The care and keeping of vascular access for home hemodialysis patients.
Creating and maintaining a healthy vascular access is a critical factor in successful home hemodialysis (HD). This article aims to serve as a "how-to manual" regarding vascular access issues for both patients and health-care providers in a home HD program. This document outlines cannulation options for patients with arteriovenous access and describes troubleshooting techniques for potential complications; strategies are suggested to help patients overcome fear of cannulation and address problems associated with difficult cannulation. Technical aspects of central venous catheter care, as well as a guide to troubleshooting catheter complications, are covered in detail. Monitoring for access-related complications of stenosis, infection, and thrombosis is a key part of every home HD program. Key performance and quality indicators are important mechanisms to ensure patient safety in home HD and should be used during routine clinic visits.
University Health Network, Toronto, Ontario, Canada.
Rose
R
Faratro
Janine
J
Jeffries
Gihad E
GE
Nesrallah
Jennifer M
JM
MacRae
D062905:Central Venous Catheters; D006437:Hemodialysis, Home / Q000009:adverse effects / Q000379:methods; D006801:Humans; D017053:Infection Control / Q000379:methods*; D010353:Patient Education as Topic; D013927:Thrombosis / Q000517:prevention & control*
Home hemodialysis; arteriovenous fistula; buttonhole cannulation; cannulation; rope ladder cannulation; vascular access