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

• Published in: The journal of vascular access Vol. 22; no. 1; p. 75
• 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: Journal Article
• Language: English
• Published: United States 01.01.2021
• 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; surveillance; Hemodialysis; arteriovenous fistula; blood flow
• ISSN: 1724-6032
• DOI: 10.1177/1129729820923939

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. 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. The correlation coefficients ( ) 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 < 0.001). 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.