Investigation And Analysis Of Hemodialysis Blood Tubing Vein Pot Particle Formation And Related Factors

Objectives:To investigate the spontaneous formation of adherent particles in the vein pot of blood tubing during routine in-center hemodialysis treatments and analyze its potential influencing factors.Methods:The composition of the particles was determined by chemical experiments and scanning electron microscopy.From January to February in 2016,92 outpatients in the Hemodialysis Center of Shengzhou People's Hospital in Zhejiang Province were interviewed with informed consent.A literature review was conducted to collect data including demographic,medical history and dialysis treatment.34 variables.Thirty-four patients in the venous jugs were observed to have particulate matter during the observation period(the particles were present in the vena cava after each hemodialysis period during the observation period)and the pelvic veins remained in the vena cava jar(the patients were observed every time during the observation period Twenty patients with no particles in the venous jug after hemodialysis were classified as non-particu-lar,and the remaining 38 patients with or without particulate matter were not included in the test range.Using the single factor analysis in statistics,the relevant factors of particulate matter formation were obtained.Univariate logistic regression analysis was used to analyze the factors of univariate analysis(P<0.05)by logistic regression equation.Supplementary experiments will be low molecular weight heparin sodium injection method from the arterial end of the arterial blood into the machine before the vascular access venous injection,re-observation of the particles.In the supplementary investigation,105 questionnaires were administered to 105 hemodialysis centers nationwide through questionnaires.Results:We compared the baseline demographics between the particulate and nonpollutant groups and there were no significant differences in age,diabetes,or dialysis prescription characteristics between the two groups.(See Table 3.1).Over a 4-wk interval,63%(34 of 54)of the chronic hemodialysis patients unexpectedly developed a white precipitate adhering to the vein pot of their dialysis blood tubing,with 377 of 586 chronic dialysis treatments exhibiting the phenomenon.Microscopic and biochemical analyses were consistent with white thrombus,formed by an aggregation of platelets and fibrin and rare embedded red blood cells.There were significant differences in gender,smoking,dry weight,low molecular weight heparin sodium,high sensitivity C-reactive protein(hsCRP),venous pressure,dialysate temperature,thrombosis and granulocyte formation in the vascular pathway by single factor analysis(P<0.05).Univariate logistic regression analysis was used to analyze the factors of univariate analysis(P<0.05)by logistic regression equation.The results showed that low molecular weight heparin(OR= 1.001,P<0.01)had significant statistically significant positive correlation.The low molecular weight heparin injection method from the machine after the end of the arterial blood artery into the front of the vascular access to the venous injection,can reduce the white thrombosis.The supplementary questionnaire survey showed that 105 hemodialysis centers(1.9%in primary hospitals,69.52%in secondary hospitals and 28.57%in tertiary hospitals)participated in the survey,and whether hemodialysis was observed after completion of hemodialysis Tube venom filter at the issue of particulate matter,and occasionally see accounted for 74.29%,often see accounted for 10.48%,did not see accounted for 8.57%,did not pay attention to 6.67%.Conclusions:On the hemodialysis blood vessels of the venous pot analysis of particles obtained by the activation of platelets and fibrin aggregates formed,and embedded in a small amount of red blood cells.In univariate analysis,eight factors were statistically significant,male,smoking,vascular thrombosis,dry weight,low molecular weight heparin,hsCRP,venous pressure,and dialysate temperature.Eight factors were analyzed by multivariate unconditional logistic regression analysis.Only low molecular weight heparin sodium entered the equation,indicating that low molecular weight heparin sodium had significant statistical significance.The injection of low molecular weight heparin from the arterial side of the arterial blood into the machine before the end of the vascular access venous injection,may reduce the white thrombosis production.