Lavarias VA, Kaufman AM, Levine MI, Levin NW
Extracorporeal venous drip chamber pressure measurement screening does not predict impending hemodialysis access graft failure
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Nov) 6:496 1995

This paper contradicts previously reported results by Schwab (Kidney Int 36:707-711, 1989) that venous outlet pressure is useful in predicting graft failure. Schwab found that Vpm > 150 using 16-gauge needles was a good predictor of future graft thrombosis. This group monitored Vpm using 15 gauge needles for 23 weeks in 102 patients. In 27 patients whose accesses clotted, Vpm measured just prior to the event was similar to the Vpm in 75 patients without access problems (about 95 mm Hg). The authors conclude that serial monitoring of Vpm is of limited use.

Comment: Besarab et al, however, found that static measurements of venous pressure (at zero extracorporeal flow) factored for blood pressure was a useful predictor of both access flow and thrombosis. Also, Boereboom et al. found that venous pressure was higher with graft stenosis and reduced access flow. (Daugirdas)

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Am Soc Nephrol
Basic hemodialysis : Vascular Access: graft/fistula