Abstract: FR-PO783
Impact of a Compressive Therapy via Arm Sleeve on High Flow Arteriovenous Fistula and Cardiac Output in Patients with ESRD
Session Information
- Hemodialysis: Vascular Access - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 603 Hemodialysis: Vascular Access
Authors
- Jung, Jong-Hwan, Wonkwang University Hospital, Iksan, Korea (the Republic of)
- Ahn, Seon-Ho, Wonkwang University Hospital, Iksan, Korea (the Republic of)
Background
Heart failure is among cardiac complications in patients with end-stage renal disease (ESRD) undergoing hemodialysis via arteriovenous fistula (AVF). AVF creation may result in several cardiac dysfunctions, such as increase of left ventricular end-diastolic diameter, left ventricular hypertrophy, and high output heart failure, particularly in patients with AVF flow over 2000 ml/min. Surgical reduction of AVF to improve cardiac dysfunctions may often result in complications, such as access thrombosis. Thus, we suggests non-invasive compressive method via arm sleeve to reduce blood flow of high flow AVF.
Methods
Data were collected from total 30 patients with ESRD and high flow AVFs. All patients have autologous AVFs and have undergoing hemodialysis of three times sessions per week. All patients also have high flow AVFs with blood flow rate over 1200 ml/min. Arm sleeve (Nambuk Surgical®, Seoul, Korea) with pressure of 30~40 mmHg was applied during 8 hours on non-hemodialysis dates for three months in only fifteen patients. We performed comparative analysis for changes of AVF flow rates, cardiac output, and arm edema after application of arm sleeve in two groups.
Results
The average change of AVF flow rate in group which arm sleeve was applied was – 60 ml/min. On the contrary, average change of AVF flow in control group was 19.33 ml/min. The average AVF flow rate in group which arm sleeve was applied decreased statistically significant. (p <0.001) Also, arm edemas decreased significantly in patient which arm sleeve was applied. (-0.28 ± 0.28 vs 0.23 ± 0.26, -0.32 ± 0.25 vs 0.12 ± 0.24, -0.36 ± 0.37 vs 0.31 ± 0.21, -0.37 ± 0.30 vs 0.31 ± 0.32, and -0.45 ± 0.44 vs 0.33 ± 0.34; p <0.001) We analyzed changes of cardiac output. However, there was no significant difference concerning of change of cardiac output in two groups. (-0.01 ± 0.005 vs 0.005 ± 0.17, p =0.091)
Conclusion
The non-invasive compressive method reduced arm edema and AVF flow rate in patients with high flow AVFs. High flow rate over 2000 ml/min of AVF can be a risk factor of development of high output heart failure in patients with AVFs. Although there was no an effective impact of the non-invasive compressive method on cardiac output, reduction of edema and AVF flow rate might inhibit development of high output heart failure in patients with high flow AVFs