A Holistic Approach to Vascular Access in Hemodialysis

Junglee, Naushad A.; Owen, Anna; Jibani, Mahdi; Williams, Dean T.

doi:10.5772/53146

Cited by 2 publications

(1 citation statement)

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“…Questa tecnica si adatta bene a situazioni in cui lo spazio di puntura è molto ridotto e non consentirebbe rotazioni efficaci. La puntura BH, inoltre, è senz'altro superiore alle altre dal punto di vista estetico (1). È vero, però, che la Bh assomiglia pericolosamente a un cVc, come intuito in modo originale da Napoli (2), e le segnalazioni di complicanze infettive, anche gravi, non mancano (3).…”

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Buttonhole Yes or No? Maybe, Cautiously…

Bonucchi

Damiano

Pivetti

2014

Giornale di Tecniche Nefrologiche e Dialitiche

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Arteriovenous (AV) fistula cannulation plays a key role in the management of dialysis sessions, and is crucial for the reinforcement of the patient-to-staff relationship. Compliant patients prefer the buttonhole technique (BH); however, this “funnel” shows a high risk of infections. It is like a short catheter and, therefore, carries an increased risk of infectious complications. The BH cannulation should therefore be considered as a part of the complex planning of VA utilization, including rope-ladder cannulation as the standard of care, and should be reserved to selected patients. Also, prostheses cannulation should be taught and practiced in order to reduce the use of central venous catheters (CVC). In addition, cannulation should be considered as a part of the complete managing process of VA, together with the phases of creation, monitoring, and repair of the vascular access. The dialysis nurse must be considered both as the primary caregiver and the manager of this life-warranting pipeline.

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