Author/Editor		Knehtl, Maša; Krajnc, Mitja
Title		Vpliv arteriovenske fistule kot žilnega pristopa za hemodializo na prekrvljenost distalnih struktur - dlani in prstov (ocena treh parametrov)
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2003
Volume		str. 32
Language		slo
Abstract		BACKGROUND. Hemodialysis is the most widely used method of renal replacement therapy in end-stage renal disease. It requires a reliable permanent vascular access. Arteriovenous fistula (AVF) is the one most commonly used. Among other complications it may cause hand (palm and fingers) ischemia. The hand ischemia (incidence 1-10%) is the consequence of altered hemodynamic circumstances in the area distal to anasthomosis (the most important reason is decrease in distal arterial blood pressure). It presents with typical signs and symptoms, especially in patients with preexisting ishemic disease. AIM. The aim was to estimate the clinical significance of the measured parameters, temperature of the skin , pulse oxymetry and dynamometry in patients with blood perfusion problems in hands after AVF construction. Measuring of the above mentioned parameters is accessible, simple, noninvasive and does not require any special professional training. Clinical importance of dynamometry and skin temperature is yet to be established. Until now there is not any definite answer about the value of pulse oxymetry. HYPOTHESIS. Measurements of the chosen parameters were performed on a AVF-hand and a non AVF-hand in different time periods to confirm the following hypotheses: (1) blood perfusion in the AVF-hand is sufficient before and after AVF creation in previously asymptomatic patients. We shall not be able to prove the significant differences in the measured parameters on the AVFhand compared to the non AVF-hand (controle hand) on the same day; (2) blood perfusion of the AVF-hand will not be signi6cant different in time (when measurements were performed) after AVF construction. METHODS. In the prospective clinical study we have measured the above mentioned parameters in the end-stage renal disease patients who needed hemodialysis and who had no signs/symptoms of hand ischemia, on both hands. (Abstract truncated at 2000 characters).
Descriptors		KIDNEY FAILURE, CHRONIC HEMODIALYSIS CATHETERS, INDWELLING HAND ARTERIOVENOUS SHUNT, SURGICAL SKIN TEMPERATURE OXIMETRY HAND STRENGTH