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Pregnancy & H1N1 Facts for Healthcare Workers


July 17, 2013- DMC Harper University Hospital Dialysis Access Center Introduces A Safer, Longer-Lasting Approach to “Vascular Graft” Procedure
Pioneering kidney program becomes one of only ten healthcare centers in the nation to
make less invasive, FDA-approved “Flixene IFG” graft available to kidney dialysis patients.

   
A team of physicians at DMC Harper University Hospital announced yesterday that it has
successfully treated several patients with a new high-tech “vascular graft” that significantly reduces
the risk of trauma to blood vessels used in connecting patients to the kidney dialysis machines that
are essential to protecting their health.

The new vascular graft device – a specially engineered plastic tube that links veins to arteries to form
a “bridge” between them as part of maintaining a safe and long-lasting connection between patient
and kidney dialysis machine – is especially effective because it doesn’t require suturing blood
vessels, as happens in more traditional “venous anastomosis” surgical procedures, according to
kidney specialists at the DMC.

Recently approved by the FDA for use in the United States, the “Flixene IFG” allows the connection
between vein and artery (a key step in creating the “bridge” between patient and dialysis machine) to
be made via the specially engineered plastic tube, thus eliminating the need for sewing the blood
vessels together.

“The good news for kidney patients is that the use of this new vascular tool means it is no longer
necessary to sew the graft into place,” said Yevgeniy Rits, M.D., the vascular surgeon who has
directed the Harper Dialysis Access Center (DAC) since its creation two years ago. “Because there is
less trauma to the blood vessels involved, there is less chance that the graft will fail.”

Until now, the sewn areas of the blood vessels in vascular grafts have often been the areas where
they fail. But because the new Flixene IFG doesn’t require any sutures at all, it seems likely to last
much longer than the sewn grafts of the past.

“At the Harper DAC, we’re encouraged by the fact that we are one of the first kidney care facilities in
the country to make this powerful new tool available to patients.”

The Dialysis Access Center at Harper University Hospital, unique in Michigan, is now helping more
than 600 patients a year to maintain the vascular access required for successful linkage to kidney
dialysis machines.

In the Detroit area, where diabetes-linked Chronic Kidney Disease (CKD) is a major public health
problem, the two-year-old Harper program is saving an ever-increasing number of lives by providing
the tools and specialized care that kidney patients need to maintain safe, healthy access to dialysis
over the long term. With yesterday’s announcement, the program “has gained another very important
tool,” said Dr. Rits.

The problem of creating and then protecting access to dialysis is especially acute in Detroit, where an
estimated more than one-half of Michigan’s current 12,000 kidney dialysis patients now live.
For these urban dialysis recipients – most of whom develop CKD as a result of severe diabetes, also
a major pubic health threat in Detroit – establishing and then protecting a continuing “lifeline” that
permits safe blood-flow between the dialysis machine and the patient’s cardiovascular system is
crucial to a successful outcome.

Because many patients with severe CKD will eventually require a kidney transplant, it’s critically
important for them to maintain their access – via several types of surgical procedures designed to
help create an open pathway in the body between the bloodstream and the dialysis machine – until a
healthy new kidney can be obtained from a donor.

At Harper, the Dialysis Access Center (DAC) brings together a wide array of high-tech medical tools
and clinical specialists who can combine their skills and knowledge to provide custom-tailored,
ongoing care for each individual patient.

“When it comes to providing the best possible care for a kidney patient, the key is being able to
coordinate every aspect of that care at a single location,” said Rits.

“For many CKD patients, good access to the dialysis machine is absolutely essential,” he added.
“Without it, the chances for a long-term successful outcome are greatly reduced. In addition, the
possibility of eventually being able to undergo a successful kidney transplant is much smaller for
those who lose the vital ‘lifeline’ which permits effective dialysis over an extended period of time.”
Because the DAC is the only hospital-based facility of its kind in Michigan, the clinical specialists
there can bring together all the tools they need to “take ownership” of each kidney patient’s “access
lifeline” to dialysis, he said. “The new vascular graft we have just introduced will help us achieve that
goal,” he added, “because it’s a major step forward in protecting access to the kidney machine over
the long term.
“Also, because our program is based at the hospital, we can maintain the complete, detailed history –
including photographs, charts, diagnostics and all the rest – that is essential for monitoring each
patient’s specific care over time.”

“That’s a huge advantage, when it comes to making sure the patient is being monitored and followed
at every stage of dialysis care, all the way through kidney transplant, should that particular therapy be
required.”

The DAC provides a comprehensive team of multidisciplinary experts that includes nephrologists
(kidney specialists), general surgeons, vascular surgeons, interventionists and nurses, all of whom
are dedicated to giving patients complete and safe access to dialysis care.

The DAC also provides continuing cardiovascular care, inpatient and outpatient services, a
hypertension program and kidney transplant services to all kidney patients who require them.
In order to provide the best continuing access to dialysis, the DAC relies on a variety of procedures
designed to establish a permanent connecting-point that will allow patients to link up with a dialysis
machine whenever required.
There are two basic types of access-establishing procedures. One of them, known as a “Fistula
Procedure,” connects a vein (typically located in the patient’s arm) with a nearby artery. This bridge
between the two – permanently maintained beneath the patient’s skin – then provides a safe and
reliable entry point for the needle-fronted line that will carry the patient’s blood through the dialysis
machine, so that it can be cleaned of waste products and then returned to the patient’s own
bloodstream.

The second type of dialysis access is achieved via a tube (or “catheter”) that is inserted into a large
vein in the neck, chest or groin and then connected to the dialysis machine.

Because the catheter approach presents a higher rate of infection, many kidney specialists prefer to
use the Fistula Procedure.

Dr. Rits also noted that the DAC is providing an important public-health benefit in Detroit, where
diabetes-linked kidney disease has long been a chronic health problem.

“I think what’s really significant about our program is that it’s targeted to the thousands of Detroit-area
patients who have an urgent need to maintain safe, healthy access to kidney dialysis,” he said.

“Meeting the needs of that population is extremely important to us at Harper – which is why we’ve
created the only hospital-based program in Michigan designed to help achieve continuing access to
dialysis for patients with kidney disease.”


WHAT IS H1N1 INFLUENZA?
H1N1 influenza is a respiratory disease that is caused by a type A influenza virus. The current H1N1 virus contains unique genes from pig and human influenza viruses and hence is called the “Novel H1N1 Influenza Virus”. This strain of flu germ spreads from human to human and can cause illness.



Does H1N1 INFLUENZA pose special risks for pregnant women?
Pregnant women are at an increased risk of catching H1N1 or seasonal flu. Pregnant patients with H1N1 infection have an increased risk of complications. Although influenza viruses do not infect the baby while in the uterus, the high fever and any complications caused by the flu can potentially be harmful to the baby.



WHAT PRECAUTIONS CAN I TAKE TO PROTECT MYSELF AND MY UNBORN BABY?
The best way to protect yourself and your unborn baby is to have a vaccination (which is safe during pregnancy). You should also make sure you follow good hygiene practices including:

 

  • Wash your hands often with soap and warm water. Alcohol-based gel hand cleaners are also good to use.
  • Try to avoid close contact with sick people.
  • Talk to your doctor about your concerns.

WHAT ARE THE SYMPTOMS OF H1N1 INFLUENZA?
The symptoms of H1N1 flu are similar to the symptoms of seasonal flu and may include acute onset of:

  • Fever (greater than 100 F or 37.8 C)
  • Cough
  • Sore Throat
  • Stuffy nose
  • Chills
  • Headache
  • Fatigue
  • Some people have reported diarrhea and vomiting associated with H1N1 flu.


WILL THE SYMPTOMS BE THE SAME IF I AM PREGNANT?
Yes, the symptoms of flu will be the same as in women who are not pregnant.




WHAT SHOULD I DO IF I GET SICK?
If you get sick with flu-like symptoms, stay home, limit contact with others, and call your doctor as soon as possible.

  • Treat any fever right away. Tylenol® (acetaminophen) is the best treatment of fever in pregnancy.
  • Get plenty of rest and drink clear fluids.
  • Your doctor may test you for flu or will decide if you need medications to treat the flu.
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash and cleanse your hands.
  • Clean hands often with soap and water or alcohol- based hand rub.
  • Do not go to work, school, or other public places while you are ill.
  • Avoid close contact with other people.
  • Get emergency medical care right away if you have trouble breathing, chest pain, purple or blue lips or skin, severe vomiting and are dehydrated and/or dizzy, unresponsive or confused.


IS IT OK TO BREAST FEED MY BABY IF I AM SICK?

  • Do not stop breastfeeding if you are ill. This will help protect your baby from infection.
  • Be careful not to cough or sneeze in the baby’s face, wash your hands often.
  • Your doctor might ask you to wear a mask to keep from spreading this new virus to your baby.
  • If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby.


IS THERE A VACCINE FOR H1N1 INFLUENZA?
Yes, an H1N1 virus vaccine is expected to be available in mid- to late October 2009. The CDC recommends this vaccine for pregnant women when it first becomes available. This vaccine has been tested in pregnant women and found to be safe and effective.


REMEMBER: The seasonal flu vaccine is not expected to protect against the H1N1 flu, therefore individuals are encouraged to get both types of vaccines.

 

 

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