LS2-01 Vascular punctures for GMA treatment

Hisashi Matono1), Akiyoshi Okada2), Junya Imada1), Tetsushi Nakahara1),
Atsushi Ono1), Takuma Usuda1), Atsuo Kitano

poster at ISFA 2019 pag 164

Introduction
We can provide the GMA treatment by venepuncture without VAC detaining you like other blood purification therapy. The puncture by the peripheral vein puncture is easy, but, on the other hand, it often becomes difficult to secure blood flow necessary for extracorporeal circulation enough and is one of the trouble factors of the GMA treatment We use an echo to
evade a puncture trouble in our institution. We introduce the approach this time.
Approach method The site of puncture uses brachial veins basically. There is little valve of vein as a reason and chooses the blood stream because securing of blood flow with a little meandering is relatively easy. However, the depth from skin may be deepened as compared with the erasion blood vessel such as radius cutaneous veins, and the like, too, and attention is necessary. We often perform GMA in outpatient department at this hospital, and order enters the new induction when a chief physician judged induction from an encounter. Therefore it is difficult to obtain the patients information beforehand and a blood vessel echo uses site of puncture after the patients admission and is determined and performs the puncture in echo guides, if necessary. Also, the judgments such as the dehydration, and the like are possible by using an echo, and there is the
merit that they receive instructions such as the transfusion load, and the like in what we report to a chief physician, and can dissolve puncture difficulty.
Conclusion One of the troubles of the GMA treatment has securing of access. If extracorporeal circulation is possible without poor blood removal, we can provide GMA treatment more effectively. We regard the echo inflection of that purpose as a required device on providing GMA treatment.

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