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    Vascular access for hemodialysis

    Main article: Cimino fistula

    A radiocephalic fistula.Patients with end stage renal failure are treated with hemodialysis. In dialysis, blood iswithdrawn from an artery or vein, purified, and returned to a vein. The volume of bloodis too great for veins to handle, so a vein must be enlarged. An artery and vein, usuallyin the arm above or below the elbow, are sewn together, to create a fistula, and arterialpressure eventually enlarges the vein. The enlarged vein can accommodate a cannula orlarge needle.

    [edit] Physiology

    When an arteriovenous fistula is formed involving a major artery like the abdominalaorta, it can lead to a large decrease inperipheral resistance. This lowered peripheralresistance causes the heart to increase cardiac output to maintain proper blood flow toall tissues. The physical manifestations of this would be a relatively normal systolicblood pressure with a decreased diastolic blood pressure resulting in a wide (large)pulsepressure.

    Normal blood flow in thebrachial artery is 85 to 110 milliliters per minute (mL/min). After the creation of a fistula, the blood flow increases to 400 to 500 mL/minimmediately, and 700 to 1,000 mL/min within 1 month. A bracheocephalic fistulaabove the elbow has a greater flow rate than a radiocephalic fistula at the wrist. Both theartery and the vein dilate and elongate in response to the greater blood flow and shearstress, but the vein dilates more and becomes "arterialized". In one study, the cephalic

    vein increased from 2.3 mm to 6.3 mm diameter after 2 months. When the vein is largeenough to allow cannulation, the fistula is defined as "mature." [1]

    An arteriovenous fistula can increasepreload.[2]

    [edit] See also

    REACH US

    http://en.wikipedia.org/wiki/Cimino_fistulahttp://en.wikipedia.org/wiki/End_stage_renal_failurehttp://en.wikipedia.org/wiki/Hemodialysishttp://en.wikipedia.org/wiki/Cimino_fistulahttp://en.wikipedia.org/w/index.php?title=Arteriovenous_fistula&action=edit&section=2http://en.wikipedia.org/wiki/Abdominal_aortahttp://en.wikipedia.org/wiki/Abdominal_aortahttp://en.wikipedia.org/wiki/Peripheral_resistancehttp://en.wikipedia.org/wiki/Cardiac_outputhttp://en.wikipedia.org/wiki/Blood_pressurehttp://en.wikipedia.org/wiki/Pulse_pressurehttp://en.wikipedia.org/wiki/Pulse_pressurehttp://en.wikipedia.org/wiki/Brachial_arteryhttp://en.wikipedia.org/wiki/Cephalic_veinhttp://en.wikipedia.org/wiki/Cephalic_veinhttp://en.wikipedia.org/wiki/Arteriovenous_fistulahttp://en.wikipedia.org/wiki/Preload_(cardiology)http://en.wikipedia.org/wiki/Arteriovenous_fistulahttp://en.wikipedia.org/w/index.php?title=Arteriovenous_fistula&action=edit&section=3http://en.wikipedia.org/w/index.php?title=Arteriovenous_fistula&action=edit&section=3http://en.wikipedia.org/wiki/Arteriovenous_fistulahttp://en.wikipedia.org/wiki/Preload_(cardiology)http://en.wikipedia.org/wiki/Arteriovenous_fistulahttp://en.wikipedia.org/wiki/Cephalic_veinhttp://en.wikipedia.org/wiki/Cephalic_veinhttp://en.wikipedia.org/wiki/Brachial_arteryhttp://en.wikipedia.org/wiki/Pulse_pressurehttp://en.wikipedia.org/wiki/Pulse_pressurehttp://en.wikipedia.org/wiki/Blood_pressurehttp://en.wikipedia.org/wiki/Cardiac_outputhttp://en.wikipedia.org/wiki/Peripheral_resistancehttp://en.wikipedia.org/wiki/Abdominal_aortahttp://en.wikipedia.org/wiki/Abdominal_aortahttp://en.wikipedia.org/w/index.php?title=Arteriovenous_fistula&action=edit&section=2http://en.wikipedia.org/wiki/Cimino_fistulahttp://en.wikipedia.org/wiki/Hemodialysishttp://en.wikipedia.org/wiki/End_stage_renal_failurehttp://en.wikipedia.org/wiki/Cimino_fistula
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    Black eye needle to minimize interruption in blood flow

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    Medical Fistula Needle Fixed type 17G

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    Category: Health & Medical | Transfusion ApparatusRelatedKeywords: A.v Fistula Needle | Fistula Needle Sets | Av Fistula NeedleChat Now!Contact SupplierJiangxi Sanxin Medtec Co., Ltd.Contact Details China (Mainland)

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    SAFETY AV Fistula needle

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    Category: Health & Medical | Injection & Puncture InstrumentRelatedKeywords:Needle | Fistula Needles | A.v. Fistula NeedlesChat Now!Contact SupplierHospital & Homecare Imp. & Exp. Co., Ltd. NanjingContact Details China (Mainland)

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