Rescate de un acceso vascular para hemodiálisis. A propósito de un caso

Abstract

The best vascular access (VA) for hemodialysis (HD) is undoubtedly the native arteriovenous fistula (AVF) as presents more advantages and fewer complications than other vascular access.
Nursing, using surveillance protocols of vascular, plays an essential role in the early detection of complications that might lead to their loss.
We conducted this study with two objectives:
1) To present a clinical case of an AVF in which appeared on several complications.
2) Analyze the importance of the existence of a multidisciplinary team for vascular access in the implementation and monitoring of the same and in the treatment of possible complications.
A male patient in stage five of CKD is studied, bearing a right radiocephalic AVF, which during a routine inspection of the AV when he came to the HD session, nursing detected decreased murmur and thrill appearing thrombosis first followed by stenosis treated surgically and finally a serious infection in the surgical wound by a Gram negative germs. During the study, subsequent complications that emerged and the strategies developed by the members of the multidisciplinary team are being presented: nurses, nephrologists and vascular surgeons, among others, to solve them, which finally got coming to rescue a vascular access a priori lost.