Abstract

FERNANDEZ MARTINEZ, Ana Vanessa et al. Vascular access monitoring: conventional parameters versus intra-access flow. Enferm Nefrol [online]. 2014, vol.17, n.3, pp.198-201. ISSN 2255-3517.  https://dx.doi.org/10.4321/S2254-28842014000300006.

It is a major goal in hemodialysis patient to maintain permeable vascular access. Classic parameters for monitoring the vascular access are generally slow to detect stenosis. Intra-access flow calculation is a second-generation method that allows knowing the maximum access blood flow and to detect stenosis when there is a decreased flow. The aim of this study is to assess the efficacy of the measurement and monitoring of intra-access flow compared to first-generation clinical parameters. Vascular access monitoring is done monthly, recording the physical and dynamic examination variables. The determination of intra-access flow is performed quarterly in AVF and monthly in PTFE. Fistulography is recommended if the intra-access flow is less than 500 ml / min or a decrease by 20% confirmed on two consecutive measurements, or if there are variations in the physical examination and Kt decreased by over 25%, blood flow or increased venous pressure or recirculation. 61 fistulographies were performed. Significant differences by valuation method (p <0.001) and in false positives (stenosis <50%) (p = 0.024) was found. Intra-access flow monitoring is a highly sensitive method for detection of vascular access dysfunction. The combination of clinical, classical parameters and intra-access flow in a monitoring program for vascular access, can detect more than 80% of confirmed cases by fistulography.

Keywords : Vascular access; monitoring; surveillance; intra-access flow.

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