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Žilni pristopi za hemodializo = Vascular access for hemodialysisPonikvar, RafaelThe prerequisite for performing hemodialysis is adequate vascular access enabling blood flow of 200 to 400 ml/min in adults. Vascular access can be temporary or permanent. Temporary vascular access ... is used in acute hemodialysis, for several weeks. Single or double lumen hemodialysis cathetersare placed into the right jugular, femoral or subclavian veins, and rarely into the left jugular vein. They are used exclusively for hemodialysis hemoperfusion or apheresis. During interdialytic periods, they are filled withan anticoagulant solution and closed. In addition to acute complications during insertion, the main complications include thrombosis or malfunction andinfection (exit site infection and sepsis). Central vein stenosis and thrombosis are increasingly recognized late complications, especially after subclavian catheter insertion. Permanent vascular access is necessary for chronic hemodialysis. Native radiocephalic arteriovenous (AV) fistula is the best type of permanent vascular access in terms of high survival and low complication rates. However, adequate and undamaged forearm arteries and veinsare necessary for successful construction of AV fistulas, and this important condition is lacking in many chronic renal failure patients with comorbid conditions. A native AV fistula can be constructed on the upper arm or the thigh. If appropriate veins are lacking, synthetic graft can be placed between the artery and the vein. Synthetic polytetrafluoroethylene material (PTFE, also known as Goretex) is usually used. The survival rate of the graftsare significantly lower compared to those of native AV fistulas. The last option (if neither native nor graft AV fistula construction is possible) is permanent tunneled cuffed silastic atrial catheter. The main complications are malfunction and infection and the survival rate is significantly lower than that of grafts. (Abstract truncated at 2000 characters).Source: Medicinski razgledi. Supplement. - ISSN 0353-3484 (Letn. 42, supl. 2, maj 2003, str. 133-140)Type of material - conference contributionPublish date - 2003Language - slovenianCOBISS.SI-ID - 16286681
Author
Ponikvar, Rafael
Topics
Hemodialysis |
Catheters, Indwelling |
Catheterization, Peripheral |
Arteriovenous Shunt, Surgical |
Graft Occlusion, Vascular |
Thrombosis |
Inflammation |
Arteriovenski obvoz kirurški |
Kateterizacija periferna |
Katetri, vstavljanje |
Presadek, okluzija vaskularna |
Tromboza |
Vnetje |
ledvične bolezni |
hemodializa |
arteriovenska fistula |
venski katetri
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source: Medicinski razgledi. Supplement. - ISSN 0353-3484 (Letn. 42, supl. 2, maj 2003, str. 133-140)
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