Abstract

MARTINEZ OCANA, Olga et al. Fistula catheter: a new alternative in venous access puncture. Rev Soc Esp Enferm Nefrol [online]. 2010, vol.13, n.2, pp.105-111. ISSN 1139-1375.

Adequate vascular access is essential in order to obtain optimal haemodialysis. The damage caused by conventional needle puncture or intradialytic complications deriving from the movement of the arm can compromise the survival of the access. Another essential factor in the quality of the haemodialysis, closely related to the calibre of the needle, is obtaining a greater efficient blood flow. The fistula catheter, a new puncture cannula made of fluoroplastic, reduces the damage to the internal wall of the access and presents a lower puncture calibre with a higher interior calibre, which allows it to reach better flows with maximum efficiency and fewer vascular complications. The aim of this prospective study was to compare the use of the fistula catheter with the use of the needle. Eighteen haemodialysis sessions were carried out with each of the devices in stable patients with good vascular access, recording in all cases the flow obtained, pressures and other monitor parameters, test results and incidents. The results have shown that the use of the fistula catheter reduced the arterial pressure and venous pressure, without reducing the dialytic efficiency, and consequently the haemodynamic profile improved. The actual blood flow, number of litres dialysed and Kt improved significantly. The lesser mechanical trauma caused in the vascular access made it possible to reduce the dose of heparin, the haemostasis time and there was a reduction in vascular complications: extravasation and rebleeding. While the puncture is well tolerated, there is a slight worsening in the feeling of pain, explained by the lack of experience in handling. The improvement in dynamic parameters opens up the possibilities of achieving greater dialytic efficiency by making it feasible to use greater blood flows with more adequate pressures.

Keywords : Fistula catheter; Vascular access; Puncture; Venous pressure; Blood flow.

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