How to carry out monthly blood flow surveillance of fistula in large-scale hemodialysis units: A cross-sectional study

Background: The important effect of regular blood flow surveillance on arteriovenous fistula maintenance is emphasized. The ultrasonic dilution technique for blood flow surveillance can be performed during hemodialysis, but there are some limitations. Blood flow is traditionally measured by duplex D...

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Bibliographic Details
Published in:The journal of vascular access 2021-01, Vol.22 (1), p.75-80
Main Authors: Mo, Ya-wen, Sun, Chun-yan, Song, Li, Zhou, Li-fang, Zhuang, Ting-ting, Zhong, Mi, Zheng, Shu-qian, Chen, Ying-gui, Chen, Yuan-han, Liu, Shuang-xin, Liang, Xin-ling, Fu, Xia
Format: Article
Language:English
Subjects:
Adult
Aged
Arteriovenous Shunt, Surgical - adverse effects
Blood Flow Velocity
Brachial Artery - diagnostic imaging
Brachial Artery - physiopathology
Brachial Artery - surgery
Cross-Sectional Studies
Female
Forearm - blood supply
Humans
Indicator Dilution Techniques
Male
Middle Aged
Predictive Value of Tests
Radial Artery - diagnostic imaging
Radial Artery - physiopathology
Radial Artery - surgery
Regional Blood Flow
Renal Dialysis
Reproducibility of Results
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Color
Vascular Patency
Young Adult
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Summary:Background: The important effect of regular blood flow surveillance on arteriovenous fistula maintenance is emphasized. The ultrasonic dilution technique for blood flow surveillance can be performed during hemodialysis, but there are some limitations. Blood flow is traditionally measured by duplex Doppler ultrasound during the nondialysis period. However, the surveillance workload for arteriovenous fistula has increased with the rapid increase in the hemodialysis population size. Efficient methods for blood flow surveillance during hemodialysis are needed. Methods: Eighty-four hemodialysis patients with a forearm radiocephalic arteriovenous fistula were enrolled in this cross-sectional study. Each received blood flow measurements using ultrasonic dilution technique and duplex Doppler ultrasound during hemodialysis. Duplex Doppler ultrasound measurements included the blood flow of the brachial artery and radial artery. The correlations between these variables were analyzed. Results: The correlation coefficients (r) between flow measured by ultrasonic dilution technique and brachial artery flow measured by duplex Doppler ultrasound, between flow measured by ultrasonic dilution technique and radial artery flow measured by duplex Doppler ultrasound, and between brachial artery flow and radial artery flow measured by duplex Doppler ultrasound were 0.724, 0.784, and 0.749, respectively (all p < 0.001). Conclusion: Blood flow measured by ultrasonic dilution technique was positively correlated with blood flow measured by duplex Doppler ultrasound during hemodialysis, suggesting that duplex Doppler ultrasound can be used to monitor the trends in the blood flow of the brachial artery and radial artery for timely intervention to improve patency during hemodialysis.
ISSN:1129-7298
1724-6032
DOI:10.1177/1129729820923939