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Revista Mexicana de Angiología

Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular
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2010, Number 2

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Rev Mex Angiol 2010; 38 (2)

Accesos vasculares para hemodiálisis. Un modelo de atención

Vejerano APP, Tamayo OJA, Ramos LCR, Vejerano GPP
Full text How to cite this article

Language: Spanish
References: 10
Page: 56-64
PDF size: 335.77 Kb.


Key words:

Vascular access, hemodialysis, fistula, graft.

ABSTRACT

Introduction: The vascular access for hemodialysis constitutes the angular stone for the handling of the patients who suffer for chronic renal insufficiency and require prolonged therapy. The handling of the accesses and in particular the arteriovenous fistulas are assumed in the immense majority of the services of health by the vascular surgeons, it is increased and acquired more use in present times when understanding to the hospital or center of health like a company or integrating them with the contract of companies for its operation in the concept of integral health services and to the patient like client, forces to establish organizational schemes for the benefit and implementation of these services of standarized way and with the required quality.
Objective: To propose an organizational chart of operation for the evaluation, creation and handling of vascular access for hemodialysis and to demonstrate its feasibility.
Patients and method: Design and proposed a protocol of handling of the vascular access for the patients who was put under hemodialysis in the unit of Bernardo Sepulveda general hospital from Ixtapa- Zihuatanejo operated by Medika Humana company of the Vitalmex Group, this protocol was implemented and the data of the procedures as well as the handling of the access would take shelter in the Nefrolink system.
Results: 23 arteriovenous fistulas with different variants from surgical techniques were performed, and in all the cases was applied the protocol design previously raised, obtaining the use of all of them, reporting two failures that were corrected, all this in a period of ten months since May of the 2006 to February of the 2007 both months including and with an evaluation at the year of the cut of this series.
Conclusions: Is demonstrated that was feasible to apply part of the organizational chart of operation for the evaluation, creation and handling of accesses for hemodialysis. The volume of complications is low and in relation to an evaluation and pursuit of the cases, this dice by the interrelation between nephrologists, vascular surgeon as well as the other parts implied in the evaluation and pursuit of the patients.


REFERENCES

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  2. Allon M, Bailey R, Ballard R, Deierhoi MH, Hamrick K, Oser K, et al. A multidisciplinary approach to hemodialysis access: prospective evaluation. Kidney Int 1998; 53(2): 473-9.

  3. Ravani P, Spergel LM, Asif A, Roy-Chaudhury P, Besarab A. Clinical Epidemiology of Arteriovenous Fistula in 2007. J Nephrol 2007; 20: 141-9.

  4. Hayashi R, Huang E, Nissenson AR. Vascular access for hemodialysis. Nature ClinPract Nephrol 2006; 2: 9: 504-13.

  5. Ortega LJS, Sabag RE. Fístulas arteriovenosas para hemodialisis. Experiencia de Centro Médico del Noreste, IMSS. Rev Mex Angiol 2004; 32(4): 119-25.

  6. Rodriguez CR. Accesos vasculares en una Unidad de Hemodiálisis y la participación del cirujano vascular. Rev Mex Angiol 2008; 36(3): 76-81.

  7. Quinton WE, et al. Canulation of blood vessels for prolonged hemodialysis. Transp Am Soc Artif Intern Organs 1960; 6: 104.

  8. Brescia MJ, et al. Chronic hemodialysis using venipuncture and surgically created fistula. N Engl J Med 1966; 275: 1089.

  9. Nguyen MD, Griffith CN, Reus J, Barclay C, Alford S, Treat LBSN, et al. SUCCESSFUL AV FISTULA CREATION DOES NOT LEAD TO HIGHER CATHETER USE: THE EXPERIENCE BY THE NORTHWEST RENAL NETWORK 16 VASCULAR ACCESS QUALITY IMPROVEMENT PROGRAM. FOUR YEARS FOLLOW UP. http://www.fistulafirst.org/about_us/2008_FFBI_Summit_Presentations.php.

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Rev Mex Angiol. 2010;38