Department of Health Professions, University Hospital of Padova, Padova, Italy.
Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino, Urbino, Italy.
J Vasc Access. 2023 Sep;24(5):1025-1031. doi: 10.1177/11297298211066763. Epub 2021 Dec 30.
In haemodialysis is key to successfully obtaining cannulation of the arteriovenous fistula (AVF). The literature agrees that cannulation, failing in the initial maturation period, can lead to delayed dialysis, haematoma, scarring, needle phobia and loss of confidence in the cannulator. The introduction of plastic cannulae for haemodialysis has changed cannulation practice positively, preventing frequent complications such as infiltration or trauma. Despite that, most countries have continued to use metal cannulation, in particular in Europe. This study investigates the common use of plastic cannulae versus metal needles for cannulation in dialysis units and explores the implications of focusing on the side effects of cannulation.
The study is a cross-sectional survey. A questionnaire was created by a team of experts from the European Dialysis Transplant Nurse Association/European Renal Care Association (EDTNA/ERCA) to address the study's aims and sent online to nurse members.
Data collected suggested a strong resistance towards using plastic cannulae, with few respondents claiming to use these cannulas. Most of the respondents were female (74%), Europeans, working in nephrology for more than 10 years and most worked in the public sector. There was a strong correlation between the use of plastic cannulae and fewer adverse events in elbow located AVF and newly created or fragile AVF.
The results are in line with the current literature. Possible resistance to the use of the plastic device includes the difference in cost between the two devices in favour of metal needles. However, it should be considered that the lower number of adverse events, in particular infiltration and haematoma caused by the metal needle, involves a considerable saving both in money and in terms of time and distress for the patient.
在血液透析中，成功进行动静脉瘘（AVF）插管是关键。文献一致认为，在初始成熟阶段插管失败会导致透析延迟、血肿、瘢痕形成、针头恐惧症和插管者信心丧失。用于血液透析的塑料插管的引入已经积极地改变了插管实践，防止了频繁的并发症，如渗透或创伤。尽管如此，大多数国家仍继续使用金属插管，特别是在欧洲。本研究调查了在透析单位中使用塑料插管与金属针进行插管的常见情况，并探讨了关注插管副作用的意义。
该研究是一项横断面调查。欧洲透析移植护士协会/欧洲肾脏护理协会（EDTNA/ERCA）的一个专家团队创建了一份问卷，以解决研究目的，并在线发送给护士成员。
收集的数据表明，人们对使用塑料插管存在强烈的抵制，很少有受访者声称使用这些插管。大多数受访者是女性（74%），欧洲人，从事肾病学工作超过 10 年，大多数人在公共部门工作。在肘部位置的 AVF 和新创建或脆弱的 AVF 中，使用塑料插管与较少的不良事件之间存在很强的相关性。
结果与当前文献一致。对塑料设备使用的可能抵制包括两种设备之间的成本差异，金属针更具优势。然而，应该考虑到金属针引起的不良事件（特别是渗透和血肿）的数量较少，这不仅在金钱方面，而且在患者的时间和痛苦方面都节省了相当多的费用。
