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Kidney Week

Abstract: TH-PO345

Post-Dialysis Bleeding from AV Fistula (AVF) or Graft (AVG)

Session Information

  • Vascular Access - I
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Kushnir, Daniel, Carmel Medical Center, Haifa, Israel
  • Antebi, Alon, Carmel Medical Center, Haifa, Israel
  • Tanasiychuk, Tatiana, Carmel Medical Center, Haifa, Israel
  • Marcuson, Jerom, Carmel Medical Center, Haifa, Israel
  • Sura, Oleg, Carmel Medical Center, Haifa, Israel
  • Gil, Amnon, Carmel Medical Center, Haifa, Israel
  • Frajewicki, Victor, Carmel Medical Center, Haifa, Israel
Background

AVF is the the preferred access for hemodialysis, and AVG is considered the second best choice. Bleeding from the puncture site after withdrawal of needles is a frequent event in the dialysis unit.
The duration of “normal” bleeding time is not well defined. Usually bleeding lasts for up to 10 min, but if this bleeding persists for more than 30 min is considered as prolonged. The purpose of this study was to understand what is considered a normal bleeding time among patients and staff.

Methods

This was a cross-sectional study using a convenient cohort. In this setup, we conducted an
anonymous survey in 4 dialysis units (3 hospital based and 1 community located), asking patients,
nurses and physicians about issues related with bleeding after needles are removed: the average
bleeding time, the difference time between AVF/AVG, the effect of Heparin use on postdialysis
hemorrhage, the use of device for bleeding control and the influence of high venous pressure on
bleeding.

Results

A total of 92 persons (patients 50%, nurses 38%, physicians 12%) answered the survey. The average bleeding time after a puncture of AVF recorded by patients was 11±7 min and 14±6 with an AVG. This bleeding time was not significantly different from the time defined by nurses (9±7 and 14±4 min) or physicians (8.5±2 and 12±5min). In terms of differences between AVF/AVG, 32% of patients, 26% of nurses and 10% of physicians estimated that there was no difference. Around 30% of the interviewed stated that bleeding may be related to the heparin administration. Use of an hemostatic device was registered by patients in 37%, nurses in 77% and physicians in 90%. Fifty percent of patients thought that bleeding may be related to high venous pressure, as opposed to 88% of the nurses and 100% of the physicians.

Conclusion

Bleeding from the puncture site concern patients, nurses and physicians. Differences of
understanding and expectations were appreciated between these groups, showing how much more
education must be provided in this field.