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- Title
Hemostasis of arteriovenous fistula: Comparison of direct two-finger pressure to an adjustable device.
- Authors
Álvaro Cristóbal, Alejandro; París Boal, Carmen; Blanco Velasco, Noelia; Matesanz Sanchidrián, Sergio; Mayoral-Peñas, Azucena; Arévalo Manso, Juan José; Velasco-Ballesteros, Sonia; Fernandez-Reyes Luis, María José
- Abstract
Background and objectives: To evaluate the pressure generated by an adjustable hemostasis clamp on arteriovenous fistulas (AVF) during the hemostasis proccess, and compare it with the direct two-finger pressure applied by the patient. To evaluate the variations of the direct two-finger pressure along the hemostasis process. Methods: We analyzed data obtained in 51 hemodialysis procedures from 15 patients. AVF intraaccess pressure was used as indirect indicator of the pressure generated by both methods. It was recorded before venous needle removal (PBasal), at clamp application (P1), after clamp adjustement by a nurse (P2), at the beginning of the direct two-finger pressure by the patient (M0), after 3 min of two-finger pressure (M3) and after 6 min of two-finger pressure (M6). Results: Intra-access pressure was lower with the adjusted clamp (P2) than with the direct two-finger pressure by the patient (M0) (variation of -18.57%, 95%CI -14.09 to -4.77 mmHg, P < 0.001). Intraaccess pressure generated by the direct two-finger pressure method showed a decreasing trend along the hemostasis process (M3-M0: -8.82 mmHg, P < 0.001; M6-M0: -12.55 mmHg, P < 0.001). Conclusion: An adjustable fistula arm clamp generates a lower pressure in AVF than the direct two-finger pressure applied by the patient. The latter showed a decreasing trend along the hemostasis process. These data suggest that some of the recommendations from clinical guidelines could be based on inaccurate premises.
- Subjects
ARTERIOVENOUS fistula; HEMOSTASIS; COMPRESSION therapy; MEDICAL equipment
- Publication
Nefrologia, 2021, Vol 41, Issue 5, p566
- ISSN
0211-6995
- Publication type
Article
- DOI
10.1016/j.nefroe.2021.12.001