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permanent acces
Metalia Puspitasari
Pendahuluan
TYPES
• Temporary access
• Permanent access
TEMPORARY ACCESS
• Permanent catheters
[Tunnelled, cuffed
catheters]
TEMPORARY CATHETERS
• Temporary catheters are composed of
polyurethane which is stiff at room
temperature to facilitate insertion but
softens at body temperature to minimize
the vessel trauma.
• Temporary catheterization should be done
in operating rooms or in dialysis procedure
room under aseptic technique.
• X-ray should be taken after
catheterization before
starting dialysis to verify
the catheter is in correct
placement.
• Catheter length varies
greatly to accommodate
proper positioning of the
tip.
INSERTION LOCATION
• The optimal insertion site is
right internal jugular vein.
• An AVF is formed by
subcutaneous anastomosis of
artery and vein.
• Its maturation period is 4 to 6
weeks.
• During this interval the flow in
the fistula increases and the
vein wall thickens.
• Fistula is created in the non-
dominant hand.
INDICATIONS
INDICATION:
• Patients with GFR < 30 ml/min [ CKD stage 3 ]
LOCATIONS
• Radio-median
antecubital fistula
• Ulnar basilic fistula
• Brachio bi-directional
cephalic fistula