Uremia
Conditions
Interventions
Arteriovenous fistula group:Blood flow rates180-200ml/min
Arteriovenous fistula group:Select the best puncture method according to the patients previous puncture method
Arteriovenous fistula group:plastic cannula for puncture
Temporary central venous catheterization group:Blood flow rates180-200ml/min
Temporary central venous catheterization group:Ultrasound localization was performed in all patients before catheterization
Temporary central venous catheterization group:The site of catheter placement:first, right jugular vein
second, femoral vein
third, left jugular vein
fourth, subclavian vein
Temporary central venous catheterization group:For patients without active bleeding or risk of bleeding, catheter closure was performed with 1000U/ml heparin saline
Temporary central venous catheterization group:For patients with active bleeding, the tube was sealed with 4% sodium citrate solution once every 24 hours
Sponsors
Medical Ethics Committee of the First Affiliated Hospital of the Air Force Medical University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1.age >=18 years; 2.Regular use of arteriovenous fistula in maintenance hemodialysis patients; 3.Admission required CRRT treatment; 4.The arteriovenous fistula can be used normally this time:Experienced nurses judged that arteriovenous fistulas could be used normally or within 1 week before admission.There is no indication of arteriovenous fistula dysfunction (such as the pulsation intensity is enhanced and strong, the tremor is limited and enhanced, and there is eddy current only in systole, and the murmur is limited and discontinuous, and there is high tone only in systole); 5.Willing to participate in this study and sign informed consent.
Exclusion criteria
Exclusion criteria: 1.Pregnant or breastfeeding; 2.After discharge, arteriovenous fistula is no longer needed for MHD (such as kidney transplantation); 3.Patients with advanced malignant tumors; 4.Infected with HIV and syphilis; 5.Unconditional establishment of temporary vascular access.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Access-related serious complications during hospitalization: fatal bleeding associated with temporary dialysis catheters;Access-related serious complications during hospitalization:serious hematoma associated with temporary dialysis catheters ;Access-related serious complications during hospitalization:pneumothorax associated with temporary dialysis catheters;Access-related serious complications during hospitalization:hemothorax associated with temporary dialysis catheters;Access-related serious complications during hospitalization:thrombus requiring surgical intervention;Access-related serious complications during hospitalization:infection associated with temporary dialysis catheters;Access-related serious complications during hospitalization: infection associated with arteriovenous fistula;Access-related serious complications during hospitalization: subcutaneous haematomas associated with arteriovenous fistula;Access-related serious complications during hospitalization: arteriovenous fistula dysfunction;Access-related serious complications during hospitalization: fistula aneurysm;Access-related serious complications during hospitalization: pseudoaneurysm;Replacement of vascular access: arteriovenous fistula was replaced with temporary catheter, and the puncture site of temporary catheter was replaced;Arteriovenous fistula dysfunction occurred during follow-up ;During the follow up duration, the central vein stenosis at the side of temporary catheter placement was observed; | — |
Secondary
| Measure | Time frame |
|---|---|
| All-cause mortality rate;Arteriovenous fistula intervention in 1 year(percutaneous transluminal balloon angioplasty,surgical revision, reconstruction fistula);Number and reason of filter and extracorporeal circuit replacement during CRRT treatment;Average delivered dose of CRRT after each treatment during hospitalization (ml/kg.h);Frequency and reason of pump stop during CRRT treatment;Urea clearance index (Kt/V) after each treatment during hospitalization and monthly follow-up after discharge;Urea reduction rate(URR) after each treatment during hospitalization and monthly follow-up after discharge;Average filtration fraction(FF) of CRRT each treatment during hospitalization;Common complications and severity associated with temporary catheterization: bleeding;Common complications and severity associated with temporary catheterization: hematoma;Common complications and severity associated with temporary catheterization: thrombus;Common complications and severity associated with temporary catheterization: pneumothorax;Common complications and severity associated with temporary catheterization: hemothorax;Common complications and severity associated with temporary catheterization: infection;Common complications and severity associated with arteriovenous fistula: bleeding and oozing around the needle;Common complications and severity associated with arteriovenous fistula: subcutaneous haematomas;Common complications and severity associated with arteriovenous fistula: infection;Common complications and severity associated with arteriovenous fistula: arteriovenous fistula dysfunction;Common complications and severity associated with arteriovenous fistula: fistula aneurysm;Common complications and severity associated with arteriovenous fistula: pseudoaneurysm;APACHE? score after each treatment during hospitalization;SOFA score after each treatment during hospitalization; | — |
Countries
China
Contacts
Public ContactMing Bai
The First Affiliated Hospital of the Air Force Medical University
Outcome results
None listed