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SHARP VERSUS BLUNT DIALYSIS NEEDLE USE WITH BUTTONHOLE METHOD: OPEN RANDOMISED TRIAL
Author(s) -
Morselli Claudio,
Chiari Paolo,
Aliberti Tiziana,
Celli Guglielmo,
Catalani Silvia,
Miale Ignazia,
Melandri Vanessa,
Bianchi Lorenza
Publication year - 2015
Publication title -
journal of renal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.381
H-Index - 27
eISSN - 1755-6686
pISSN - 1755-6678
DOI - 10.1111/jorc.12119
Subject(s) - medicine , trampoline , surgery , arteriovenous fistula , blunt , incidence (geometry) , fistula , dialysis , physics , computer science , optics , operating system
SUMMARY Background Current protocols recommend the use of a blunt needle to access the arteriovenous fistula via a buttonhole. This study aims to demonstrate whether a sharp needle can be used at the same buttonhole site without causing complications. Goal To measure and compare fistula cannulation failures between the use of blunt and sharp needles. Plan Open‐crossover randomised controlled trial. Participants Adult out‐patients who had provided consent and were on dialysis with a mature arteriovenous fistula and buttonhole cannulation. Outcome measures Failed cannulation—difficulty in inserting the needle and the trampoline effect; incidence of complications, such as infection and haematomas; times to haemostasis; patients’ pain; and patients’ preferences. Results Based on analysis of the data from the 35 patients enrolled, no significant differences were detected in failed cannulation of the fistulae between the use of a blunt needle and a sharp needle for the 335 venous accesses (p = 0.071). However, a significant difference was detected for the 335 arterial accesses (p = 0.001), in which the sharp needle was more effective. Significant differences were also detected in the difficulty of insertion and in the trampoline effect for both venous and arterial access (p < 0.05); the use of a sharp needle was more favourable. Conclusion This study demonstrates an increased incidence of failed cannulation using a blunt needle compared with using a sharp needle, although this was not significant. In addition, the use of a sharp needle did not result in any increase in complications.