Abstract

FERNANDEZ CASTILLO, Rafael; CANADAS DE LA FUENTE, Guillermo A.; FERNANDEZ GALLEGOS, Ruth  and  CANADAS DE LA FUENTE, Gustavo R.. Effect of the position of the bevel of the needle on access to the internal arteriovenous fistula. Rev Soc Esp Enferm Nefrol [online]. 2008, vol.11, n.4, pp.254-258. ISSN 1139-1375.

Introduction: The arteriovenous fistula, is today the vascular access of choice in patients with Chronic Kidney Disease in terminal renal replacement therapy. However, over the time and after repeated punctures, fistulas tend to deteriorate and develop a number of complications such as: aneurysms, thrombosis, stenosis and infections. Objectives: This study intends to evaluate two methods of puncture, by the position of the bevel of the needle, upwards or downwards with the following objective: To compare the bleeding at the site of the vascular access, and determine whether the position of the bevel influences at the time of haemostasis after haemodialysis. Methodology: The sample was composed of 100 patients in haemodialysis programme, aged between 24 and 72. The average duration of dialysis session was 4 hours. We studied variables such as difficulties accessing fistula, bleeding at the puncture, bleeding during the dialysis and later, bleeding from fistula after haemostasis, heparin dosage at the beginning and end of dialysis and total dose of heparin. Results: The bevel’s position down reduces bleeding from the puncture area, facilitates puncture in the area of access to the fistula and minimizes bleeding at the puncture site.

Keywords : Haemodialysis; dialysis's time; bevel's position; heparin dose.

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