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Admission After Intervention: When and Why

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Abstract

Hospitalization of end-stage renal disease (ESRD) is a major morbidity to the patient and cost to the payer. Forty-eight percent decline has been noted in admissions related to vascular access in 2009 compared to 1994, and the number one reason for hospitalization in ESRD patients now is infection-related admissions. Interventionists are routinely performing these procedures at outpatient vascular access centers providing limiting disruptions in dialysis care. Invasive procedures have associated complications and require that the operator has in-depth knowledge of rescue when required and use inpatient admission if indicated. Procedure sedation analgesia (PSA) plays an integral role in managing invasive procedures and has risks that should be weighed prior to each encounter. Comprehensive intraoperative care and on occasion’s inpatient observation is warranted after a complication is witnessed. This chapter reviews the conditions that warrant the patient to be operated inpatient or placed in observation after the procedure.

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References

  1. USRDS: U S Renal Data System, USRDS 2011 Annual Data Report: atlas of chronic kidney disease and end-stage renal disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda; 2011.

    Google Scholar 

  2. Beathard GA, Litchfield T, Physician Operators Forum of RMS Lifeline, Inc. Effectiveness and safety of dialysis vascular access procedures performed by interventional nephrologists. Kidney Int. 2004;66(4):1622–32.

    Article  PubMed  Google Scholar 

  3. Vachharajani TJ, Moossavi S, Salman L, et al. Dialysis vascular access management by Interventional Nephrology Programs at University Medical Centers in the United States. Semin Dial. 2011;24(5):564–9.

    Article  PubMed  Google Scholar 

  4. Gan TJ. Pharmacokinetic and pharmacodynamic characteristics of medications used for moderate sedation. Clin Pharmacokinet. 2006;45(9):855–69.

    Article  PubMed  CAS  Google Scholar 

  5. Beathard GA, Urbanes A, Litchfield T, Weinstein A. The risk of sedation/analgesia in hemodialysis patients undergoing interventional procedures. Semin Dial. 2011;24(1):97–103.

    Article  PubMed  Google Scholar 

  6. Mace SE. 190: Adverse events of emergency department procedural sedation. Ann Emerg Med. 2006;48(4):59.

    Article  Google Scholar 

  7. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96(4):1004–17.

    Article  Google Scholar 

  8. Holdgate A, Taylor DM, Bell A, et al. Factors associated with failure to successfully complete a procedure during emergency department sedation. Emerg Med Australas. 2011;23(4):474–8.

    Article  PubMed  Google Scholar 

  9. Sacchetti A, Senula G, Strickland J, Dubin R. Procedural sedation in the community emergency department: initial results of the ProSCED registry. Acad Emerg Med. 2007;14(1):41–6.

    Article  PubMed  Google Scholar 

  10. Weaver CS, Terrell KM, Bassett R, et al. ED procedural sedation of elderly patients: is it safe? Am J Emerg Med. 2011;29(5):541–4.

    Article  PubMed  Google Scholar 

  11. Asif A, Yevzlin AS. Arterial stent placement in arteriovenous dialysis access by interventional nephrologists. Semin Dial. 2009;22(5):557–60.

    Article  PubMed  Google Scholar 

  12. Carrillo RG, Garisto JD, Salman L, Merrill D, Asif A. A novel technique for tethered dialysis catheter removal using the laser sheath. Semin Dial. 2009;22(6):688–91.

    Article  PubMed  Google Scholar 

  13. Pervez A, Zaman F, Aslam A, et al. Port catheter placement by nephrologists in an interventional nephrology training program. Semin Dial. 2004;17(1):61–4.

    Article  PubMed  Google Scholar 

  14. Zaman F, Pervez A, Atray NK, Murphy S, Work J, Abreo KD. Fluoroscopy-assisted placement of peritoneal dialysis catheters by nephrologists. Semin Dial. 2005;18(3):247–51.

    Article  PubMed  Google Scholar 

  15. Khajehdehi P, Junaid SMA, Salinas-Madrigal L, Schmitz PG, Bastani B. Percutaneous renal biopsy in the 1990s: safety, value, and implications for early hospital discharge. Am J Kidney Dis. 1999;34(1):92–7.

    Article  PubMed  CAS  Google Scholar 

  16. Manno C, Strippoli GF, Arnesano L, et al. Predictors of bleeding complications in percutaneous ultrasound-guided renal biopsy. Kidney Int. 2004;66(4):1570–7.

    Article  PubMed  Google Scholar 

  17. Marwah DS, Korbet SM. Timing of complications in percutaneous renal biopsy: what is the optimal period of observation? Am J Kidney Dis. 1996;28(1):47–52.

    Article  PubMed  CAS  Google Scholar 

  18. Kim D, Kim H, Shin G, et al. A randomized, prospective, comparative study of manual and automated renal biopsies. Am J Kidney Dis. 1998;32(3):426–31.

    Article  PubMed  CAS  Google Scholar 

  19. Vesely TM, Beathard G, Ash S, Hoggard J, Schon D, ACPC: Classification of complications associated with hemodialysis vascular access procedures. A position statement from the American Society of Diagnostic and Interventional Nephrology. Semin Dial. 2007;20(4):359–64.

    Article  PubMed  Google Scholar 

  20. Asif A, Salman L, Carrillo RG, et al. Patency rates for angioplasty in the treatment of pacemaker-induced central venous stenosis in hemodialysis patients: results of a multi-center study. Semin Dial. 2009;22(6):671–6.

    Article  PubMed  Google Scholar 

  21. Lifeline Access 2011 Outcomes Report, LifelineAcess.com, Three Hawthorn Parkway, Suite 410; Vernon Hills 60061.

    Google Scholar 

  22. Schinstock CA, Albright RC, Williams AW, et al. Outcomes of arteriovenous fistula creation after the fistula first initiative. Clin J Am Soc Nephrol. 2011;6(8):1996–2002.

    Article  PubMed  Google Scholar 

  23. Allon M. Dialysis catheter-related bacteremia: treatment and prophylaxis. Am J Kidney Dis. 2004;44(5):779–91.

    PubMed  Google Scholar 

  24. Lee T, Barker J, Allon M. Tunneled catheters in hemodialysis patients: reasons and subsequent outcomes. Am J Kidney Dis. 2005;46(3):501–8.

    Article  PubMed  Google Scholar 

  25. Beathard GA, Urbanes A. Infection associated with tunneled hemodialysis catheters. Semin Dial. 2008;21(6):528–38.

    Article  PubMed  Google Scholar 

  26. Sharma M, Sachdeva B. Percutaneous peritoneal dialysis catheter insertion: making a case for an outpatient procedure. J Invest Med. 2012;60(1):1.

    Google Scholar 

  27. Maya ID. Ambulatory setting for peritoneal dialysis catheter placement. Semin Dial. 2008;21(5):457–8.

    Article  PubMed  Google Scholar 

  28. Alvarez AC, Salman L. Peritoneal dialysis catheter insertion by interventional nephrologists. Adv Chronic Kidney Dis. 2009;16(5):378–85.

    Article  PubMed  Google Scholar 

  29. Li PK, Szeto CC, Piraino B, et al. Peritoneal dialysis-related infections recommendations: 2010 update. Perit Dial Int. 2010;30(4):393–423.

    Article  PubMed  Google Scholar 

  30. Leon C, Asif A. Arteriovenous access and hand pain: the distal hypoperfusion ischemic syndrome. Clin J Am Soc Nephrol. 2007;2(1):175–83.

    Article  PubMed  Google Scholar 

  31. Yevzlin AS, Schoenkerman AB, Gimelli G, Asif A. Arterial interventions in arteriovenous access and chronic kidney disease: a role for interventional nephrologists. Semin Dial. 2009;22(5):545–56.

    Article  PubMed  Google Scholar 

  32. Pinard EA, Fazal S, Schussler JM. Catastrophic paradoxical embolus after hemodialysis access thrombectomy in a patient with a patent foramen ovale. Int Urol Nephrol. 2012;45(4):1215–7.

    Article  PubMed  Google Scholar 

  33. Kar S, Webel R. Septic thrombophlebitis: percutaneous mechanical thrombectomy and thrombolytic therapies. Am J Ther. 2011.

    Google Scholar 

  34. Mufarrij AJ, Hitti E. A case of phlegmesia cerulea dolens after dialysis catheter insertion. Emerg Med Australas. 2011;23(5):644–6.

    Article  PubMed  Google Scholar 

  35. Hershberger R, Bornak A, Aulivola B, Mannava K. Acute pancreatitis after percutaneous mechanical thrombectomy: case report and review of the literature. Cardiovasc Intervent Radiol. 2011;34 Suppl 2:S25–30.

    Article  PubMed  Google Scholar 

  36. Rabinstein A, Wijdicks E. Fatal brain swelling due to superior vena cava syndrome. Neurocrit Care. 2009;10(1):91–2.

    Article  PubMed  Google Scholar 

  37. Küçükarslan N, Yilmaz M, Us M, Arslan Y, Güler A, Yilmaz A. Superior vena cava syndrome caused by dialysis catheter. Ulus Travma Acil Cerrahi Derg. 2007;13(1):63–6.

    PubMed  Google Scholar 

  38. Sequeira A, Sachdeva B, Abreo K. Uncommon complications of long-term hemodialysis catheters: adhesion, migration, and perforation by the catheter tip. Semin Dial. 2010;23(1):100–4.

    Article  PubMed  Google Scholar 

  39. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603–10.

    Article  PubMed  Google Scholar 

  40. Sacks D, McClenny T, Cardella J, Lewis C. Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14(9 Pt 2):S199–202.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Nephrology Section, Department of Medicine, LSU Health Sciences Center, Shreveport, LA, 71106, USA

    Bharat Sachdeva MD

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  1. Bharat Sachdeva MD
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Correspondence to Bharat Sachdeva MD .

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Editors and Affiliations

  1. Department of Medicine (CHS), Division of Nephrology, Madison, Wisconsin, USA

    Alexander S. Yevzlin

  2. Medicine, Nephrology and Hypertension, Albany Medical College, Albany, New York, USA

    Arif Asif

  3. Interventional Nephrology Nephrology and Hypertension, University of Miami Miller School of Med, Miami, Florida, USA

    Loay Salman

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Sachdeva, B. (2014). Admission After Intervention: When and Why. In: Yevzlin, A., Asif, A., Salman, L. (eds) Interventional Nephrology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8803-3_3

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  • DOI: https://doi.org/10.1007/978-1-4614-8803-3_3

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8802-6

  • Online ISBN: 978-1-4614-8803-3

  • eBook Packages: MedicineMedicine (R0)

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