Balancing the Covid-19-motivated vascular access guidelines and patient-centred care of pre-dialysis candidates. Issue 4 (July 2020)

• Record Type: Journal Article
• Authors: Georgiadis, George S; Argyriou, Christos; Baktiroglu, Selcuk; Lazarides, Miltos K; Mallios, Alexandros; Tordoir, Jan HM
• Is Part Of: Journal of vascular access. Volume 21:Issue 4(2020)
• Page Start: 536
• Page End: 538
• Publication Date: 2020-07
• Subjects: Covid-19 vascular guidelines -- pre-dialysis patients -- catheters -- dialysis access -- arteriovenous fistula -- economics and health services -- dialysis -- ethics and end-of-life issues; Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.1177/1129729820926860
• Languages: English
• ISSNs: 1129-7298

Abstract

The recommendations recently proposed by the European and American Vascular Societies in this new 'Covid-19' era regarding the triage of various vascular operations into urgent, emergent and programmed based on the nature of their pathology aim at reserving health care expenses and hospital staff towards managing the current unexpected worldwide pandemic to the highest possible degree. The suggestion for implementation of these changes into real-world practice, however, does not come without a cost. In particular, the recommendation for deferral of access creation in pre-dialysis patients, ethical, socio-economic and medico-legal issues arise which should be seriously taken into consideration. At the end of the day, vascular access creation is the lifeline of haemodialysis patients and the indication for surgery warrants patient-specific clinical judgement rather than 'group labelling'.