Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem
Ano de defesa: | 2018 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , , |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de Goiás
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Programa de Pós-Graduação: |
Programa de Pós-graduação em Enfermagem (FEN)
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Departamento: |
Faculdade de Enfermagem - FEN (RG)
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://repositorio.bc.ufg.br/tede/handle/tede/8339 |
Resumo: | Hemodialysis is the most common category of kidney replacement therapy set for chronical kidney disease. In order to perform this treatment it’s needed a vascular access (VA) that offers an adequate flow rate, a long use-life and a low rate of complications. The Arteriovenous Fistula (AVF) is the closest access to meet these requirements. It can, however, present complications and, during the cannulation that usually happens three times per week, adverse events (AE) can occur to the patient. The arteriovenous fistula cannulation must happen with safety in order to prevent future patency problems. There are three methods of cannulation: area, rope ladder and buttonhole. In the area method, the insertion points of the needles are in the same area; in the rope ladder method there’s the varying of the place of the puncture, at a distance defined by the previous puncture, all along the VA; and in the buttonhole method, the needle’s insertion happen in the same place, angle and deepness, forming a subcutaneous tunnel that will be cannulated with the blunt needle. Each one of these methods has its own particularity and can influence in the need to repair the fistula. This is a prospective cohort study, during the course of six months, from April to September of 2017, conducted with the participation of 347 patients using the vascular access by autologous arteriovenous fistula, within three hemodialysis clinics in the city of Goiânia - GO. The data collection happened by weekly interview to the patients, using a structured instrument online. The research was approved by the Ethics Committee and the participation conditioned to signing of the consent form by the patient. The general objective was to analyze the factors that can influence in the necessity to repair the arteriovenous fistula of patients in hemodialytic treatment cannulated by different cannulation methods. The specific objective was to relate the adverse events and complications in the different arteriovenous fistula cannulation methods. We’ve found that in the buttonhole method, the most frequent AE was dermatitis and misscannulation, and in the area/rope-ladder methods, the most frequent AE were haematoma and peri-punction bleeding. The patients in the buttonhole method group received the hemodialytic treatment with a higher blood flow compared the other group. We’ve observed that the dual lumen catheter (DLC) is a predictor to the need of AVF repairments, due to enhancing in 28% the risk of need for AFV repair. The “arterial” retrograde cannulation has presented itself as a protection factor, diminishing the need to AVF repairments in 1%. In conclusion, the buttonhole method is recommended, since there is an intermittent surveillance of the arteriovenous fistula by the nurse in the touching exam. The area method is not recommended, and the rope ladder method should be individually evaluated in future studies. The nurse must act by monitoring the AFV, surveillance of the patency parameters and health education to the patients for the AVF self-care, as well as continued education to the nursing team in order to promote safe and scientifically based practices. |
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Barreto, Regiane Aparecida dos Santos Soareshttp://lattes.cnpq.br/4032250808062336Barreto, Regiane Aparecida dos Santos SoaresSilva, Ana Elisa Bauer de CamargoFreitas, Nara Rúbia dehttp://lattes.cnpq.br/5180841622752638Rodrigues, Jéssica Guimarães2018-04-16T13:27:10Z2018-03-16RODRIGUES, J. G. Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem. 2018. 66 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Enfermagem, 2018.http://repositorio.bc.ufg.br/tede/handle/tede/8339Hemodialysis is the most common category of kidney replacement therapy set for chronical kidney disease. In order to perform this treatment it’s needed a vascular access (VA) that offers an adequate flow rate, a long use-life and a low rate of complications. The Arteriovenous Fistula (AVF) is the closest access to meet these requirements. It can, however, present complications and, during the cannulation that usually happens three times per week, adverse events (AE) can occur to the patient. The arteriovenous fistula cannulation must happen with safety in order to prevent future patency problems. There are three methods of cannulation: area, rope ladder and buttonhole. In the area method, the insertion points of the needles are in the same area; in the rope ladder method there’s the varying of the place of the puncture, at a distance defined by the previous puncture, all along the VA; and in the buttonhole method, the needle’s insertion happen in the same place, angle and deepness, forming a subcutaneous tunnel that will be cannulated with the blunt needle. Each one of these methods has its own particularity and can influence in the need to repair the fistula. This is a prospective cohort study, during the course of six months, from April to September of 2017, conducted with the participation of 347 patients using the vascular access by autologous arteriovenous fistula, within three hemodialysis clinics in the city of Goiânia - GO. The data collection happened by weekly interview to the patients, using a structured instrument online. The research was approved by the Ethics Committee and the participation conditioned to signing of the consent form by the patient. The general objective was to analyze the factors that can influence in the necessity to repair the arteriovenous fistula of patients in hemodialytic treatment cannulated by different cannulation methods. The specific objective was to relate the adverse events and complications in the different arteriovenous fistula cannulation methods. We’ve found that in the buttonhole method, the most frequent AE was dermatitis and misscannulation, and in the area/rope-ladder methods, the most frequent AE were haematoma and peri-punction bleeding. The patients in the buttonhole method group received the hemodialytic treatment with a higher blood flow compared the other group. We’ve observed that the dual lumen catheter (DLC) is a predictor to the need of AVF repairments, due to enhancing in 28% the risk of need for AFV repair. The “arterial” retrograde cannulation has presented itself as a protection factor, diminishing the need to AVF repairments in 1%. In conclusion, the buttonhole method is recommended, since there is an intermittent surveillance of the arteriovenous fistula by the nurse in the touching exam. The area method is not recommended, and the rope ladder method should be individually evaluated in future studies. The nurse must act by monitoring the AFV, surveillance of the patency parameters and health education to the patients for the AVF self-care, as well as continued education to the nursing team in order to promote safe and scientifically based practices.A hemodiálise é a modalidade de terapia renal substitutiva mais comumente instituída para a doença renal crônica. Para esse tratamento é necessário um acesso vascular que ofereça fluxo sanguíneo adequado à necessidade dialítica, meia vida longa e baixo índice de complicações. A fístula arteriovenosa é o acesso que mais se aproxima desses requisitos. Porém, não obstante, pode apresentar complicações, e durante as punções, que comumente se repetem três vezes por semana, pode haver eventos adversos (EA) ao paciente. A punção da fístula arteriovenosa deve ser realizada com segurança a fim de prevenir futuros problemas de perviedade. Há três métodos de punção: regional, escada de corda, e buttonhole. No método regional, os pontos de inserção das agulhas são na mesma região; no método escada de corda, há rotação do sítio de punção, a uma distância definida a partir da anterior ao longo de todo o AV; e no buttonhole, a inserção da agulha é no mesmo local, ângulo e profundidade, formando de um túnel subcutâneo que será puncionado com agulha romba. Cada um desses métodos tem sua particularidade e podem influenciar na necessidade para reparos na fístula. Este é um estudo longitudinal de coorte prospectiva, no período de seis meses, abril a setembro de 2017, realizado com 347 pacientes em hemodiálise usando acesso vascular por fístula arteriovenosa autóloga, em três clínicas satélites do município de Goiânia - GO. A coleta de dados foi por entrevista semanal aos pacientes, por meio de instrumento estruturado online. A pesquisa foi aprovada por comitê de ética, e a participação condicionada à assinatura do Termo de Consentimento Livre e Esclarecido do paciente. O objetivo geral foi analisar fatores que influenciam na necessidade de reparo à fístula arteriovenosa de pacientes em hemodiálise puncionados por distintos métodos de punção. E os objetivos específicos foram identificar e relacionar os eventos adversos e complicações em distintos métodos de punção da fístula arteriovenosa, e caracterizar os preditores de complicações da fístula arteriovenosa. Encontramos como resultados que no método de punção de fístula arteriovenosa buttonhole o EA mais frequente foi dermatite e reinserção de agulhas de punção, e nos métodos escada/regional foram hematoma e sangramento peripunção. Os pacientes no grupo puncionado pelo método buttonhole receberam hemodiálise sob fluxos de sangue mais altos comparado ao outro grupo. Observamos que o uso do cateter venoso central de duplo lúmen (CDL) caracteriza-se um preditor de necessidade de reparo da fístula arteriovenosa, pois aumenta em 28% o risco dessa necessidade. A punção “arterial” retrógrada apresentou-se como fator de proteção, diminuindo em 1% a necessidade de reparos. Concluímos que o método de punção buttonhole é recomendado desde que haja a monitoração intermitente da fístula arteriovenosa pelo enfermeiro durante exame físico. O método regional é desestimulado. E o método escada de corda deve ser avaliado individualmente em estudos futuros. O enfermeiro deve estabelecer a vigilância dos parâmetros de perviedade, educação em saúde para autocuidado da fístula arteriovenosa, bem como educação continuada para a equipe de enfermagem a fim de promover práticas seguras e cientificamente embasadas.Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2018-04-16T13:26:11Z No. of bitstreams: 2 Dissertação - Jéssica Guimarães Rodrigues - 2018.pdf: 4231969 bytes, checksum: 7cd99fc018c0461eb571ee4a66eb3bbc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-04-16T13:27:10Z (GMT) No. of bitstreams: 2 Dissertação - Jéssica Guimarães Rodrigues - 2018.pdf: 4231969 bytes, checksum: 7cd99fc018c0461eb571ee4a66eb3bbc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2018-04-16T13:27:10Z (GMT). No. of bitstreams: 2 Dissertação - Jéssica Guimarães Rodrigues - 2018.pdf: 4231969 bytes, checksum: 7cd99fc018c0461eb571ee4a66eb3bbc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-03-16application/pdfporUniversidade Federal de GoiásPrograma de Pós-graduação em Enfermagem (FEN)UFGBrasilFaculdade de Enfermagem - FEN (RG)http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessEnfermagem em nefrologiaFístula arteriovenosaDiálise renalVigilância de evento sentinelaPesquisa em enfermagem clínicaNephrology nursingArteriovenous fistulaRenal dialysisSentinel surveillanceClinical nursing researchCIENCIAS DA SAUDE::ENFERMAGEMPunção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagemArteriovenous fistula cannulation in hemodialysis patients: evidences for nursinginfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis45061628303650419816006006002756753233336908714-7702826533010964327reponame:Repositório Institucional da UFGinstname:Universidade Federal de Goiás (UFG)instacron:UFGORIGINALDissertação - Jéssica Guimarães Rodrigues - 2018.pdfDissertação - Jéssica Guimarães Rodrigues - 2018.pdfapplication/pdf4231394http://repositorio.bc.ufg.br/tede/bitstreams/25a34b56-7c5b-44cd-9066-527ebc2a63ae/downloada06a343caf001b133cb72b58b47f8a86MD55LICENSElicense.txtlicense.txttext/plain; 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dc.title.eng.fl_str_mv |
Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem |
dc.title.alternative.eng.fl_str_mv |
Arteriovenous fistula cannulation in hemodialysis patients: evidences for nursing |
title |
Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem |
spellingShingle |
Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem Rodrigues, Jéssica Guimarães Enfermagem em nefrologia Fístula arteriovenosa Diálise renal Vigilância de evento sentinela Pesquisa em enfermagem clínica Nephrology nursing Arteriovenous fistula Renal dialysis Sentinel surveillance Clinical nursing research CIENCIAS DA SAUDE::ENFERMAGEM |
title_short |
Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem |
title_full |
Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem |
title_fullStr |
Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem |
title_full_unstemmed |
Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem |
title_sort |
Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem |
author |
Rodrigues, Jéssica Guimarães |
author_facet |
Rodrigues, Jéssica Guimarães |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Barreto, Regiane Aparecida dos Santos Soares |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4032250808062336 |
dc.contributor.referee1.fl_str_mv |
Barreto, Regiane Aparecida dos Santos Soares |
dc.contributor.referee2.fl_str_mv |
Silva, Ana Elisa Bauer de Camargo |
dc.contributor.referee3.fl_str_mv |
Freitas, Nara Rúbia de |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5180841622752638 |
dc.contributor.author.fl_str_mv |
Rodrigues, Jéssica Guimarães |
contributor_str_mv |
Barreto, Regiane Aparecida dos Santos Soares Barreto, Regiane Aparecida dos Santos Soares Silva, Ana Elisa Bauer de Camargo Freitas, Nara Rúbia de |
dc.subject.por.fl_str_mv |
Enfermagem em nefrologia Fístula arteriovenosa Diálise renal Vigilância de evento sentinela Pesquisa em enfermagem clínica |
topic |
Enfermagem em nefrologia Fístula arteriovenosa Diálise renal Vigilância de evento sentinela Pesquisa em enfermagem clínica Nephrology nursing Arteriovenous fistula Renal dialysis Sentinel surveillance Clinical nursing research CIENCIAS DA SAUDE::ENFERMAGEM |
dc.subject.eng.fl_str_mv |
Nephrology nursing Arteriovenous fistula Renal dialysis Sentinel surveillance Clinical nursing research |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::ENFERMAGEM |
description |
Hemodialysis is the most common category of kidney replacement therapy set for chronical kidney disease. In order to perform this treatment it’s needed a vascular access (VA) that offers an adequate flow rate, a long use-life and a low rate of complications. The Arteriovenous Fistula (AVF) is the closest access to meet these requirements. It can, however, present complications and, during the cannulation that usually happens three times per week, adverse events (AE) can occur to the patient. The arteriovenous fistula cannulation must happen with safety in order to prevent future patency problems. There are three methods of cannulation: area, rope ladder and buttonhole. In the area method, the insertion points of the needles are in the same area; in the rope ladder method there’s the varying of the place of the puncture, at a distance defined by the previous puncture, all along the VA; and in the buttonhole method, the needle’s insertion happen in the same place, angle and deepness, forming a subcutaneous tunnel that will be cannulated with the blunt needle. Each one of these methods has its own particularity and can influence in the need to repair the fistula. This is a prospective cohort study, during the course of six months, from April to September of 2017, conducted with the participation of 347 patients using the vascular access by autologous arteriovenous fistula, within three hemodialysis clinics in the city of Goiânia - GO. The data collection happened by weekly interview to the patients, using a structured instrument online. The research was approved by the Ethics Committee and the participation conditioned to signing of the consent form by the patient. The general objective was to analyze the factors that can influence in the necessity to repair the arteriovenous fistula of patients in hemodialytic treatment cannulated by different cannulation methods. The specific objective was to relate the adverse events and complications in the different arteriovenous fistula cannulation methods. We’ve found that in the buttonhole method, the most frequent AE was dermatitis and misscannulation, and in the area/rope-ladder methods, the most frequent AE were haematoma and peri-punction bleeding. The patients in the buttonhole method group received the hemodialytic treatment with a higher blood flow compared the other group. We’ve observed that the dual lumen catheter (DLC) is a predictor to the need of AVF repairments, due to enhancing in 28% the risk of need for AFV repair. The “arterial” retrograde cannulation has presented itself as a protection factor, diminishing the need to AVF repairments in 1%. In conclusion, the buttonhole method is recommended, since there is an intermittent surveillance of the arteriovenous fistula by the nurse in the touching exam. The area method is not recommended, and the rope ladder method should be individually evaluated in future studies. The nurse must act by monitoring the AFV, surveillance of the patency parameters and health education to the patients for the AVF self-care, as well as continued education to the nursing team in order to promote safe and scientifically based practices. |
publishDate |
2018 |
dc.date.accessioned.fl_str_mv |
2018-04-16T13:27:10Z |
dc.date.issued.fl_str_mv |
2018-03-16 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
RODRIGUES, J. G. Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem. 2018. 66 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Enfermagem, 2018. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/8339 |
identifier_str_mv |
RODRIGUES, J. G. Punção de fístula arteriovenosa de pacientes em hemodiálise: evidências para a enfermagem. 2018. 66 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Enfermagem, 2018. |
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Universidade Federal de Goiás |
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