TY - JOUR T1 - Hemostasis of arteriovenous fistula: Comparison of direct two-finger pressure to an adjustable device JO - Nefrología (English Edition) T2 - AU - Álvaro Cristóbal,Alejandro AU - París Boal,Carmen AU - Blanco Velasco,Noelia AU - Matesanz Sanchidrián,Sergio AU - Mayoral-Peñas,Azucena AU - Arévalo Manso,Juan José AU - Velasco-Ballesteros,Sonia AU - Fernandez-Reyes Luis,María José SN - 20132514 M3 - 10.1016/j.nefroe.2021.12.001 DO - 10.1016/j.nefroe.2021.12.001 UR - https://www.revistanefrologia.com/en-hemostasis-arteriovenous-fistula-comparison-direct-articulo-S2013251421001243 AB - Background and objectivesTo evaluate the pressure generated by an adjustable hemostasis clamp on arteriovenous fistulas (AVF) during the hemostasis proccess, and compare it with the direct two-finger pressure applied by the patient. To evaluate the variations of the direct two-finger pressure along the hemostasis process. MethodsWe analyzed data obtained in 51 hemodialysis procedures from 15 patients. AVF intraaccess pressure was used as indirect indicator of the pressure generated by both methods. It was recorded before venous needle removal (PBasal), at clamp application (P1), after clamp adjustement by a nurse (P2), at the beginning of the direct two-finger pressure by the patient (M0), after 3 min of two-finger pressure (M3) and after 6 min of two-finger pressure (M6). ResultsIntra-access pressure was lower with the adjusted clamp (P2) than with the direct two-finger pressure by the patient (M0) (variation of −18.57%, 95%CI −14.09 to -4.77 mmHg, P < 0.001). Intraaccess pressure generated by the direct two-finger pressure method showed a decreasing trend along the hemostasis process (M3-M0: −8.82 mmHg, P < 0.001; M6-M0: −12.55 mmHg, P < 0.001). ConclusionAn adjustable fistula arm clamp generates a lower pressure in AVF than the direct two-finger pressure applied by the patient. The latter showed a decreasing trend along the hemostasis process. These data suggest that some of the recommendations from clinical guidelines could be based on inaccurate premises. ER -