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Implications for maintaining vascular access device patency and performance: Application of science to practice
Alexandra Hawthorn1,2,3, Andrew C Bulmer2,3, Sapha Mosawy2
11 School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia.
The Journal of Vascular Access
|January 23, 2019
Summary
Understanding vascular access device (VAD) failure requires revisiting blood and vessel physiology. This review explores how clinical practices impact vessel health, offering insights into VAD occlusion and maintenance strategies.
Area of Science:
- Biomedical Engineering
- Physiology
- Vascular Access
Background:
- Vascular access devices (VADs) are crucial for fluid/drug administration and blood sampling.
- VADs are prone to occlusion and failure, leading to patient discomfort, inflammation, and infection risk.
- Current VAD maintenance strategies lack robust evidence, and failure mechanisms remain poorly understood.
Purpose of the Study:
- Revisit understanding of blood, vessel physiology, and fluid dynamics.
- Assess the impact of clinical practices on vascular health.
- Apply findings to improve vascular access device research and practice.
Main Methods:
- Narrative review of biomedical and bioengineering literature.
- Analysis of studies related to vascular access practices.
Main Results:
- VAD insertion and maintenance practices are inconsistent and lack strong clinical evidence.
- Physiological responses to VADs affect vein, blood components, and flow dynamics.
- Intravascular forces impact blood components and endothelium, potentially explaining VAD failure.
Conclusions:
- Current knowledge of vascular physiology and hemodynamic response is updated.
- Assumptions regarding VAD maintenance require re-evaluation.
- Further investigation into VAD failure mechanisms is necessary.
