シャント流量と再循環率の関連 Correlation between vascular access and re-circulation rate
Adequacy of dialysis is very important for the dialysis patient. Vascular access is one of the most important factors influencing the quality of dialysis ; sufficient blood flow is needed and there must not be re-circulation. There are few reports investigating the concrete conditions under which re-circulation appears. Therefore, we investigated 1) the influence of distance between puncture sites and puncture direction on the appearance of re-circulation, 2) the relation between vascular access flow and re-circulation. Thirty-seven dialysis patients were selected for this study. Using a dialysis monitor, HD02<SUP>®</SUP>(Transonic Systems company, NY, USA), we measured vascular access flow and re-circulation rate, and examined the correlation among the re-circulation rate, puncture needle distance and puncture direction. We also examined minimum vascular access flow in the absence of re-circulationn. In this study, we demonstrated that re-circulation never appeared when the distance between the puncture sites was more than 30mm, but did not depend on puncture direction, when fair vascular access was achieved without stenosis and showed limited branching with a blood flow over 700mL/min. In addition, when distance between the puncture sites was 50mm in case of the opposite puncture, re-circulation appeared with vascular access flow less than 300mL/min. There was no improvement in the re-circulation rate even if blood flow was reduced by 20% (Q<SUB>B</SUB>250→200mL).
- 日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy
日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy 41(4), 245-249, 2008-04-28
The Japanese Society for Dialysis Therapy