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Dialysis, Percutaneous Tracheostomies,Chest Drain Insertions and Fibre-Optic Bronchoscopies in Hebbal, Bangalore

Dialysis, Percutaneous Tracheostomies, Chest Drain Insertions and Fibre-Optic Bronchoscopies

Dialysis, Percutaneous Tracheostomies,Chest Drain Insertions and Fibre-Optic Bronchoscopies in Hebbal, Bangalore

Dialysis

Dialysis treatment in Hebbal,Bangalore performs some of the functions of healthy kidneys. It is done when kidneys are not working to fulfill the requirements of the body.  

Dialysis is required at the time of end stage kidney failure, generally when the body loses approximately 85 - 90 % of the kidney function.

Dialysis maintains body balance by doing the following,

  • Removal of excess water, salt, and waste to prevent their buildup in the body

  • Maintain a safe level of specific chemicals in the blood, like bicarbonates, sodium, and potassium

  • Help to keep blood pressure in control

Dialysis is of two types,

  • Hemodialysis

  • Peritoneal

Hemodialysis Dialysis

With hemodialysis, an artificial kidney is used for removing excess fluid, chemicals, and waste from the blood. For moving the blood to the artificial kidney, an access needs to be made in the blood vessel of the leg or arm, with a minor surgery. At times, a fistula, a bigger blood vessel, is formed as an access by joining together a vein and an artery under the skin.  Sometimes, the access is created by using a narrow plastic tube (catheter) inserted into a large vein in the neck. While such an access is generally temporary, it might be employed long-term treatment.

Peritoneal Dialysis

Peritoneal dialysis cleans the blood inside the body. Doctor surgically places a plastic tube (catheter) in the patient’s abdomen for access. At the time of the treatment, the catheter is used to fill the abdominal area (peritoneal cavity) with dialysate. The blood remains within the veins and arteries lining the peritoneal cavity. Waste, chemicals and excess fluid is pulled out of the blood and goes into the dialysate. 

Peritoneal dialysis is of two major types,

  • Automated Peritoneal Dialysis (APD)

  • Continuous Ambulatory Peritoneal Dialysis (CAPD)

Only CAPD is a peritoneal dialysis that does not need a machine. A person can do it on their own, 4 to 5 times per day and is called an exchange. It is done by placing a bag full of dialysate in the peritoneal cavity via the catheter. Leave the dialysate in the cavity for 4-5 hours and go about a normal work-day, then drain the fluid into the bag and discard. A new bag of dialysate is to be used for every exchange. 

APD happens in the home with the help of a special machine (cycler). It is much like CAPD, but for the fact that several exchanges happen, each lasting 1-1/2 hours.  Exchanges happen all night long, even during sleep. 

Percutaneous Tracheostomies

Percutaneous Dilational Tracheostomy (PDT), refers to the placing of a tracheostomy tube with no direct surgical visualisation of the trachea. It is a minimally invasive bedside procedure, easily done in the Intensive Care Unit (ICU) or the bedside of a patient with the vital signs of the patient being monitored continuously. 

Procedure

  • A skin incision is made, then blunt dissection is used to clear the pretracheal tissue

  • Withdrawing of the endotracheal tube is done so that the cuff can be placed at the glottis level

  • Tip of the bronchoscope is placed by the endoscopist so that its light shines through the surgical wound

  • The operator accesses the tracheal lumen under the second tracheal ring using an introducer needle

  • Serial dilation is done on the tract between the tracheal lumen and skin over a stylet and guidewire

  • The tracheostomy tube is placed over a dilator under direct bronchoscopic vision

  • Reconfirmation is done of the tube’s placement through visualising the tracheobronchial tree through the tube

  • The tube is secured to the skin by using tracheostomy tape and sutures.

Chest Drain Insertions

A chest tube is used for draining fluids, blood, or air from the pleural space, the space that surrounds the lungs.

Chest tube thoracostomy is an emergency procedure. At the time of insertion of the chest tube, a plastic tube that is hollow is placed between the pleural space and the ribs. The tube could be connected to a machine to aid with drainage. The tube is kept in place till the draining is complete. 

Procedure for Chest Tube Insertion

Anesthesia

The doctor could inject an anesthetic into the vein / skin where the chest tube will be inserted. 

Incision

A small (1/4- to 1 1/2-inch) incision is made with a scalpel between the ribs, in the upper area of the chest. The location is decided by the purpose of tube insertion. 

Insertion

A space is opened in the chest cavity and the tube is guided into the chest. The tube is stitched into place so that it stays in place when the procedure is being performed. A sterile bandage is applied to the site of the insertion.

Drainage

The tube is affixed to a system of drainage that is one-way, so that the flow is outwards and cannot go back to the body. 

Fibre Optic Bronchoscopies

The invasive procedure of Flexible Fibreoptic Bronchoscopy (FFB) is used for both diagnostic and therapeutic reasons. There is a source of light, a camera, and fibre optics for direct visualisation of lower and upper airways. This procedure is usually safe with a high diagnostic yield of respiratory disease. The ability it provides for establishing diagnosis is much improved as better technologies have emerged.

FFB well diagnoses situations like,

  • Chest infection

  • Hemoptysis

  • Lung masses / nodules

  • Mediastinal lymphadenopathy

  • Parenchymal lung disease

  • Persistent lung infiltrates

  • Suspected lung transplant rejection

Consult with the best critical care doctors in Hebbal, Bangalore to know more about treatments at Manipal Hospitals.

Experience world-class healthcare at Manipal Hospitals. Our expert team of doctors and state-of-the-art facilities ensure personalized and advanced treatments. Take the first step towards wellness. Book an appointment today.

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