SAGE open medicine · 2025
Arteriovenous shunt cannulation in hemodialysis patients: A prospective cohort study of outcomes and complications in a resource-limited healthcare system.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shawahna Ramzi, Hafaitha Aseel, Saadi Lyan, Haj-Yahia Salwa, Adawi Tala, Saada Sultan, Hijaz Hatim
Аннотация
OBJECTIVES: The primary objective of this study was to assess the outcomes and complication rates associated with different arteriovenous shunt cannulation methods among patients with end-stage chronic kidney disease.
METHODS: The study was carried out at two major hemodialysis centers in a resource-limited healthcare system. A total of 309 patients were included. Vascular access was achieved using the area puncture technique in 171 patients (55.3%) and the rope-ladder technique in 138 patients (44.7%).
RESULTS: Of the patients, 62 (20.1%) suffered vascular access complications (0.63 events/1000 access days). Hematoma was the most common complication, occurring in 43 patients. Hematoma was significantly associated with female sex (p = 0.024), shorter hemodialysis vintage (p = 0.026), and longer duration of hemodialysis sessions (p = 0.048). High venous access pressure was significantly associated with the rope-ladder technique (p = 0.022), jugular implanted shunts (p < 0.001), and with longer duration of hemodialysis sessions (p = 0.002). Bleeding was associated with a shorter hemodialysis vintage (p = 0.047). Infection was significantly associated with the area puncture technique (p = 0.043) and with cannulation during the noon dialysis shift (p = 0.007). Moreover, thrombosis was significantly associated with female sex (p = 0.014), residing in rural areas (p = 0.018), and absence of comorbidities (p = 0.008).
CONCLUSION: Our findings underscore the critical need to implement evidence-based protocols, enhance staff training, and address systemic obstacles in vascular access management.
METHODS: The study was carried out at two major hemodialysis centers in a resource-limited healthcare system. A total of 309 patients were included. Vascular access was achieved using the area puncture technique in 171 patients (55.3%) and the rope-ladder technique in 138 patients (44.7%).
RESULTS: Of the patients, 62 (20.1%) suffered vascular access complications (0.63 events/1000 access days). Hematoma was the most common complication, occurring in 43 patients. Hematoma was significantly associated with female sex (p = 0.024), shorter hemodialysis vintage (p = 0.026), and longer duration of hemodialysis sessions (p = 0.048). High venous access pressure was significantly associated with the rope-ladder technique (p = 0.022), jugular implanted shunts (p < 0.001), and with longer duration of hemodialysis sessions (p = 0.002). Bleeding was associated with a shorter hemodialysis vintage (p = 0.047). Infection was significantly associated with the area puncture technique (p = 0.043) and with cannulation during the noon dialysis shift (p = 0.007). Moreover, thrombosis was significantly associated with female sex (p = 0.014), residing in rural areas (p = 0.018), and absence of comorbidities (p = 0.008).
CONCLUSION: Our findings underscore the critical need to implement evidence-based protocols, enhance staff training, and address systemic obstacles in vascular access management.