Control de presiones venosa y arterial para evitar la disfunción del acceso vascular y su influencia en la dosis de diálisis

Abstract

Introduction: Clinical guidelines vascular access, recommend tracking and monitoring arteriovenous fistula and recent studies maintaining maintaining venous and arterial pressure in safe limits.
Objective: To analyse dialysis monitoring patterns in our patients and to adjust them in order to get safe dynamic pressures.
To value the influence in the dialysis dose and to carry out the required changes to restore it in an individualized way.
Materials and methods: Dates of three periods in 29 patients has been taken in. Period zero: Usual dialysis pattern: Period one: Protective blood flow not changeable. Period two: Blood flow according to diary pressure and modified dialysis pattern. The variables analyzed are; blood flow, venous and arterial pressure, dialysis dose according to the Kt.
Results: In period zero, 83% of the patients present a venous pressure >160 mm Hg and the 21% an arterial pressure < -200 mm Hg. In period one after the action above the flow 20% of the patients has a venous pressure > de 160 mm Hg and 3.4% an arterial pressure < -200 mm Hg. In period three, the 100% of the patients have safe pressures. In relation with the Kt, it was mean of 49l in the period zero, 46,8l in the period one and it regain in the period two to 50,65l (p<0,001). For that in the period two, 21 individualized interventions in 18 patients were performed.
Conclusions: It is possible to dialyze according to the last guidelines in dynamic pressure limits, keeping the dialysis dose and acting in others parameters of the individualized pattern.