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AP and VP during treatment
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<LLC>
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What would a consistent -50AP and 240VP be indicative of on a buttonhole site? There is a bit of back pressure upon venous cannulation, but otherwise no resistance in getting the cannula in the tunnel
 
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If the sticks are good, a venous stenosis.

Chuck


DISCLAIMER : My opinions and views are mine and may not be the same as my employer.
 
Posts: 1767 | Location: Baltimore, MD USA | Registered: 24 October 2001Report This Post
<Mark>
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A stenosis between the needles.
 
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This high venous pressure with back pressure when inserting the needles would indicated outflow, venous stenosis. Does this person have prolonged bleeding post treatment? This would be anything greater than 5-10 post needle removal.

What was the blood flow rate set at when you recorded these numbers.

Your arterial pressures seem low, which would also indicate an inflow, arterial issue.
 
Posts: 4 | Registered: 06 April 2012Report This Post
<old school>
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Tish, you are correct.We need more Access detectives in the clinic who are trained to do good physical assessements of accesses PRIOR to cannulation. This is paramount for a great Access program.
 
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quote:
Your arterial pressures seem low, which would also indicate an inflow, arterial issue.


Actually, the opposite is true. A -50 AP by itself would indicate very good inflow. When coupled with a likely venous (outflow) stenosis it really has little meaning.

A very easy way to verify a venous stenosis is to clamp the arterial bloodline prior to the saline T, give a 200cc bolus of NSS, remove the clamp and watch the arterial line for color change.

Chuck


DISCLAIMER : My opinions and views are mine and may not be the same as my employer.
 
Posts: 1767 | Location: Baltimore, MD USA | Registered: 24 October 2001Report This Post
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