Arterial Connections for Kidney Dialysis Patients
Renal failure patients mainly rely on an external device to perform kidney function that has become unable to perform its functions; So these patients need regular dialysis at a rate of 3 sessions per week.
During the dialysis session, needles are placed to transfer blood from the patient's body to the dialysis device to remove excess fluids and toxins, then the blood is returned to the patient after purification.
The arterial connections of dialysis patients take place through an arm operation to connect the arm vein to the arm's artery, helping to expand and strengthen the vein, earning it the ability to withstand blood back with high pressure. The process is done by anaesthesia to the patient locally.
Kidney Dialysis patients' arterial connections are better than cervical catheters, which are also used in dialysis.
Types of Arterial Connections:
Kidney Dialysis patients' arterial connections are divided into two types:
• Natural connections.
• Artificial connections.
Natural connections are the best in use and are directly connected between the artery and the vein, these natural connections have better blood flow efficiency and are less susceptible to bacterial infections, but are difficult to do in patients with blood vessel problems such as diabetics; We must also wait two months after its establishment to be ready for use in terms of the strength and tolerance of its walls. Natural connections include many advantages including:
1. Easy placement of needles to start a dialysis session.
2. Provide sufficient blood flow.
3. Work for longer periods.
4. The incidence of bacterial inflammation is low.
5. The connection's dropout rate is small.
Natural Connections Places:
Dr. Waleed El-Daly studies the tests and results of sound waves on the arm, to ensure that the conditions required for conducting the arterial connection in terms of the required size and diameter are met, to choose the most appropriate thing for the patient's condition, and from the most famous natural connections:
- In the wrist area: Some consider this type to be the best within normal connections but it needs to be with good blood flow in the body so that this type of connection can be made and those connections usually last for a long time, extending between 5 and 7 years.
- Elbow joint: We go for it in the case of venous problems at the wrist or the patient suffers from blood pressure deficiency in the artery. The validity of this connection is shorter than the link found from the wrist area.
In some cases, Dr. Waleed El-Daly flattens the vein if the vein is non-superficial for use in dialysis sessions.
Doctors go for artificial connections in case of a problem happening with the patient's natural vein, which is usually the result of draining all the natural veins due to the repeat of kidney dialysis sessions, that the patient may continue for it for many years so the veins will be damaged.
Artificial connections are made by the doctor by installing a plastic tube with a diameter of 6 mL, to act as an artery-vein link. Artificial connections last for periods ranging from 2 to 3 years.
Artificial connections have the potential to be placed in the thigh as well as not only in the arm and can start dialysis sessions only two weeks after their installation, but they have a shorter shelf life than natural connections because they are prone to clotting and bacterial infections that occur to lower degrees in natural connections.
Is the feeling of trembling above the Arterial Connection normal?
The patient's feeling of trembling above the arterial connection, is the strongest evidence of the health of blood flow from the artery to the vein. Conversely, the disappearance of such trembling requires communication with a physician.
Signs of Danger in the Arterial connection:
- Disappearance of trembling.
- The feeling of pulse above this connection.
- Feeling hot, redness, or bloated at the connection place.
- The exit of any pus discharge.
- Inability to move fingers in the arm having the arterial connection.
Complications of Arterial Connections surgery:
Post-operative bleeding: Bloating may appear in the area of operation with a sense of heavy load on the arm, and the onset of blood leakage between surgical stitches and their appearance on the medical gauze increasingly.
Bacterial infection: It may occur as a result of contamination of surgical instruments or substances used during medical dressings, and body temperature begins to rise and there is swelling and redness appears in the area of operation as the vibration sensation disappears.
Twice the amount of blood flowing into the hand: The patient feels severe pain in the hand, coldness, and loss of ability to perform functions; This is due to a lack of arterial irrigation of the arm.
These complications may occur when visiting an inexperienced physician and practicing these processes, but you are safe with Dr. Waleed El-Daly, Assistant Professor of Vascular Diseases and Diabetic foot.
Dr. Waleed El-Daly's instructions to follow after the Operation:
1- Lift the arm on a pillow to relieve swelling and bloating.
2- Pain can be controlled by the analgesics prescribed by Dr. Waleed El-Daly, along with the required antibiotics that prevent bacterial infection.
3- The cold sensation quickly fades gradually, due to the conversion of the blood bound to the lower arm to the connection directly; This causes a decrease in finger-bound blood. You can wear gloves to reduce that feeling.
4- Avoid sleeping on the arm with the arterial connection, to keep the blood running.
5- Avoid low blood pressure so that flowing blood impairment does not block the connection. Blood pressure can be maintained through regular fluid drinking and healthy nutrition, in a way that doesn't interfere with the kidney condition.
6- Compress a spongy ball as a type of exercise that strengthens the connection by preventing clots and increasing blood flow.
7- Avoid wearing tight clothes, watches, rings, or bracelets in the arm containing the arterial connection so that the blood flow does not stop.
8- Avoid carrying heavy objects in the hand where the arterial connection is located.
9- Ensure that the arm is extended instead of being bent, in case of swelling of the arm.
10- Ensure that fingers are constantly moved.
11- Avoid violent sports that need physical contact.
12- Check the arterial connection daily and make sure you feel shaken on top of it.
13- Make sure they are constantly clean.
14- Avoid getting blood samples or measuring blood pressure in that arm.
Tips for Maintaining the Arterial Connection:
- Wash the venous connection and your arm with warm water and antibacterial soap before each dialysis session.
- You can apply a topical sedative before each session to relieve the pain of needles used to connect the dialysis device.
- The arterial connection is not used to withdraw blood samples, but only for dialysis sessions.
- Continuous follow-up of the trembling coming from the connection and ensure that there is no swelling or change in skin colour.
Where can the Arterial connections of Kidney Dialysis Patients be performed?
Dr. Waleed El-Daly, Assistant Professor of Vascular Surgery and Diabetic Foot Treatment at Cairo University, goes for the placement all types of Arterial Connections for Kidney Dialysis patients, in proportion to their health condition.