Assessment of dry weight by monitoring changes in blood volume during hemodialysis using Crit-Line.

BACKGROUND: Routine assessment of dry weight in chronic hemodialysis patients relies primarily on clinical evaluation of patient fluid status. We evaluated whether measurement of postdialytic vascular refill could assist in the assessment of dry weight. METHODS: Twenty-eight chronic, stable hemodialysis patients were studied during routine treatment sessions using constant dialysate temperature and dialysate sodium concentration, and relative changes in blood volume were monitored using Crit-Line III monitors throughout this study. The study was divided into three phases. Phase 1 studies evaluated the time-dependence of vascular compartment refill after completion of hemodialysis. Phase 2 studies evaluated the relationships in patient subgroups between intradialytic changes in blood volume and the presence of postdialytic vascular compartment refill during that last 10 minutes of hemodialysis after stopping ultrafiltration. Phase 3 studies evaluated the extent of dry weight changes following the application of a protocol for blood volume reduction, postdialytic vascular compartment refill, and correlation with clinical evidence of intradialytic hypovolemia and/or postdialytic fatigue. Phase 3 included anywhere from three to five treatments. RESULTS: Phase 1 studies demonstrated that despite interpatient variability in the magnitude of postdialytic vascular compartment refill, when significant refill was evident, it always continued for at least 30 minutes. However, the majority of refill took place within 10 minutes postdialysis. Phase 2 studies identified 3 groups of patients: those who exhibited intradialytic reductions in blood volume but not postdialytic vascular compartment refill (group 1), those who exhibited intradialytic reductions in blood volume and postdialytic vascular compartment refill (group 2), and those whose blood volume did not change substantially during hemodialysis treatment (group 3). In phase 3 studies, use of an ultrafiltration protocol for blood volume reduction and monitoring of postdialytic vascular compartment refill combined with clinical assessment of hypovolemia and postdialytic fatigue demonstrated that patients often had a clinical dry weight assessment which was too low or too high. In all 28 patients studied, dry weight was either increased or decreased following use of this protocol. CONCLUSION: Determination of the extent of both intradialytic decreases in blood volume and postdialytic vascular compartment refill, combined with clinical assessment of intradialytic hypovolemia and postdialytic fatigue, can help assess patient dry weight and optimize volume status while reducing dialysis associated morbidity. The number of hospital admissions due to fluid overload may be reduced.

Masonry response to tunnelling: a sensitivity study on the effect of cracking and building weight

Predicting damage to masonry structures due to tunnelling-induced ground movements remains a challenge for practising design engineers. Useful simplified procedures exist, but more detailed analysis has the potential to improve these procedures. This paper considers the use of finite element modelling, including non-linear constitutive laws for the soil and the structure, to simulate damage to a simple masonry structure subjected to tunnelling in sand. The numerical model is validated through comparison with the results of a series of centrifuge tests and used to perform a sensitivity study on the effect of building weight and masonry damage on the structural response. Results show a direct correlation between the weight of the structure, normalised to the relative stiffness between the structure and the soil, and the modification of the settlement profile. By including a cracking model for the masonry, the reduction in structural stiffness caused by progressive masonry damage is also proven to affect the building deflection.

Comparison of relative flexoelectric coefficients measured by different techniques

While it is well known that it is possible to determine the effective flexoelectric coefficient of nematic liquid crystals using hybrid cells [1], this technique can be difficult due to the necessity of using a D.C. field. We have used a second method[2], requiring an A.C. field, to determine this parameter and here we compare the two techniques. The A.C. method employs the linear flexoelectrically induced linear electro-optic switching mechanism observed in chiral nematics. In order to use this second technique a chiral nematic phase is induced in an achiral nematic by the addition of a small amount of chiral additive (∼3% concentration w/w) to give helix pitch lengths of typically 0.5-1.0 μm. We note that the two methods can be used interchangeably, since they produce similar results, and we conclude with a discussion of their relative merits.

Comparison between weight loss of bends in a pneumatic conveyor and erosion rate obtained in a centrifugal erosion tester for the same materials

In order to find a link between results obtained from a laboratory erosion tester and tests carried out on a pneumatic conveyor, a comparison has been made between weight loss from bends on an industrial-scale pneumatic conveyor and erosion rates obtained in a small centrifugal erosion tester, for the same materials. Identical test conditions have been applied to both experiments so that comparable test results have been obtained. The erosion rate of mild steel commonly used as the wall material of conveyor pipes and pipe bends was determined individually on both test rigs. A relationship between weight loss from the bends and erosion rate determined from the tester has been developed. A discussion based on the results and their applicability to the prediction of wear in pneumatic conveyors concludes the paper. © 2004 Elsevier B.V. All rights reserved.

Assessing the relative road damaging potential of HGVs

Assessing the road damaging potential of heavy vehicles is becoming an increasingly important issue. In this paper, current vehicle regulations and possible future alternatives are reviewed, and are categorized as tests on individual axles and whole vehicles, and 'direct' and 'indirect' tests. Whole vehicle methods of assessing road damaging potential accurately are then discussed. Direct methods are investigated (focussing on using a force measuring mat), and drawbacks are highlighted. Indirect methods using a transient input applied to individual axles are then examined. Results indicate that if non-linearities are accounted for properly, indirect methods of assessing whole vehicle road damaging potential could offer the required accuracy for a possible future test procedure.