Hemodialysis Vascular Access Procedures Research Articles

A Sterile Elastic Exsanguination Tourniquet is Effective in Preventing Blood Loss during Hemodialysis Access Surgery

PurposeWe report the first use of a sterile elastic exsanguination tourniquet (SET) in performing hemodialysis vascular access procedures in 27 patients. The main advantages of this tourniquet are the reduction of blood loss and need for possible transfusions. Additional benefits are the near-perfect exsanguination and excellent exposure of the operative field.MethodsThis SET is a sterile elastic stockinet device that rolls up the arm starting from the hand by pulling on two handles. The elastic silicone ring provides sufficient pressure (220 ± 30 mmHg) to block arterial flow into the limb. The stockinet can be cut to provide access to the incision area while providing an additional sterile cover over the rest of the limb.ResultsNo transfusions were required in any patients. Minor adverse effects occurred in four patients, including a twisted vessel, a bleeding vascular branch, a tear in atrophic arm skin, and pain, all of which had resolved on subsequent follow-up. Operational recommendations to avoid these adverse effects are outlined.ConclusionsWe conclude that this sterile elastic exsanguination tourniquet is effective and safe in preventing bleeding during upper extremity hemodialysis vascular access procedures.

Classification of Complications Associated with Hemodialysis Vascular Access Procedures

Classification of Complications Associated with Hemodialysis Vascular Access Procedures

Complications Associated with Hemodialysis Vascular Access Procedures: The Case for a Classification

Complications Associated with Hemodialysis Vascular Access Procedures: The Case for a Classification

Classification of Complications Associated with Hemodialysis Vascular Access Procedures: A Position Statement from the American Society of Diagnostic and Interventional Nephrology

AbstractA procedure‐related complication is an unanticipated adverse event that requires therapy. In order to analyze frequency and severity of complications in the process of quality assurance, it is useful to have a classification of complications, indicating the type and severity. The Clinical Practice Committee of American Society of Diagnostic and Interventional Nephrology has developed a Classification of Complications relating to Hemodialysis Vascular Access Procedures, based on the system first proposed by Beathard in 2006. In this system, the “type” refers to the procedure being performed or vessel entered, and the “grade” is based on the intensity of medical care needed to address the complication. This publication describes 10 Types and 4 Grades of complications.