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Hemodialysis: Using an AV graft or AV fistula for ease of accessHHemodialysis: Using an AV graft or AV fistula for ease of accessHemodialysis: Using an AV graft or AV fistula for ease of accessEnglishNephrologyChild (0-12 years);Teen (13-18 years)ArmArteries;VeinsProceduresCaregivers Adult (19+)NA2011-11-22T05:00:00ZMaria Di Mola, RN8.0000000000000064.0000000000000658.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about the two main options to create a vein or artery that is easy to use for your child's hemodialysis.</p><h2>What is an arteriovenous graft (AV graft)?</h2><p>An AV graft is an artificial vein made from a synthetic tube inserted under the skin.</p> <figure class="asset-c-80"><span class="asset-image-title">Arteriovenous graft (AV graft)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Hemodialysis_AV_Graft_MED_ILL_EN.jpg" alt="An AV graft attached to a vein and two needles inserted into the vein allowing blood to pass to and from the dialysis machine" /><figcaption class="asset-image-caption">AV graft is a synthetic tube used to surgically connect a vein and an artery in the arm. This increases the blood volume passing through the vein. The size of the vein increases with time, which creates an easy access for dialysis needles.</figcaption> </figure> <h2>What is an arteriovenous fistula (AV fistula)?</h2><p>An AV fistula is an artery and a vein sewn together.</p> <figure class="asset-c-80"><span class="asset-image-title">Arteriovenous fistula (AV fistula)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Hemodialysis_AV_Fistula_MED_ILL_EN.jpg" alt="AV fistula and two needles in vein to allow blood to pass to and from the dialysis machine" /><figcaption class="asset-image-caption">To make an AV Fistula, a vein and an artery in the arm are surgically fused. This increases the blood volume passing through the vein. The size of the vein increases with time, which creates an easy access for dialysis needles.</figcaption> </figure><h2>Key points</h2> <ul> <li>An AV fistula takes about six to eight weeks to mature. At this point, the AV fistula can be used for dialysis.</li> <li>Have your child strengthen their fistula by squeezing and releasing a rubber ball 10 times. Your child should do this exercise three to four times a day.</li> <li>An AV graft takes about two weeks to heal. At this point, it can be used for dialysis.</li> <li>Tell the anaesthetist if your child is taking any blood thinning medication such as warfarin or acetylsalicylic acid (ASA).</li> </ul><h2>AV access on your child's body</h2> <ul> <li>Usually, AV fistulas and grafts are made in your child's forearm or upper arm. Depending on what is best for your child, the surgeon will put the AV graft in as a straight tube or as a U-shaped loop.</li> <li>Your child's non-dominant arm is used whenever possible. This leaves their dominant hand free during hemodialysis. For example, if your child is right-handed, the access will be placed in the left arm.</li> </ul> <h2>AV access for hemodialysis treatment</h2> <ul> <li>To have hemodialysis, your child needs a vein that is easy to find and use. Once found, this vein becomes the AV access for hemodialysis.</li> <li>Before each treatment, your child's nurse will insert two needles into the fistula or graft. One needle takes the blood from your child's body to the artificial kidney (dialyzer). This purifies the blood. The second needle returns the blood to your child's body.</li> <li>At the end of each treatment, your child's nurse will remove both needles and place bandages over the needle sites. The bandages can be removed after a few hours.</li> </ul><h2>What I need to know about my child's fistula or graft</h2> <p>Your child's AV fistula will usually take six to eight weeks to mature before it can be used for dialysis. After the staples are removed, roughly two weeks after the surgery, have your child strengthen their fistula by squeezing and releasing a rubber ball 10 times. Your child should do this three to four times a day. It is not necessary for your child to exercise their AV graft because the graft is already the correct size when it is placed in the arm. Two weeks after the surgery, or as soon as the swelling is gone, your child's AV graft can be used for dialysis.</p><h2>Getting ready for surgery</h2> <h3>Clinic appointment</h3> <ul> <li>Your child will have an ultrasound of their upper and lower arms.</li> <li>Your child's surgeon will check your child's arms to decide whether to create an AV fistula or an AV graft. After talking to the surgeon about the type of access, you will be asked to sign a consent form to confirm that you agree to the surgery.</li> <li>Your child's nephrology team will tell you what to expect before and after surgery, including any potential complications.</li> </ul> <h3>Pre-admission visit</h3> <p>On the same day as the clinic appointment, your child will visit the pre-admission clinic. Here your child will:</p> <ul> <li>have blood tests and an electrocardiogram (ECG)</li> <li>see an anaesthetist for an anaesthetic consultation</li> <li>see an endocrinologist if they have diabetes.</li> </ul> <h3>Anaesthetist consultation</h3> <ul> <li>During your child's visit with the anaesthetist, the doctor will talk to you about your child's health. The anaesthetist will also talk to you about which anaesthetic is best for your child: a general anaesthetic (a mix of medicines that puts your child into a deep sleep) or a local anaesthetic (freezing to the area that is being operated on) and some sedation (medicine to make your child sleepy or more comfortable during surgery).</li> <li>If you have already talked to your child's surgeon about the types of anaesthesia that may be used, be sure to tell the anaesthetist.</li> <li>Please tell the anaesthetist if your child is currently taking any blood thinning medication such as warfarin or <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>. To prevent bleeding after surgery, the anaesthetist may tell you to stop giving your child this medication before the day of the surgery.</li> </ul> <h3>The night before your child's surgery</h3> <ul> <li>Make sure your child doesn't eat or drink anything after midnight or the surgery will be postponed.</li> <li>Your child may take any medication on the morning of the surgery with a sip of water (except blood thinning medication and <a href="/Article?contentid=1728&language=English">insulin</a>).</li> </ul><h2>At SickKids</h2> <h3>Day of the surgery</h3> <p>Please come to the _______________________ at: ____________.</p> <p>Your operation will be done at: ___________________.</p> <p>The nurses will:</p> <ul> <li>help your child change into a hospital gown</li> <li>check your child's blood pressure</li> <li>take some blood to check your child's <a href="/Article?contentid=220&language=English">potassium</a> count</li> <li>complete a surgical checklist.<br></li> </ul>
Hémodialyse : faciliter l’accès par une greffe artérioveineuse ou une fistule artérioveineuseHHémodialyse : faciliter l’accès par une greffe artérioveineuse ou une fistule artérioveineuseHemodialysis: Using an AV graft or AV fistula for ease of accessFrenchNephrologyChild (0-12 years);Teen (13-18 years)ArmArteries;VeinsProceduresCaregivers Adult (19+)NA2011-11-22T05:00:00Z Maria Di Mola, RNHealth (A-Z) - ProcedureHealth A-Z<p>Découvrez les deux options principales visant à faciliter l’accès à une veine ou à une artère pour l’hémodialyse de votre enfant.</p><h2>Qu’est-ce qu’une greffe artérioveineuse?</h2><p>Une greffe artérioveineuse est une veine artificielle formée d’un tube synthétique inséré sous la peau.</p><h2>Qu’est-ce qu’une fistule artérioveineuse?</h2><p>Une fistule artérioveineuse est constituée d’une artère et d’une veine cousues l’une à l’autre.</p><h2>À retenir</h2><ul><li>Les fistules artérioveineuses prennent de six à huit semaines environ pour faire effet. Au bout de cette période, on peut s’en servir pour procéder à la dialyse.</li><li>Demandez à votre enfant de renforcer sa fistule en comprimant et en relâchant 10 fois une balle de caoutchouc. Il doit faire cet exercice trois ou quatre fois par jour.</li><li>La greffe artérioveineuse prend environ deux semaines à guérir. Au bout de cette période, on peut s’en servir pour procéder à la dialyse.</li><li>Dites à l’anesthésiste si votre enfant prend un anticoagulant comme la warfarine ou de l’acide acétylsalicylique.</li></ul><h2>Accès artérioveineux au corps de votre enfant</h2><ul><li>Normalement, les fistules et les greffes artérioveineuses sont effectuées dans l’avant-bras ou le bras de votre enfant. Selon le cas, le chirurgien donnera à la greffe la forme d’un tube droit ou d’une boucle en U.</li><li>Il faut opérer le bras non dominant de votre enfant dans la mesure du possible, de façon à ce que sa main dominante soit libre pendant l’hémodialyse. Par exemple, s’il est droitier, il faut opérer le bras gauche.</li></ul><h2>Accès artérioveineux pour l’hémodialyse</h2><ul><li>Pour l’hémodialyse de votre enfant, il faut trouver une veine facile à repérer et à utiliser. Cette veine constitue l’accès artérioveineux au patient pour l’hémodialyse.</li><li>Avant chaque traitement, l’infirmier de votre enfant insérera deux aiguilles dans la fistule ou la greffe. La première envoie son sang vers le dialyseur, qui lui sert de rein et lui purifie le sang. La seconde renvoie le sang purifié vers le corps de l’enfant.</li><li>À la fin de chaque traitement, l’infirmière retire les deux aiguilles et bande les points d’insertion des aiguilles. Ces bandages peuvent être enlevés au bout de quelques heures.</li></ul><h2>Ce que je dois savoir sur la fistule ou la greffe de mon enfant</h2><p>La fistule artérioveineuse prend normalement de six à huit semaines avant d’être prête pour la dialyse. Après l’enlèvement des points de suture, environ deux semaines après l’opération, demandez à votre enfant de renforcer sa fistule en comprimant et en relâchant dix fois une balle de caoutchouc. Il doit faire cet exercice trois ou quatre fois par jour. Par contre, il n’est pas nécessaire qu’il renforce sa greffe artérioveineuse, car elle est déjà de la bonne grosseur au moment de l’insertion. Deux semaines après l’opération ou dès que l’enflure a disparu, la greffe artérioveineuse de votre enfant peut servir à la dialyse.</p><h2>Se préparer à l’opération</h2><h3>Rendez-vous clinique</h3><ul><li>Votre enfant passera une échographie de son avant-bras et de son bras.</li><li>Le chirurgien de votre enfant vérifiera son bras afin de choisir entre la fistule et la greffe. Après avoir discuté avec lui du type d’accès, vous devrez signer un formulaire de consentement qui confirmera que vous consentez à l’opération.</li><li>L’équipe de néphrologie de votre enfant vous dira à quoi vous attendre avant et après l’opération, y compris les complications éventuelles.</li></ul><h3>Visite avant l’admission</h3><p>Le jour du rendez-vous clinique, votre enfant aura une consultation préadmission :</p><ul><li>Il subira des tests sanguins et un électrocardiogramme.</li><li>Il consultera un anesthésiste.</li><li>Il consultera un endocrinologue s’il est diabétique.</li></ul><h3>Consultation de l’anesthésiste </h3><ul><li>Pendant que votre enfant consultera l’anesthésiste, le médecin vous parlera de sa santé. De plus, l’anesthésiste vous expliquera quel type d’anesthésie lui conviendra le mieux : une anesthésie générale (où un mélange de médicaments provoquera un sommeil profond) ou encore une anesthésie locale de la partie du corps qui se fera opérer, accompagnée d’un sédatif (médicament qui endormira votre enfant ou le rendra plus à l’aise pendant l’opération).</li><li>N’oubliez pas de le mentionner à l’anesthésiste si vous avez déjà discuté avec le chirurgien des types d’anesthésie possibles pendant l’opération.</li><li>Veuillez prévenir l’anesthésiste si votre enfant prend un anticoagulant comme la <a href="/Article?contentid=265&language=French">warfarine</a> ou de l’<a href="/Article?contentid=77&language=French">acide acétylsalicylique</a>. Afin de prévenir toute hémorragie après l’opération, l’anesthésiste peut vous dire d’arrêter de donner ce médicament avant l’intervention.</li></ul><h3>La nuit avant l’opération</h3><ul><li>Assurez-vous que votre enfant ne mange ni ne boive rien avant minuit, sinon l’opération devra être remise à plus tard.</li><li>Le matin de l’opération, il peut toutefois prendre ses médicaments en avalant une gorgée d’eau (à l’exception des anticoagulants et de l’<a href="/Article?contentid=1728&language=French">insuline</a>).</li></ul><h2>À l’hôpital SickKids</h2><h3>La journée de l’opération</h3><p>Veuillez vous présenter à/au _______________________ à ___ h____.</p><p>L’opération aura lieu à __ h___.</p><p>Les infirmiers :</p><ul><li>aideront votre enfant à enfiler sa chemise d’hôpital</li><li>vérifieront sa tension artérielle</li><li>prélèveront du sang pour vérifier ses niveaux de <a href="/Article?contentid=220&language=French">potassium</a></li><li>dresseront une liste de contrôle chirurgicale</li></ul>

 

 

Hemodialysis: Using an AV graft or AV fistula for ease of access1034.00000000000Hemodialysis: Using an AV graft or AV fistula for ease of accessHemodialysis: Using an AV graft or AV fistula for ease of accessHEnglishNephrologyChild (0-12 years);Teen (13-18 years)ArmArteries;VeinsProceduresCaregivers Adult (19+)NA2011-11-22T05:00:00ZMaria Di Mola, RN8.0000000000000064.0000000000000658.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about the two main options to create a vein or artery that is easy to use for your child's hemodialysis.</p><h2>What is an arteriovenous graft (AV graft)?</h2><p>An AV graft is an artificial vein made from a synthetic tube inserted under the skin.</p> <figure class="asset-c-80"><span class="asset-image-title">Arteriovenous graft (AV graft)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Hemodialysis_AV_Graft_MED_ILL_EN.jpg" alt="An AV graft attached to a vein and two needles inserted into the vein allowing blood to pass to and from the dialysis machine" /><figcaption class="asset-image-caption">AV graft is a synthetic tube used to surgically connect a vein and an artery in the arm. This increases the blood volume passing through the vein. The size of the vein increases with time, which creates an easy access for dialysis needles.</figcaption> </figure> <h2>What is an arteriovenous fistula (AV fistula)?</h2><p>An AV fistula is an artery and a vein sewn together.</p> <figure class="asset-c-80"><span class="asset-image-title">Arteriovenous fistula (AV fistula)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Hemodialysis_AV_Fistula_MED_ILL_EN.jpg" alt="AV fistula and two needles in vein to allow blood to pass to and from the dialysis machine" /><figcaption class="asset-image-caption">To make an AV Fistula, a vein and an artery in the arm are surgically fused. This increases the blood volume passing through the vein. The size of the vein increases with time, which creates an easy access for dialysis needles.</figcaption> </figure><h2>Key points</h2> <ul> <li>An AV fistula takes about six to eight weeks to mature. At this point, the AV fistula can be used for dialysis.</li> <li>Have your child strengthen their fistula by squeezing and releasing a rubber ball 10 times. Your child should do this exercise three to four times a day.</li> <li>An AV graft takes about two weeks to heal. At this point, it can be used for dialysis.</li> <li>Tell the anaesthetist if your child is taking any blood thinning medication such as warfarin or acetylsalicylic acid (ASA).</li> </ul><h2>AV access on your child's body</h2> <ul> <li>Usually, AV fistulas and grafts are made in your child's forearm or upper arm. Depending on what is best for your child, the surgeon will put the AV graft in as a straight tube or as a U-shaped loop.</li> <li>Your child's non-dominant arm is used whenever possible. This leaves their dominant hand free during hemodialysis. For example, if your child is right-handed, the access will be placed in the left arm.</li> </ul> <h2>AV access for hemodialysis treatment</h2> <ul> <li>To have hemodialysis, your child needs a vein that is easy to find and use. Once found, this vein becomes the AV access for hemodialysis.</li> <li>Before each treatment, your child's nurse will insert two needles into the fistula or graft. One needle takes the blood from your child's body to the artificial kidney (dialyzer). This purifies the blood. The second needle returns the blood to your child's body.</li> <li>At the end of each treatment, your child's nurse will remove both needles and place bandages over the needle sites. The bandages can be removed after a few hours.</li> </ul><h2>What I need to know about my child's fistula or graft</h2> <p>Your child's AV fistula will usually take six to eight weeks to mature before it can be used for dialysis. After the staples are removed, roughly two weeks after the surgery, have your child strengthen their fistula by squeezing and releasing a rubber ball 10 times. Your child should do this three to four times a day. It is not necessary for your child to exercise their AV graft because the graft is already the correct size when it is placed in the arm. Two weeks after the surgery, or as soon as the swelling is gone, your child's AV graft can be used for dialysis.</p><h2>Getting ready for surgery</h2> <h3>Clinic appointment</h3> <ul> <li>Your child will have an ultrasound of their upper and lower arms.</li> <li>Your child's surgeon will check your child's arms to decide whether to create an AV fistula or an AV graft. After talking to the surgeon about the type of access, you will be asked to sign a consent form to confirm that you agree to the surgery.</li> <li>Your child's nephrology team will tell you what to expect before and after surgery, including any potential complications.</li> </ul> <h3>Pre-admission visit</h3> <p>On the same day as the clinic appointment, your child will visit the pre-admission clinic. Here your child will:</p> <ul> <li>have blood tests and an electrocardiogram (ECG)</li> <li>see an anaesthetist for an anaesthetic consultation</li> <li>see an endocrinologist if they have diabetes.</li> </ul> <h3>Anaesthetist consultation</h3> <ul> <li>During your child's visit with the anaesthetist, the doctor will talk to you about your child's health. The anaesthetist will also talk to you about which anaesthetic is best for your child: a general anaesthetic (a mix of medicines that puts your child into a deep sleep) or a local anaesthetic (freezing to the area that is being operated on) and some sedation (medicine to make your child sleepy or more comfortable during surgery).</li> <li>If you have already talked to your child's surgeon about the types of anaesthesia that may be used, be sure to tell the anaesthetist.</li> <li>Please tell the anaesthetist if your child is currently taking any blood thinning medication such as warfarin or <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>. To prevent bleeding after surgery, the anaesthetist may tell you to stop giving your child this medication before the day of the surgery.</li> </ul> <h3>The night before your child's surgery</h3> <ul> <li>Make sure your child doesn't eat or drink anything after midnight or the surgery will be postponed.</li> <li>Your child may take any medication on the morning of the surgery with a sip of water (except blood thinning medication and <a href="/Article?contentid=1728&language=English">insulin</a>).</li> </ul><h2>At SickKids</h2> <h3>Day of the surgery</h3> <p>Please come to the _______________________ at: ____________.</p> <p>Your operation will be done at: ___________________.</p> <p>The nurses will:</p> <ul> <li>help your child change into a hospital gown</li> <li>check your child's blood pressure</li> <li>take some blood to check your child's <a href="/Article?contentid=220&language=English">potassium</a> count</li> <li>complete a surgical checklist.<br></li> </ul>https://assets.aboutkidshealth.ca/akhassets/Hemodialysis_AV_Graft_MED_ILL_EN.jpgHemodialysis: Using an AV graft or AV fistula for ease of accessFalse

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