DIRECT PUNCTURE - AN EASY AND RAPID ALTERNATIVE FOR ESTABLISHING TEMPORARY HEMODIALYSIS VASCULAR ACCESS

There are many methods available for establishing a temporary hemodial ysis vascular access. In this study, 32 patients were enrolled to unde rgo direct puncture for the purpose of short-term dialysis for acute r enal failure or fluid overload; thrombosis of a permanent vascular acc ess; fungal sepsis; or catheter-related sepsis before infection contro l. The femoral vein was punctured by a 16-gauge arteriovenous fistula needle to establish blood outflow; the dialyzed blood was returned via a second 16-gauge arteriovenous fistula needle inserted into a periph eral vein or the contralateral femoral vein. It took 6 min on average to perform this procedure, excluding the time spent in local preparati on. In 169 direct punctures of these 32 patients, the procedure provid ed a sufficient blood flow rate and treatment duration as prescribed f or our patients. Only one active bleeding episode was encountered (rep resenting an immediate complication rate of 0.6%), and symptomatic lat e complications were not noted during follow-up. In summary, direct pu ncture is an easy, rapid and safe procedure. It should be considered a good alternative for establishing a temporary access for the patient who needs short-term hemodialysis.