1. Challenges of Vascular Access in the Pediatric Population.
- Author
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Raina R, Mittal A, Sethi SK, and Chakraborty R
- Subjects
- Child, Humans, Arteriovenous Shunt, Surgical instrumentation, Arteriovenous Shunt, Surgical methods, Catheterization, Central Venous instrumentation, Catheterization, Central Venous methods, Kidney Failure, Chronic therapy, Pediatrics methods, Pediatrics trends, Renal Dialysis methods, Vascular Access Devices adverse effects, Vascular Access Devices classification, Vascular Access Devices trends
- Abstract
The incidence and prevalence of renal replacement therapy has continued to increase in the pediatric population. Recent data have shown that hemodialysis was the most frequently used dialysis modality, especially in pediatric ESRD patients (age 0-21 years). A well-functioning vascular access is required for effective hemodialysis and choosing the best vascular access option for pediatric patients can be difficult. Pediatric vascular options include arteriovenous fistula, arteriovenous graft, and central venous catheters (CVCs). There is a national initiative for fistula first-catheter last approach; however, CVCs have been reported as the most conventionally utilized vascular access option in pediatric patients. The use of CVCs should be minimized or avoided as they are associated with high risk of infections, thrombosis, and other complications. Thus, it is important for practitioners to plan appropriately in advance, practice good clinical judgment, and assure that the best vascular access is placed according to the patient's needs. Therefore, this article reviews the different types of pediatric vascular access and the associated benefits and potential complications of each., (Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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