reviewing literature comparing #peritoneal #Dialysis outcomes vs #hemodialysis outcomes
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Overall review statement: #peritoneal #Dialysis is a good option for younger, non-diabetic, mobile patients.
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Test! Which modality of #dialysis is most suitable:
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds 45 yo Hispanic math professor with ESRD 2/2 diabetes, HTN and eGFR 7ml/min = PD or HD
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds 12 yo male with post urethral valves and failing renal transplant = PD (used as a bridge to transplant)
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres 74 yo rural farmer w/ #renal failure from vasculitis, independent, still makes urine = PD (bc miles from center, independent)
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Anephric 42 yo F smoker w/ severe PVD now s/p b/l nephrectomy 2/2 renal cell ca = PD (bc would be difficult access)
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Summary: no good RCTs comparing PD to HD; PD survival best in the first 2 yrs (better than HD) but declines w/ time
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Troubleshooting #peritoneal #Dialysis problems: Cuff extrusion (may be secondary to tunnel infection +- abscess)
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Diagnosing #peritonitis in PD pts: signs/symptoms of peritoneal inflamm, cloudy fluid with >100 WBC and >50% neuts
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Common causative organisms: S Epi, S Aureus, Strep, Klebsiella, Pseudomonas
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Initial management for #peritonitis : fluid for analysis and cx, rapid 1L flushes until fluid clears
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Can also use heparin to break up fibrin clots
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Differential for "milky" #peritoneal fluid: Chloe's leak, hypertriglyceridemia.
ecuimchiefs
https://pbs.twimg.com/profile_images/3588499938/a235cf550dcbe6c959316431615eea5b_normal.png
#ecuimres #grandrounds Case: 50 yo pt comes into ED w/ SOB during dialysis, worse when supine =pleuroperitoneal leak (So stop dialysis!)

Content from Twitter