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Title: Análisis de los accesos venosos en pacientes que precisan hemodiálisis, realizados antes y después de la creación de una comisión multidisciplinar para su manejo en un centro hospitalario
Author: Revuelta Mariño, Livia
Director: Prados Carrasco, Ferran
Tutor: Mayer Pujadas, Miguel Ángel
Keywords: vascular access
Issue Date: 2-Jan-2019
Publisher: Universitat Oberta de Catalunya (UOC)
Abstract: Venous accesses for hemodialysis are essential for patients with renal failure. Consisting in surgical procedures in which an artificial union between an artery and a vein is made (arterio-venous fistula) to obtain a vessel to provide through puncture sufficient flow to perform external filtering of the blood. When this type of access can not be done, the alternative is a venous catheter, which presents a higher risk of complications. The creation of vascular accesses requires careful planning and specific maintenance and surveillance, with different medical specialists involved, therefore the multidisciplinary management initiatives are now increasing. We analyzed such initiative in our hospital, trhough variables related to the current venous access management standards before and after the beginning of a multidisciplinary teamwork. In the period before the creation of the teamwork 50 interventions were performed and 44 later on. More than 30% of patients in both periods had a venous catheter in the moment of the first clinical evaluation, and some did not have an imaging test associated with the evaluation. There was an increase in the percentage of patients assessed with Doppler ultrasound in the second period but without significant difference. A significant reduction in the number of reinterventions was found in the second period, but not in the waiting time until surgery or in the need for rescue interventions (angioplasty). In conclusion, an improvement of the performance of the teamwork should be made to obtain an optimization in the management of these patients.
Language: Spanish
Appears in Collections:Bachelor thesis, research projects, etc.

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