Utilidad de un mapa de punción programada del acceso vascular protésico para hemodiálisis en la práctica diaria
Year: 2025
Type: article
Abstract: Introduction: Polytetrafluoroethylene prosthetic fistulas are an alternative when native vascular accesses are not viable. Their use is associated with more complications and lower survival related to repetitive punctures.Objectives: To describe the technique and puncturecharacteristics of prosthetic fistulas, and analyze the practical utility after the implementation of a scheduled puncture map.Material and Method: We conducted a 6-week prospective,single-center study, with patients with prosthetic fistulas.We analyzed clinical and sociodemographic characteristics,puncture technique, ultrasound parameters, degree ofclinical and ultrasound destructuring, dialysis characteristics, and vascular access-related complications, after the implementation of a scheduled puncture map.Results: A total of 6 hemodialysis patients with prostheticfistulas were studied (50% women, 80% humeroaxillary). The mean prosthesis usage time was: 47.1±46.1 months and they had a mean of 2.6±3.4 previous vascular accesses. All patients were punctured in an antegrade direction and with 16G gauge needles. At the end of the 3 study, we increased the percentage of patients with ladder puncture (60 vs 100%) as well as the distance between needles (9.3±1.3 vs 12.3±1.4 cm; p < 0.05), withoutchanges to the analyzed parameters. Throughout the study, 2 patients presented hematomas and extravasations, without other complications.Conclusions: The implementation of a scheduled puncture map allowed us to improve the technique and optimize the puncture of prosthetic fistulas without any associated complications. We consider the implementation of our scheduled puncture map important in our routine clinical practice.
Source: Enfermería Nefrológica
Institution: Consorci Sanitari de Terrassa
Language: Spanish
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409643164