Lindsay RM, Bradfield, E, Rothera C, Kianfer C, Malek P,
Blake PG
A comparison of methods for the measurement of access
recirculation and access flow
43rd Annual ASAIO Conference, Atlanta
ASAIO J
(Apr) 43:70 1997
This is a straightforward comparison of three devices with regard to
their ability to reproducibly measure access recirculation and access
blood flow. The systems from Transonic (ultrasound) and Cobe (magnetic
measurement of conductivity--a newcomer) seem to be about equal in
ability, but the In-Line Diagnostics Crit-Line (hematocrit dilution)
would appear to be an unsatisfactory tool for these measurements.
Some of the statistics and terminology leave a bit to be desired, and there
is no "gold standard" by which to judge the accuracy of the devices, but
one thing is clear: if what is reported here as "normalized SD" (without
mention of normalization to what) is the coefficient of variation (CV),
then the reproducibility of the Crit-Line measurements was horrible,
with CV values of 17.4 and 25.2%. The Crit-Line is also reported to
"over-read" blood flow and "under-read" recirculation, although without
any indication of by how much. The lesson seems to be that hematocrit
dilution may not be the way monitor access function.
(Robert H. Barth, M.D., VA Medical Center, Brooklyn, NY)
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43rd Annual ASAIO Conference, Atlanta
Basic hemodialysis :
Vascular Access: graft/fistula