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MINERVA UROLOGICA E NEFROLOGICA
A Journal on Nephrology and Urology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
XIV CONGRESS OF THE SOCIETA' ITALIANA DI NEFROLOGIA SEZIONE PIEMONTE-VALLE D'AOSTA
(Ivrea, October 5, 1996)
Minerva Urologica e Nefrologica 1998 March;50(1):1-8
Temporary and emergency vascular access
Paternoster G., Molino A., Alloatti S.
Ospedale Regionale - Aosta, Servizio di Nefrologia e Dialisi
The vascular access in emergency represents a basic need for every nephrologist in order to realize an extracorporeal circuit necessary to perform hemodialysis and many other derived therapies. In the eighties a progressive abandonment of the external shunt was noted with a concomitant increase of vena cava catheterization simpler to perform, expecially under echographic control, and made increasingly possible by continous technological improvements. The femoral access is utilized in about 30% of cases, expecially in critically ill patients, due to easy performing procedures and few complications. Subclavian vein is abandoned as a first choice in favour of the jugular vein due to frequent and severe early complications and to thrombo-stenotic lesions observed in about 50% of catheterizations. Prevention and rapid treatment of the complications and careful management have an important role in obtaining a prolonged catheter survival. Even if, when possible, the classical arterio-venous fistula remains the ideal solution, at least in particular patient categories a jugular vein utilization as permanent access is justified.