Cannulation practice patterns in haemodialysis vascular access: predictors for unsuccessful cannulation

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.

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.

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).

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.