BACKGROUND: Little is known about the relationship of cannulation practices in dialysis facilities with the frequency of failed cannulations, complications and subsequent vascular access (VA) failure. METHODS: In an observational study the incidence of mis-cannulations and related complications were observed. Patient characteristics, comorbidities and VA characteristics like type of VA were correlated with occurrence of cannulation-related complications. In addition, the cannulation technique and practice patterns like needle direction, tourniquet use and years of experience of dialysis nurses were registered. RESULTS: During the study period, 37% of patients with autogenous arteriovenous fistulae (AVF), and 19% of patients with arteriovenous grafts (AVG) had more than 10 miscannulations. Cannulation-induced haematoma resulted into single-needle (SN) and catheter dialysis in 40% of the patients. The use of central venous catheters (CVC) and SN dialysis were significant predictors of VA failure (p <0.0001). CONCLUSION: This study demonstrated a high incidence of unsuccessful cannulation procedures and cannulation-related complications necessitating catheter and SN dialysis. The type and location of the VA is significantly related to occurrence of unsuccessful and complicated cannulation.
BACKGROUND: Little is known about the relationship of cannulation practices in dialysis facilities with the frequency of failed cannulations, complications and subsequent vascular access (VA) failure. METHODS: In an observational study the incidence of mis-cannulations and related complications were observed. Patient characteristics, comorbidities and VA characteristics like type of VA were correlated with occurrence of cannulation-related complications. In addition, the cannulation technique and practice patterns like needle direction, tourniquet use and years of experience of dialysis nurses were registered. RESULTS: During the study period, 37% of patients with autogenous arteriovenous fistulae (AVF), and 19% of patients with arteriovenous grafts (AVG) had more than 10 miscannulations. Cannulation-induced haematoma resulted into single-needle (SN) and catheter dialysis in 40% of the patients. The use of central venous catheters (CVC) and SN dialysis were significant predictors of VA failure (p <0.0001). CONCLUSION: This study demonstrated a high incidence of unsuccessful cannulation procedures and cannulation-related complications necessitating catheter and SN dialysis. The type and location of the VA is significantly related to occurrence of unsuccessful and complicated cannulation.
Authors: Gerald A Beathard; Charmaine E Lok; Marc H Glickman; Ahmed A Al-Jaishi; Donna Bednarski; David L Cull; Jeffery H Lawson; Timmy C Lee; Vandana D Niyyar; Donna Syracuse; Scott O Trerotola; Prabir Roy-Chaudhury; Surendra Shenoy; Margo Underwood; Haimanot Wasse; Karen Woo; Theodore H Yuo; Thomas S Huber Journal: Clin J Am Soc Nephrol Date: 2017-07-20 Impact factor: 8.237
Authors: Isabelle Chapdelaine; Camiel L M de Roij van Zuijdewijn; Ira M Mostovaya; Renée Lévesque; Andrew Davenport; Peter J Blankestijn; Christoph Wanner; Menso J Nubé; Muriel P C Grooteman; P J Blankestijn; A Davenport; C Basile; F Locatelli; F Maduell; S Mitra; C Ronco; R Shroff; J Tattersall; C Wanner Journal: Clin Kidney J Date: 2015-02-16