Title: Kidney Disease
Perioperative fluid therapy management is a very difficult process. Perioperative morbidity is associated with the amount of intravenous fluid delivered and consequent postoperative complications. Not only fluid, its component and hemodynamic parameters also play important role. Studies have shown that combining fluid therapy with the goal of hemodynamic stabilization can minimize postoperative complications. Perioperative hypovolemia leads to organ dysfunction, since adaptive mechanisms cause peripheral vasoconstriction to maintain blood flow to the vital organs. Anesthetized patients often present with a functional intravascular volume deficit depending on many factors. Fluid management is a key topic for achieving advanced recovery after surgery. It is important to plan a tailor-cut fluid resuscitation for the patient perioperatively avoiding postoperative complications.
Baris Canaya is an Anesthesiologist at Marmara University Pendik Training Hospital in Istanbul, Turkey. He has deep interest for resuscitation, acute critical illness, trauma anesthesia, pediatric congenital cardiovascular anesthesia and perioperative patient safety.
Title: Kidney Transplantation and Robotic Surgery
Title: Paediatric Nephrology
Title: Diabetic Nephropathy
Aim: Permcath. Is a known vascular acess for haemodialysis patients, which may last for 2 years or more.it is a 1st line for hemodialysis for patients who were not prepaired by AVF few months before starting dialysis ,but in Egypt most of patients start dialysis with temporarily catheters (cheap)but causes stricture or occlusion of the used central vein. Method: We studied 146 patients who were submitted for permcath. Insertion in our hospital as regard:the vein used-cause of insertion –failure of insertion or using it in dialysis and longevity. Result: The results were as following: *64 (rt, int. jugular) 1- 16 were 1st prick 2-26 were waiting for maturity of AVF 3-20 due to cardiac causes 4-02 due to failed multiple AVF *30(rt. Subclavian) 1-09 were waiting for maturity of AVF 2-11 due to cardiac cuses 3-10 due to failed multiple AVF *15(left jugular) all has thromosed rt. Int. jugular 1- 06 were waiting for maturity of delayed AVF 2- 09 due to failure of multiple AVF *07(left subclavian) all were due failure of multiple AVF *30(femoral vein ) all of them has no available vascular access and 12 of them had cardiac causes Conclusion: From this study we found that most patients who were referred for permcath .insertion had a history of single or multiple temporarily catheter insertion that caused single or multiple central vein occlusion Suggestion: we recommend to use permcath. As a first prick in patients who are not prepared by AVF and avoid using temporarily catheters to save veins of patients, because the use of temporarily catheters causes stricture or occlusion of central veins
Hany Helmy Saad Attia has completed his Master degree in Internal Medicine and a Master Degree in Nephrology From Ain Shams University in Egypt. He is currently working as the Head of Nephrology at the department of Shobra General Hospital