Quinton-Scribner cannulas for hemodialysis. Review of four years' experience.

Data on a study group of 52 maintenance hemodialysis patients cannulated with Quinton-Scribner cannula in a four-year period were analyzed. The average period of dialysis was 11.8 months with either a pumped coil or a pumpless Kiil artificial kidney system. One hundred and forty-five cannulations were performed. The mean arterial cannula survival was 7.8 months and the mean venous cannula survival was 7.2 months. The exceptional longevity of cannula survival occurred despite the high incidence of atherosclerotic changes at operation and the advanced mean age (47 years) of the patients. The cannula longevity may be partially related to the technique used and to meticulous surgical care given the patient before and after cannulation. Complications from cannulation included two deaths, one from septic pulmonary embolism of Staphylococcus origin, and one from acute Pseudomonas endocarditis. A total of 36 infections of cannulas were recognized, the majority being due to Staphylococcus aureus, but 28 percent being secondary to Gram-negative bacteria.