The journal of vascular access
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Nephrologists are placing fewer non-tunneled temporary hemodialysis catheters. Requiring competence for nephrology fellow graduation is controversial. ⋯ Of the graduate respondents from a single training program, 58% continue to place non-tunneled temporary hemodialysis catheters; 55% of program directors believe non-tunneled temporary hemodialysis catheter procedural competence should be required. Graduates who had non-tunneled temporary hemodialysis catheter simulation training and younger program directors consider simulation training necessary. These findings should be considered in the discussion of non-tunneled temporary hemodialysis catheter curriculum requirements.
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Randomized Controlled Trial
The effect of stellate ganglion block on the function of arteriovenous fistulas for hemodialysis: A randomized trial.
The best access for hemodialysis is an autologous arteriovenous fistula (AVF). The most helpful way for vasodilation in the upper limb is stellate ganglion block. We aim to evaluate the effect of stellate ganglion block on outcome of vascular access for dialysis. ⋯ Stellate ganglion block before arteriovenous fistula surgery in the upper limbs improves hemodialysis success rate.
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Comparative Study
Clinical use of Sherlock-3CG® for positioning peripherally inserted central catheters.
Intracavitary electrocardiogram technique is recognized as a safe, accurate, and inexpensive method for verifying the tip location of central venous access devices. While the technique can be carried out with any standard electrocardiogram monitor, dedicated electrocardiogram monitors specifically designed for the intracavitary electrocardiogram are also available. One of these dedicated monitors is Sherlock-3CG®, characterized by the integration of a magnetic-based tip navigation method with an electrocardiogram-based tip location method. ⋯ Our study could not demonstrate any specific advantage of Sherlock-3CG either as a magnetic-based tip navigation method or as an electrocardiogram-based tip location method.
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Aneurysm of autogenous arteriovenous fistula is a common complication in patients receiving hemodialysis. We present a novel method for repair of a case of aneurysm of arteriovenous fistula resulting from stenosis. A 52-year-old woman presented with aneurysm formation of the left upper arm arteriovenous fistula, with related numbness in the left hand. ⋯ After surgery, the remodeled arteriovenous fistula was immediately usable for hemodialysis with normal arteriovenous fistula flow in the upper arm. The repair technique achieved not only aneurysmorrhaphy but also created an autologous vascular graft as the bypass after removal of the narrowed segment. Moreover, this technique achieved reduced arterial inflow and is suitable for patients with conditions similar to those of this case.
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Observational Study
EA-DIVA score (Enhanced Adult DIVA score): A new scale to predict difficult preoperative venous cannulation in adult surgical patients.
Providing peripheral intravenous access is one of the most commonly performed technical procedures in hospitals and it is mandatory for all patients undergoing surgery. Obtaining peripheral intravenous access may be difficult and this may cause delays in patient management, increased risk of adverse events and hospitalization costs. The aim of this study is to develop and validate a scale to identify patients at risk of peripheral difficult intravenous access, applicable to any adult patient undergoing surgery. ⋯ The EA-DIVA score is a simple tool to identify patients at high risk of peripheral difficult intravenous access. Its implementation is recommended in order to optimize peripheral intravenous access procedures.