In hemodialysis, what is "steal syndrome" characterized by?

In hemodialysis, "steal syndrome" is characterized by reversed distal arterial blood flow into venous circulation. This condition typically arises when a vascular access site, such as an arteriovenous (AV) fistula, diverts a significant amount of blood flow away from the distal arteries of the limb. As a result, the arterial supply to the fingers and hand is reduced, leading to ischemic symptoms.

When an access point is created for dialysis, it can create a high flow situation that essentially "steals" blood from the distal artery, compromising perfusion to the tissues beyond the point of access. This can lead to clinical presentation of pain, coldness, or even ulcers in severe cases.

Understanding the underlying physiology is key in recognizing how blood flow dynamics are altered in patients with vascular access, particularly in the setting of hemodialysis. Monitoring for signs of steal syndrome is crucial to ensuring proper blood flow and minimizing complications related to vascular access.