Masui. The Japanese journal of anesthesiology · 2004
[Perioperative failure of hemodialysis shunts: analysis of risk factors].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sumida Hiroshi, Nakamura Kumi, Katagawa Tomoko, Mizota Toshiyuki, Hashimoto Kayoko, Yamakawa Tomoyuki, Kitamura Rie
Аннотация
BACKGROUND: Because vascular access dysfunction results in substantial morbidity in patients undergoing chronic hemodialysis, this complication should be avoided. However, we experienced four patients whose hemodialysis shunts failed within 24 hours postoperatively.
METHODS: We retrospectively analyzed operations performed under general anesthesia in our hospital for patients receiving hemodialysis shunts between May 2001 and October 2002. Comparisons between cases with and without perioperative shunt failures were performed using Mann-Whitney and Fishers exact tests.
RESULTS: Spinal surgery (P<0.01) and surgery placed in prone or knee-chest positions (P<0.05) were significantly more frequent, and the operation times (P<0.01) and blood losses (P<0.05) were significantly greater, in the occluded group (n=4) than in the non-occluded group (n=12).
CONCLUSIONS: Prone position might have impaired venous backflow from the shunt, thus promoting thrombogenesis. Additionally, moderate hemorrhage, with or without blood transfusion, may have induced a transient hypercoagulable state during the operation, which thus contributed to the acute shunt failure.
METHODS: We retrospectively analyzed operations performed under general anesthesia in our hospital for patients receiving hemodialysis shunts between May 2001 and October 2002. Comparisons between cases with and without perioperative shunt failures were performed using Mann-Whitney and Fishers exact tests.
RESULTS: Spinal surgery (P<0.01) and surgery placed in prone or knee-chest positions (P<0.05) were significantly more frequent, and the operation times (P<0.01) and blood losses (P<0.05) were significantly greater, in the occluded group (n=4) than in the non-occluded group (n=12).
CONCLUSIONS: Prone position might have impaired venous backflow from the shunt, thus promoting thrombogenesis. Additionally, moderate hemorrhage, with or without blood transfusion, may have induced a transient hypercoagulable state during the operation, which thus contributed to the acute shunt failure.