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Collaborative Approach to the Creation of an Arteriovenous Fistula on a US Navy Hospital Ship

机译:美国海军医院船上创建动脉瘘的协作方法

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Early creation of arteriovenous fistulas (AVFs) decreases morbidity and mortality in patients with end-stage renal disease and is the standard of care in the United States. However, this procedure is frequently not accessible in low-and middle-income countries (LMICs). We present the first reported case of successful AVF creation as part of a humanitarian assistance mission. The patient was a 51-year-old male with diabetes, hypertension, and end-stage renal disease on hemodialysis via a temporary dialysis catheter. Preoperative assessment and patient selection were coordinated with the host nation (HN) nephrologist and dialysis team. The visiting surgical team provided education on AVF anatomy, complications, and cannulation techniques to the HN dialysis team. A left brachiocephalic AVF was created under regional anesthesia performed by the visiting surgeon and anesthesiologists. There were no postoperative complications, and the AVF was matured and accessed successfully by the HN dialysis team 7 weeks after creation. Performing AVFs as part of humanitarian assistance missions has the potential to significantly reduce morbidity and mortality in LMICs.
机译:动静脉瘘(AVFS)的早期产生降低了患有终末期肾病患者的发病率和死亡率,是美国的护理标准。但是,该过程通常无法在低收入国家(LMIC)中访问。我们将第一个报告的AVF创建案例作为人道主义援助使命的一部分。通过临时透析导管,患者是一名51岁的男性,糖尿病,高血压和血液透析血液透析导管。术前评估和患者选择与宿主国家(HN)肾病学家和透析团队协调。访问外科小组对HN透析团队的AVF解剖学,并发症和插管技术提供教育。在访问外科医生和麻醉师所表演的区域麻醉下创建左右脑子AVF。没有术后并发症,AVF已经成熟并在创建后7周后成功进入。作为人道主义援助任务的一部分执行AVF,有可能显着降低LMIC中的发病率和死亡率。

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