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Utilidad de un mapa de punción programada del acceso vascular protésico para hemodiálisis en la práctica diaria.

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Title: Utilidad de un mapa de punción programada del acceso vascular protésico para hemodiálisis en la práctica diaria.
Alternate Title: Utility of a scheduled puncture map of prosthetic vascular acess for hemodialysis in daily practice.
Authors: Gutiérrez-de la Iglesia, Javier1 JGutierrez@cst.cat, Morera-Mas, Ariadna1, Esteve-Simó, Vicent2, Alfonzo-Juliá, Jorge1, Tapia-González, I.2, Rubio-Páez, Sandra2
Source: Enfermería Nefrológica. ene-mar2025, Vol. 28 Issue 1, p45-50. 6p.
Subjects: FISTULA, HUMAN services programs, BLOOD vessels, HEMODIALYSIS, DESCRIPTIVE statistics, HEMATOMA, OPERATIVE surgery, LONGITUDINAL method, SURGICAL complications, POLYTEF, MEDICAL equipment, SOCIODEMOGRAPHIC factors, HYPODERMIC needles, MEDICAL practice
Abstract (English): 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 puncture characteristics 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 of clinical 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 prosthetic fistulas 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. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: Las fístulas protésicas de politetrafluoroetileno constituyen una alternativa cuando los accesos vasculares nativos no son viables. Su uso se asocia a más complicaciones y menor supervivencia relacionada con su punción repetitiva. Objetivos: Describir la técnica y características de punción de las fístulas protésicas, y analizar la utilidad práctica tras implementar un mapa de punción programada. Material y Método: Estudio unicéntrico prospectivo de 6 semanas, con pacientes con fístulas protésicas. Analizamos características clínicas y sociodemográficas, técnica de punción, parámetros ecográficos, grado de desestructuración clínica y ecográfica, características de diálisis, y complicaciones relacionadas con el acceso vascular, tras la implementación de un mapa de punción programada. Resultados: Se estudiaron 6 pacientes en hemodiálisis, con fístula protésicas (50% mujeres, 80% húmero axilar). El tiempo medio uso de la prótesis fue: 47,1±46,1 meses y tenían una media de 2,6±3,4 accesos vasculares previos. Todos los pacientes eran puncionados en dirección anterógrada y con agujas de calibre 16G. Al final del estudio incrementamos el porcentaje de pacientes con punción en escalera (60 vs 100%) y un aumento de la distancia entre agujas (9,3±1,3 vs 12,3±1,4 cm, p<0,05), sin alteraciones en los parámetros analizados. A lo largo del estudio, 2 pacientes presentaron hematomas y extravasaciones, sin otras complicaciones. Conclusiones: la implementación de un mapa de punción programada permitió mejorar la técnica y optimizar la punción de las fístulas protésicas sin complicaciones asociadas. Consideraremos importante la implementación de nuestro mapa de punción programada en la práctica clínica diaria. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
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 puncture characteristics 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 of clinical 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 prosthetic fistulas 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. [ABSTRACT FROM AUTHOR]
ISSN:22542884
DOI:10.37551/S2254-28842025007