Évaluation prospective de la douleur à la ponction de la fistule artérioveineuse en hémodialyse chronique

Dahri, S.; Doukkali, B.; Jaafour, S.; Hassani, A. El; Arrayhani, M.; Sqalli, T.

doi:10.1016/j.nephro.2013.07.200

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“…Les infirmières en hémodialyse ressentent très souvent l'appréhension des patients juste avant le branchement. A juste titre, ils craignent la ponction (le piquage) de leur fistule artério-veineuse (FAV), surtout si elle est récente [24,25]. Souad Dahiri et al [24] au Maroc ont rapporté en 2013 après une évaluation prospective des douleurs de ponction de FAV; que 84,5% des hémodialysés chroniques rapportait une douleur, celle-ci était d'autant plus intense sur les FAV natives récentes.…”

Section: Discussion:-unclassified

“…A juste titre, ils craignent la ponction (le piquage) de leur fistule artério-veineuse (FAV), surtout si elle est récente [24,25]. Souad Dahiri et al [24] au Maroc ont rapporté en 2013 après une évaluation prospective des douleurs de ponction de FAV; que 84,5% des hémodialysés chroniques rapportait une douleur, celle-ci était d'autant plus intense sur les FAV natives récentes. En France Coupel et al ont rapporté que 80% d'hémodialysés chroniques ont rapporté des douleurs de ponction dans un échantillon de 628 dialysés [25].…”

Section: Discussion:-unclassified

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Premieres Ponctions De Fistule Arterio-Veineuse Native Chez Les Hemodialyses Chroniques a Brazzaville

Sinomono¹,

Loumingou²,

Bouhity³

et al. 2020

IJAR

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Introduction: The arteriovenous fistula (AVF) is the vascular approach of choice recommended in hemodialysis. The objective of our work is to assess the place of AVF in hemodialysis centers in Brazzaville, to determine the complications during the first AVF punctures and their risk factors. Patients and Method: We carried out a cross-sectional, descriptive study in two hemodialysis centers in Brazzaville. The study runs from January 15 to December 31, 2019. Prosthetic AVFs were excluded. The complications that occurred during the first AVF punctures were studied and analyzed with the Epi info software. Results: first AVF punctures were performed in 24 patients (57.14% of patients on chronic dialysis). In 17 patients (70.83%) it was a radioradial AVF and in seven patients (29.17%) a humero-cephalic AVF. The intensity of the puncture pain was 8/10 in nine patients (37.5%) and 7/10 in seven patients (29.17%). Eleven patients (45.83%) developed a complication that caused the hemodialysis session to be adjourned. The complications found are a large hematoma (25%), a hemorrhage in a jet with a pre-shock state (12.5%), a rupture of the AVF (4.17%), an arterial puncture with pulsatile hematoma (4.17 %). The risk factors for the complications found are the humerocephalic site (p <0.05), overweight (p <0.01), an AVF flow rate greater than 1000 ml / min (p <0.05). Conclusion: The use of AVF is still low in our dialysis centers. The first punctures are intensely painful; complications are frequent.

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Section: Discussion:-unclassified