Publication date: Available online 10 December 2016
Source:The Journal of Emergency Medicine
Author(s): Erica Simon, Brit Long, Kyle Johnston, Shane Summers
BackgroundChronic kidney disease is common in the United States, with many patients maintained on hemodialysis (HD). The process of HD requires vascular access through an arteriovenous (AV) fistula, AV graft, or central venous catheter. Today, as a result of the National Kidney Foundation's “Fistula First” initiative, nearly 55% of HD patients utilize an AV fistula. As there is significant morbidity and mortality associated with fistula placement and recurrent fistula cannulation, emergency physicians must be equipped to recognize and treat fistula complications.ObjectiveTo detail a case study of vascular insufficiency (vascular steal) presenting to an emergency department (ED) and provide an evidence-based approach to the emergency assessment and management of HD AV fistula complications.DiscussionA 66-year-old man presented to the ED with left upper extremity pain, paresthesias, and loss of grip strength of 1-week duration 15 days after placement of left upper extremity brachiocephalic fistula. He was diagnosed with dialysis access-associated steal syndrome and taken to the operating room for revision. Patients with HD fistulas may experience several complications, including vascular insufficiency, hemorrhage, infection, stenosis, thrombosis, aneurysms, or pseudoaneurysms. Emergency physicians must be able to identify these complications and deliver timely treatment.ConclusionsA comprehensive understanding of the appropriate management of AV fistula complications is paramount for the emergency physician. Early recognition and treatment of vascular insufficiency resulting from fistula creation, fistula hemorrhage, fistula infection, stenosis, thrombosis, and aneurysms or pseudoaneurysms is vital to reducing the morbidity and mortality associated with HD.
from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2hcnqlZ
via IFTTT
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Background Hyperthyroidism is associated with increased thrombotic risk. As contact system activation through formation of neutrophil extrac...
-
UM-Chor1: establishment and characterization of the first validated clival chordoma cell line. J Neurosurg. 2017 Apr 21;:1-9 Authors:...
-
Publication date: Available online 10 May 2017 Source: Journal of Dairy Science Author(s): R.E. Vibart, M. Tavendale, D. Otter, B.H. Schw...
-
Competency-based psychiatric education for Indian medical undergraduates Vijayalakshmi Pernenkil Archives of Mental Health 2019 20(1):1-2 Be...
-
Related Articles Developmental control of macrophage function. Curr Opin Immunol. 2017 Dec 13;50:64-74 Authors: Bonnardel J, Guillia...
-
from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2tcPIjn via IFTTT
-
Abstract: Epidermolytic ichthyosis (EI) is a rare disorder of cornification caused by mutations in KRT1 and KRT10, encoding two suprabasal e...
-
Bloomberg Celgene Settles Whistle-Blower Fraud Suit for $280 Million Bloomberg Even after the FDA approved Thalomid for multiple myelo...
-
Related Articles Chinese version of the Constant-Murley questionnaire for shoulder pain and disability: a reliability and validation ...
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου