• The Korean Journal of Rehabilitation Nursing
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• v.19 no.1
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• pp.1-11
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• 2016

Purpose: To determine the effects of 10 % lidocaine spray and aroma hand massage on pain, anxiety, blood pressure, and pulse during arteriovenous (AV) fistula needling in hemodialysis (HD) patients. Methods: This study used a quasi-experimental design. Forty HD patients were assigned to either 10 % lidocaine spray group (n=21) or aroma massage group (n=19). 10 % lidocaine was sprayed 3 times around AV fistula 10 minutes before. Aroma hand massage was performed for 5 minutes with fluids containing 2 % of lavender, peppermint, and geranium concentrate mixture. Pain, anxiety, blood pressure, and pulse were measured during AV fistula needling without any intervention on the first week and during interventions on the second week. Data were analyzed with ${\chi}^2$ test, Fisher's exact test, t-test, paired t-test and MANCOVA. Results: Pain and anxiety were significantly decreased in both the lidocaine spray group and aroma massage group. Aroma hand massage was more effective to reduce pulse during AV fistula needling. Conclusion: The results suggest that 10% lidocaine spray and aroma hand massage may be effective to reduce pain, anxiety, and pulse during AV fistula needling in HD patients.

• Journal of Korean Biological Nursing Science
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• v.21 no.3
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• pp.207-216
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• 2019

Purpose: The purpose of this was to compare effects of application of the skin stimulation method and topical anesthetic cream on pain, heart rate variability and satisfaction according to nursing intervention methods during arteriovenous fistula puncture in chronic renal failure hemodialysis patients. Methods: This study was a crossover design. Participants were 36 patients with chronic renal failure receiving hemodialysis treatment. Two forms of intervention were applied to participants, and then pain and heart rate variability were measured during the puncture. Results: There were no statistically significant differences according to each treatment in vein pain and artery pain. Also, there were no statistically significant differences according to each treatment in stress index, sympathetic activity (LF), parasympathetic activity (HF) and sympathetic activity/parasympathetic activity (LF/HF ratio). Satisfaction with application of skin stimulation method was statistically higher than that of topical anesthetic cream application. Conclusion: This suggests that application of the skin stimulation method complements disadvantages of topical anesthetic cream application and demonstrates possibility of application as a nursing intervention method which can be conveniently used by nurses in clinical practice.

• Journal of Chest Surgery
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• v.11 no.2
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• pp.227-231
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• 1978

Since January 1973 we have performed 47 arteriovenous shunts and 22 arteriovenous fistulas for 57 patients with acute or chronic renal failure. Of these 57 cases, 50 cases had chronic renal failure and the other 7 cases had acute renal failure. The most frequent complications after operations were thrombosis, bleeding and infection. Less frequently dislodgement of shunt and aneurysmal change of the fistula were found. After 47 arteriovenous shunts, 21 those complications [44%] were found. On the other hand after 22 arteriovenous fistulas, 5 complications were found. Now we are using the arteriovenous shunt only for the patients who need emergency short term hemodialysis and temporary dialysis until arteriovenous fistula could be used.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.342-348
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• 2004

It is very important for hemodialysis in patients with end stage renal disease to obtain vascular access that resists repeated punctures and maintains adequate blood flow. This study was designed to indentify factors that may influence early patency rate of autogenous arteriovenous fistula. Material and Method: 49 cases in 47 patients who underwent radiocephalic fistula formation in our hospital from June 2002 through May 2003 were reviewed and analyzed. Result: The early patency rate was 79.6%. Age, sex, hypertension, and diabetes mellitus were not significant factors for patency. Body mass index and duration of hypertension and diabetes did not influence the early results either. Cephalic vein diameter measured preoperatively and blood flow at radio-cephalic fistula were significantly positive correlative factors. Groups with the vein diameter less than 2.7mm, or with the blood flow less than 100 mL/min had significantly lower early patency rate than the other groups. Conclusion: To improve early patency rate of radiocephalic fistula, large sized cephalic vein should be selected and if the intraoperative flow at radiocephalic fistula is less than 100 mL/min, another arteriovenous fistula formation should be considered.

• Journal of Korean Clinical Nursing Research
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• v.21 no.2
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• pp.215-222
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• 2015

Purpose: For hemodialysis, a vascular access which can maintain a certain speed for a long time is required. The prevention of the vascular access dysfunction is very important to decrease morbidity and to improvethe quality of life of patients receiving hemodialysis It is reported that far infrared heat increases the blood flow by expanding capillaries and micro-arteriovenouses. This study aimed to evaluate the effect of far infrared heat therapy as a new nursing intervention for maintaining vascular access function and improving the blood flow of patients receiving hemodialysis. Methods: The quasi-experimental research of nonequivalent control group pre-post test design was carried out for 59 patients receiving hemodialysis 3 times per week at K medical center. A far infrared heat was applied to the experimental group for 3 months. Results: The arteriovenous fistula blood flow of the experimental group (far infrared heat therapy group) increased significantly when compared to the control group (p=.047). However, static intra-access pressure ratio(SIAPR)was not different statistically (p=.101). Conclusion: The far infrared therapy could be considered as nursing intervention of choice as it demonstrated increase in the arteriovenous fistula blood flow in the patients receiving hemodialysis.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.73-77
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• 1995

We are reporting one case of right subclavian vein thrombotic occlusion as a result of previous hemodialysis catheter placement in a patient with a functioning right brachio-cephalic arteriovenous fistula. Its complication was painful right arm swelling, limitation of motion and cellulitis. Diagnosis was confirmed by right subclavian venography and the complication was successfully managed by right subclavian vein-superior vena cava bypass with a GoreTex vascular graft. The arteriovenous fistula had remained to protect patency of the bypass at first, but two months later after the operation, the arteriovenous fistula had to be occluded because of the heart failure resulting from shunt over flow. After ligation of arteriovenous fistula, heart failure improved, and uncomfortable arm swelling did not develop again.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.883-888
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• 1996

Expanded polytertrafluoroethylene (expanded PTFE) graft fistulas are widely used as secondary vascu- lar access for patients receiving long-term hemodialysis treatment. We implanted 48 grafts in )5 patients during the period from August 1990 to August 1995. Forty-three grafts in 32 patients were followed for 1 to 46 months. We performed forearm straight grafts in 36 grafts and upperarm straight grafts in 7 grafts. We experienced 3 operative failures, 22 early and late complications(15 graft thrombosis). Cumulative patency for all grafts at 12 months was 63%, at 24 months 32%, at 36 months 32% Forearm graft survival at 12 months was 55%, at 24 months 30%, at )6 months 30%. Upperarm graft survival at 12 months was 8)oyo and 24 months 41%. After reviewing our experience, we think that expanded-PTFE grart as secondary vascular access still have many complications and low survival than autogenous a teriovenous fistula. And so utilization of the expanded PTFE fistula requires better techniques, close observation and maintenance to keep it functional.

• Journal of Chest Surgery
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• v.46 no.6
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• pp.439-443
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• 2013

Background: The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. Methods: We retrospectively reviewed the clinical data of 113 patients who came for an outpatient clinic follow-up to the department of internal medicine of our hospital; these patients were among the 125 patients who underwent radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) in our hospital in the period from January 2006 to December 2010. Results: The patency rate showed no statistical significance with respect to sex (p=0.775), age (p=0.775), hypertension (p=0.262), diabetes (p=0.929), and cardio-neurovascular disease (p=0.717). Patency rates were 96% for the first month, 93% for the first year, and 90% for the second year for the radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) performed on the wrist. Conclusion: The patency rates revealed favorable results and few postoperative complications as compared to those of previous reports. Therefore, radiocephalic fistula using side-to-side anastomosis with distal cephalic vein ligation is considered a recommendable surgical procedure in the distal part for the hemodialysis of CRF patients.

• Journal of Korean Biological Nursing Science
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• v.9 no.2
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• pp.105-117
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• 2007

Purpose: The purpose of this study was two folds: first, to identify the level of self care behavior of the hemodialysis patients and second, to find the correlation between the self care behavior and the physiologic indices. Method: The subjects were 52 hemodialysis patients, male and female, who have regularly received hemodialysis dialysis at the Dialysis Room in a leading teaching hospital, Seoul. The patients responded to the self care behavior questionnaires including their socio-demographic characteristics. The respondents have regularly recorded the self care log book. The physiologic indices, clinical characteristics related to the disease and hemodialysis were collected by the chart review. Result: The mean score of the self care behavior was 3.46. The mean score of the self care behavior on categories demonstrated as follows: medication 4.29, fistula management 4.13, management of physical problem 3.71, diet 3.28, exercise and rest 3.22, blood pressure and body weight management 2.97 and social adjustment 2.05 in order. Thirty patients managed discomfort of their fistula. Eleven patients took exercise for 0.5-1 hr/week. Thirty patients measured their body weight daily and thirty two measured their blood pressure daily. The score of self care behavior was significantly correlated with the mean weight gains between the dialysis sessions(r=-.312, p=.05). The mean weight gains between dialysis sessions was found to be high as the level of serum phosphorus and potassium increased(r=-.316, p=.05, r=-.465, p=.01). Conclusion: The result suggests that nursing intervention to the hemodialysis patients to improve self care behavior should be encouraged and further developed.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.369-374
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• 2002

Background: Proper construction of vascular access and adequate maintenance are essential for the prognosis of the hemodialysis patients. Though arteriovenous fistula using autogenous vessel is the first of choice, the incidence of arteriovenous fistula using artificial graft is gradually increasing. The aim of this study was to analyse the patency rates between autogenous and artificial fistula, among artificial graft types, according to the accompanied disease. Material and Method: A retrospective study was conducted on 186 patients who underwent 292 arteriovenous fistula operations for hemodialysis at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 54.37 $\pm$ 12.79years, and the male: female ratio 99:87. Result: Among 292 operations, there were 156 autogenous fistula and 116 graft fistula. The other 20 operations were thrombectomy, takedown of graft, revision, and balloon dilatation. Patency rates of autogenous fistula were 92.78 $\pm$ 2.35% at 1 year and 39.03$\pm$9.08% at 5 years, and those of graft fistula were 96.09 $\pm$ 2.22% at 1 year and 16.45 $\pm$ 10.15% at 5 scars. However, there was no statistical significance between the two operations. The patients who had hypertension, diabetes or both had no statistical significance in the patency rate compared to that of patients without underlying disease. In addition, the type of graft used did not affect the patency rate. Second operation was needed in 62 patients and third operation in 31 patients, but their patency rate again had no statistical significance compared to that of the first operation. Conclusion: The patency of the artificial graft fistula was comparable to the autogenous fistula, but the patency according to types of graft need to be studied further. Furthermore, the underlying diseases did not affect the fistula patency.