Handheld Ultrasound-guided Cannulation of Difficult Haemodialysis Arteriovenous Access by Renal Nurses - A Randomised Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- percentage of successful cannulation
研究概览
简要总结
Cannulation of complex arteriovenous fistula (AVF) or graft (AVG) is a challenge to renal nurses. Ultrasound (US) guidance on central and peripheral venous access visualisation has been widely adopted in nephrology and shown to reduce complications of vascular interventions. With broader adoption of handheld US devices in clinical services, renal nurses could acquire this point-of-care technique to increase the successful cannulation rate while facilitating confidence build-up during training and practice. We aim to evaluate the use of handheld US on difficult AVF/AVG cannulation in a hospital-based dialysis unit.
详细描述
We conducted a prospective randomised controlled study from January 2021 to January 2022. Ten renal nurses were trained by an interventional nephrologist before patient recruitment and had completed a pre- and post-training questionnaire on their confidence level. Fifty haemodialysis patients with complex AVF were randomised to US-guided or conventional cannulation. The total time spent on cannulation and patients' pain scores were also collected.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 90 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •First-time cannulation,
- •Post-angioplasty or thrombectomy,
- •Partial stenosis confirmed with imaging or by vascular surgeons/interventional radiologists,
- •Failed cannulation by dialysis nurses at community centres,
- •Bruises or haematoma around AVF/AVG,
- •Presence of clots in AVF/AVG and
- •Deep-seated access by physical examination.
排除标准
- •complex access with a high risk of complications (calibre ≤0.4cm or vessels ≥0.8cm in depth from skin)
结局指标
主要结局
percentage of successful cannulation
时间窗: from skin contact to actual start of dialysis
次要结局
- complications(from skin contact to actual start of dialysis)
- pre-cannulation assessment time(from patient physical contact to the time before needling thru skin)
- cannulation time(skin contact by needle to succesful aspiration of blood from needle)
- patients' pain score(needle to skin to end of dialysis session)
研究者
Allen Liu Yan Lun
Senior Consultant
National Healthcare Group, Singapore