{"id":410,"date":"2018-07-01t12:44:48","date_gmt":"2018-07-01t12:44:48","guid":{"rendered":"\/\/www.iolishoes.com\/?page_id=410"},"modified":"2021-06-27t22:52:27","modified_gmt":"2021-06-27t12:52:27","slug":"dialysis-av-fistula","status":"publish","type":"page","link":"\/\/www.iolishoes.com\/dialysis-av-fistula\/","title":{"rendered":"dialysis av fistula"},"content":{"rendered":"\t\t
renal failure requires one of 3 supplementary therapies:<\/p>
this section deals with hemodialysis and the assessment of an arterio-venous fistula.<\/p>
importantly, always liaise with your renal team and follow departmental protocol.<\/p>
below is a guide\/proposed protocol.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t in 1943 dr willem kollf designed and built the first dialysis machine using sausage skins, juice tins and an old washing machine.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t dr willem kolff<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t one of the original renal dialysis machines.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t simplified schematic of how dialisys works:<\/p> arterial blood from the patient enters the dialyser in many small tubes.<\/p> in the dialyser the blood is in many fine tubes and surrounded by a dialysate liquid that will ‘draw’ the impurities\/waste chemicals from the blood via a semipermeable membrane and a pressure gradient between the blood and dialysate.<\/p> the ‘cleaned’ blood is returned to the venous system.<\/p> the dialysate is refreshed throughout.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t a haemodialysis machine.<\/p> image courtesy of: different methods of creating an arterio-venous fistula.<\/p> the side artery – end vein is most common.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t there are several places and methods used to create the avf.<\/p> ref: auntminnie.com<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t (arm vessels are used in these protocols, however it can also be applied to leg assessment)<\/p> the objective is to confirm:<\/p> -distal axillary artery to the wrist.<\/p> – radial artery – proximal mid and distal ideal minimum arterial luminal diameter: <\/strong>2.0 mm.<\/p> (many surgeons will accept 1.6 mm)<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t arm arterial anatomy diagram.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t transverse ultrasound of the distal radial artery (red)<\/p> and veins (blue).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/span>role of ultrasound<\/span><\/h3>
<\/span>background<\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
instructables.com\/id\/how-to-string-a-hemodialysis-machine\/<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/span>types of fistulae and anastomoses<\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
<\/span>pre-opperative assessment<\/span><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
<\/span>pre-op arterial<\/span><\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
– brachial artery – proximal & antecubital.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/span>pre-op venous