Flow-based Vascular Access Management*

An AV Access is all about flow. Its singular purpose is to serve as a conduit for adequate flow to sustain hemodialysis delivery. Insufficient flow causes underdialysis; too much flow leads to heart problems — all with associated morbidities. Best Practices for keeping access flow within its optimum range call for flow surveillance, not with surrogates like pressure or vessel cross-section measurements but with diagnostic-quality flow measurements.

Flow-QC^® Monitoring during Dialysis

Vascular Access Surveillance

Best Practice: Flow-based surveillance per K/DOQI Guidelines alerts a patient care team to patients at risk for underdialysis, thrombotic events

and cardiac failure.

 

Dialysis Adequacy

Best Practice: Ensure adequate dose delivery by direct accurate measurement of pump blood flow and access recirculation in AV accesses and catheters with

Transonic flow surveillance.

 

Cardiac Function

Sudden death is a major cause of mortality for ESRD patients.

Best Practice: Cardiac Output profiling with a Transonic HD Monitor

identifies patients with dangerously low Cardiac Index due to inadequate dry weight estimation.

 

Flow-QC^® during Surgical and PTA Procedures

Best Practice: Access flow is the quintessential “Vital Sign’ for hemodialysis vascular access patency. Therefore, the dialysis care team should refer their patients for surgical and PTA procedures to those practitioners who measure flow to confirm the success of their procedures.

Surgical Access Creation
Best Practice: Measure flow during vascular access creation to ensure that initial flows are within well-established ranges to achieve access maturation.

 

Flow-Guided Interventions
Best Practice: Avoid unsuccessful PTA outcomes by using Transonic catheter-based flow measurements during PTA.

 

Surgical Access Revision
Best Practice: Use Transonic intra-surgery flowsensors to ensure successful banding of high-flow fistulas and to correct Steal Syndrome.