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Vascular access cannulation in hemodialysis patients: technical approach

INTRODUCTION: The vascular access cannulation technique varies among clinics, and guidelines on vascular access give little importance to cannulation techniques. The objective of this study was to evaluate the cannulation technique and to determine which factors are associated with each detail of th...

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Autores principales: Castro, Manuel Carlos Martins, Carlquist, Francisca Tokiko Yanagida, Silva, Celina de Fátima, Xagoraris, Magdaleni, Centeno, Jerônimo Ruiz, de Souza, José Adilson Camargo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Nefrologia 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213941/
https://www.ncbi.nlm.nih.gov/pubmed/31826075
http://dx.doi.org/10.1590/2175-8239-JBN-2019-0031
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author Castro, Manuel Carlos Martins
Carlquist, Francisca Tokiko Yanagida
Silva, Celina de Fátima
Xagoraris, Magdaleni
Centeno, Jerônimo Ruiz
de Souza, José Adilson Camargo
author_facet Castro, Manuel Carlos Martins
Carlquist, Francisca Tokiko Yanagida
Silva, Celina de Fátima
Xagoraris, Magdaleni
Centeno, Jerônimo Ruiz
de Souza, José Adilson Camargo
author_sort Castro, Manuel Carlos Martins
collection PubMed
description INTRODUCTION: The vascular access cannulation technique varies among clinics, and guidelines on vascular access give little importance to cannulation techniques. The objective of this study was to evaluate the cannulation technique and to determine which factors are associated with each detail of the technique. MATERIAL AND METHODS: The vascular access cannulation was evaluated in 260 patients undergoing hemodialysis. The type and anatomical location of the vascular access, the cannulation technique, direction, gauge, and distance between needles, besides bevel direction and needle rotation were registered. RESULTS: The arteriovenous fistula was the most frequent vascular access (88%), the most used cannulation technique was area (100%), the needle direction was anterograde in most cases (79.5%), and the mean distance between the tips of needles was 7.57±4.43 cm. For arteriovenous grafts, the proximal anatomical location (brachial artery) and cannulation with 16G needles in anterograde position were more predominant. For arteriovenous fistulas, the distal anatomical location (radial artery) and cannulation through 15G needles were more common. Cannulation of vascular access in retrograde direction was associated with a greater distance between needles (13.2 ± 4.4 vs 6.1 ± 3 cm, p < 0.001). Kt/V was higher when the distance between needles was higher than 5 cm (1.61 ± 0.3 vs. 1.47 ± 0.28, p < 0.01). CONCLUSIONS: The vascular access cannulation technique depends on the vascular access characteristics and expertise of cannulators. Clinical trials are required for the formulation of guidelines for vascular access cannulation.
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spelling pubmed-72139412020-05-13 Vascular access cannulation in hemodialysis patients: technical approach Castro, Manuel Carlos Martins Carlquist, Francisca Tokiko Yanagida Silva, Celina de Fátima Xagoraris, Magdaleni Centeno, Jerônimo Ruiz de Souza, José Adilson Camargo J Bras Nefrol Original Articles INTRODUCTION: The vascular access cannulation technique varies among clinics, and guidelines on vascular access give little importance to cannulation techniques. The objective of this study was to evaluate the cannulation technique and to determine which factors are associated with each detail of the technique. MATERIAL AND METHODS: The vascular access cannulation was evaluated in 260 patients undergoing hemodialysis. The type and anatomical location of the vascular access, the cannulation technique, direction, gauge, and distance between needles, besides bevel direction and needle rotation were registered. RESULTS: The arteriovenous fistula was the most frequent vascular access (88%), the most used cannulation technique was area (100%), the needle direction was anterograde in most cases (79.5%), and the mean distance between the tips of needles was 7.57±4.43 cm. For arteriovenous grafts, the proximal anatomical location (brachial artery) and cannulation with 16G needles in anterograde position were more predominant. For arteriovenous fistulas, the distal anatomical location (radial artery) and cannulation through 15G needles were more common. Cannulation of vascular access in retrograde direction was associated with a greater distance between needles (13.2 ± 4.4 vs 6.1 ± 3 cm, p < 0.001). Kt/V was higher when the distance between needles was higher than 5 cm (1.61 ± 0.3 vs. 1.47 ± 0.28, p < 0.01). CONCLUSIONS: The vascular access cannulation technique depends on the vascular access characteristics and expertise of cannulators. Clinical trials are required for the formulation of guidelines for vascular access cannulation. Sociedade Brasileira de Nefrologia 2019-12-09 2020 /pmc/articles/PMC7213941/ /pubmed/31826075 http://dx.doi.org/10.1590/2175-8239-JBN-2019-0031 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Castro, Manuel Carlos Martins
Carlquist, Francisca Tokiko Yanagida
Silva, Celina de Fátima
Xagoraris, Magdaleni
Centeno, Jerônimo Ruiz
de Souza, José Adilson Camargo
Vascular access cannulation in hemodialysis patients: technical approach
title Vascular access cannulation in hemodialysis patients: technical approach
title_full Vascular access cannulation in hemodialysis patients: technical approach
title_fullStr Vascular access cannulation in hemodialysis patients: technical approach
title_full_unstemmed Vascular access cannulation in hemodialysis patients: technical approach
title_short Vascular access cannulation in hemodialysis patients: technical approach
title_sort vascular access cannulation in hemodialysis patients: technical approach
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213941/
https://www.ncbi.nlm.nih.gov/pubmed/31826075
http://dx.doi.org/10.1590/2175-8239-JBN-2019-0031
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