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

Area of Science:

• Nephrology
• Vascular Surgery
• Dialysis Nursing

Background:

• Limited understanding of dialysis cannulation practices and their link to complications.
• Investigating the relationship between cannulation techniques and vascular access (VA) failure.
• Assessing the impact of cannulation on patient outcomes in dialysis facilities.

Purpose of the Study:

• To determine the relationship between dialysis cannulation practices and the frequency of failed cannulations.
• To identify factors contributing to cannulation complications and subsequent vascular access failure.
• To correlate patient and vascular access characteristics with cannulation-related complications.

Main Methods:

• Observational study analyzing cannulation incidence, complications, and VA failure.
• Correlated patient/comorbidity data and vascular access types with complications.
• Registered cannulation techniques, needle direction, tourniquet use, and nurse experience.

Main Results:

• High rates of cannulation failures observed: 37% in autogenous arteriovenous fistulae (AVF) and 19% in arteriovenous grafts (AVG).
• Cannulation-induced hematoma led to single-needle (SN) or catheter dialysis in 40% of patients.
• Central venous catheters (CVC) and SN dialysis were significant predictors of VA failure (p <0.0001).

Conclusions:

• High incidence of unsuccessful cannulation and complications necessitates catheter and SN dialysis.
• Vascular access type and location significantly influence cannulation success and complication rates.
• Findings highlight the need for improved cannulation practices to reduce VA complications and failure.