Abstract

AGUILAR GOMEZ, Gustavo Samuel; FERNANDEZ JIMENEZ, Antonio José  and  CABRERA PLAZA, Irene. Measurement of Access Flow using the different directions of arterial puncture with ultrasound dilution technique. Rev Soc Esp Enferm Nefrol [online]. 2009, vol.12, n.4, pp.7-13. ISSN 1139-1375.

Measuring vascular access flow using the ultrasound dilution technique is based on studies by Krivitski that advise puncturing the artery proximal to the anastomosis, because the greater turbulence improves the dilution of the saline. This limits knowledge about the flow of the vascular accesses where it is not possible or advisable to perform the arterial puncture proximal to the anastomosis. We carried out a self-controlled study to detect and quantify the possible difference between access flow measurements in arterial puncture proximal and distal to the anastomosis using Transonic HD01^®; we obtained 2 flow determinations in each arterial puncture direction, corresponding to the opposite rotations of the needle bevel. We found statistically significant differences (< 0.05) between the flows with the punctures in different directions; the mean difference was 164.78 ml/min (interval of 55.63 to 273.93 ml/ min) in favour of the flow obtained with arterial puncture proximal to the anastomosis. We did not fi nd signifi cant differences between the flows observed with different rotations of the needle but in the same puncture direction. Accordingly, we consider the direction of puncture as a factor that conditions the measurement of vascular access flow using the ultrasound dilution method, but knowing this variation we can include vascular accesses that were previously excluded in monitoring with Transonic^®.

Keywords : Haemodialysis; Vascular Access; Blood Flow; Flow Measurement Devices.

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