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    The Problem of Vascular Access

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    Wira Dat
    This document discusses the problem of vascular access for hemodialysis patients. Vascular access is critical for dialysis but poses many complications. Common complications include thrombosis, infection, and venous hypertension. These complications can lead to hospitalization and increased costs. The document provides data on vascular access types from a hospital in Indonesia, showing the majority of patients use arteriovenous fistulas or catheters. It concludes by providing tips for patients to properly care for their vascular access.

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    The Problem of Vascular Access

    Uploaded by

    Wira Dat
    198 views13 pages
    This document discusses the problem of vascular access for hemodialysis patients. Vascular access is critical for dialysis but poses many complications. Common complications include thrombosis, infection, and venous hypertension. These complications can lead to hospitalization and increased costs. The document provides data on vascular access types from a hospital in Indonesia, showing the majority of patients use arteriovenous fistulas or catheters. It concludes by providing tips for patients to properly care for their vascular access.

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    THE PROBLEM OF VASCULAR ACCESS.ppt

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    This document discusses the problem of vascular access for hemodialysis patients. Vascular access is critical for dialysis but poses many complications. Common complications include thrombosis, infection, and venous hypertension. These complications can lead to hospitalization and increased costs. The document provides data on vascular access types from a hospital in Indonesia, showing the majority of patients use arteriovenous fistulas or catheters. It concludes by providing tips for patients to properly care for their vascular access.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    198 views13 pages

    The Problem of Vascular Access

    Uploaded by

    Wira Dat
    This document discusses the problem of vascular access for hemodialysis patients. Vascular access is critical for dialysis but poses many complications. Common complications include thrombosis, infection, and venous hypertension. These complications can lead to hospitalization and increased costs. The document provides data on vascular access types from a hospital in Indonesia, showing the majority of patients use arteriovenous fistulas or catheters. It concludes by providing tips for patients to properly care for their vascular access.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 13

    THE PROBLEM OF VASCULAR

    ACCESS

    WURJANTO

    UNS MEDICAL FACULTY/DR. MUWARDI HOSPITAL


    INTRODUCTION
    VASCULAR ACCESS
    The first preparation before starting regular
    Dialysis
    Which is the site on the body where blood is
    removed and returned during dialysis
    Maximise the amount of blood cleansed during
    hemodialysis treatment
    Vascular access should allow continous high
    volumes of blood flow
    Many possible complications/problem of vascular
    access
    Vascular Access Initiative: Rationale

    Vascular access is one of the most critical


    issues in improving dialysis quality:
    Recent trends:
    Access Patency, Morbidity/ Mortality, Costs
    Attributable to:
    AVF, AVG, Catheters
    Access type is a major determinant of patient
    outcomes as well as financial outcomes
    Most VA-related morbidity & costs due to grafts &
    catheters
    CONSEQUENCES OF THE PROBLEM :

    25% of deaths in HD patients are infection-related.


    Infection rate increases with temporary catheter use.
    Nearly 75% of HD patients are hospitalized for vascular
    access-related problem within 2 years.1
    Vascular access complications account for ~30% of hospital
    admissions in chronic HD programs.2
    Estimates on the cost of hospitalization for vascular access
    problems range from $2 billion3 per year to $3 billion4,
    representing 10% to 15% of Medicare ESRD expenditures.
    PROBLEM OF VASCULAR ACCESS
    PROBLEM OF VASCULAR ACCESS

    THROMBUS AV FIST VENOUS STENOSIS SEVERE EDEMA INGUINAL

    KINGKIN TUNNELED VENOUS THROMBOSIS PATIENT NERVOUS HEMATOMA

    CATH/POSITION ANERISMA ARTERIEL ARTERIEL VENOUS THROMBUS

    YUXTA ANSTOMOSIS STENOSIS ARTERIEL FRAGILE (DM)

    STENOSIS INFECTION AV GRAFT


    VENOUS CENTRALIS THROMBUS/NEO INTIMAL
    CATH STENOSIS HYPERPLASIA
    INFECTION TUNNELED/ AV
    FIST/GRAFT
    VASCULAR ACCESS COMPLICATION

    THROMBOSIS AND INFECTION


    VENOUS HYPERTENSION
    RADIAL STEAL SYNDROME
    ISHEMIC MONOMELIC NEUROPATHY
    VASCULAR ACCESS COMPLICATION

    Chronic swelling of the access hand and arm in a patient with


    proximal axillarry vein stenosis.(Courtesy of JH Hong)
    VASCULAR ACCESS COMPLICATION

    Three cases of radial steal syndrome following


    placement of vascular access showing increasing
    degress of severity of ischemia. The two most severe
    cases occurred in diabetics.(Courtesy of JH Hong)
    Vascular Access Profile in Dr. Muwardi Hospital
    October 2010
    Data Pasien HD Tipe Access
    Tunneled
    Sumber Dana AV fist Femoral Graft Jumlah
    Cath
    ASKES 19 21 6 - 46
    JAMKESMAS 19 39 2 - 60
    (gratis)
    SKTM 17 18 2 - 37
    (Keringanan)
    PKMS (Pemkot, 2 9 1 - 12
    HD Gratis)
    Pribadi 2 12 2 - 16
    JUMLAH 59 99 13 - 171
    How should I take care of my
    vascular access?
    You can take several steps to protect your access:

    Make sure your nurse or technician checks your access before each
    treatment.
    Keep your access clean at all times.
    Use your access site only for dialysis.
    Be careful not to bump or cut your access.
    Dont let anyone put a blood pressure cuff on your access arm.
    Dont wear jewelry or tight clothes over your access site.
    Dont sleep with your access arm under your head or body.
    Dont lift heavy objects or put pressure on your access arm.
    Check the pulse in your access every day.

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