Hong Kong Journal of Nephrology
Volume 12, Issue 2 , Pages 105-109, October 2010

Randomized Controlled Trial Protocol on Buttonhole Cannulation: A Technique to Reduce Arteriovenous Fistula Access Complications

  • Josephine Chow

      Affiliations

    • Area Cardiovascular Stream, Sydney South West Area Health Service, School of Nursing, University of Sydney and School, of Nursing, University of Tasmania, New South Wales, Australia
    • Corresponding Author InformationCorrespondence to: Associate Professor Josephine Chow, Liverpool Health Service, Locked Bag 7103, Liverpool BC NSW, 1870, Australia. Fax: (+ 61) 2 9828 3709
    • ,
  • Glenda Rayment

      Affiliations

    • Area Renal Service, Western Zone, Sydney South West Area Health Service, New South Wales, Australia
    • ,
  • Margaret Gilbert

      Affiliations

    • Area Renal Service, Western Zone, Sydney South West Area Health Service, New South Wales, Australia
    • ,
  • Susana SanMiguel

      Affiliations

    • Area Renal Service, Western Zone, Sydney South West Area Health Service, New South Wales, Australia

Article Outline

Objectives

This multicenter, prospective, open-label randomized controlled trial will be undertaken to determine whether or not the buttonhole cannulation technique in new and established hemodialysis fistula reduces complications and prolongs access life compared to usual practice.

Methods

A total of 70 subjects will be recruited for this study. Subjects randomized to the buttonhole group will have their fistula cannulated by the same staff member for 2-4 weeks at the same angle and direction with sharp needles. Once the tunnel is developed, blunt needles will be used. The control group will continue with usual practice (rope ladder rotation technique). Measurement of treatment effects will include: (1) quality of life; (2) pain assessment of cannulation; (3) lignocaine use; (4) intradialytic blood flow rate and venous and arterial pressures; (5) dialysis adequacy; (6) cannulation proficiency; and (7) hemostasis time.

Conclusion

This study has been designed to provide evidence to help renal clinicians and their hemodialysis patients determine the optimal cannulation technique for prevention of fistula access complications.

Key words:  buttonhole cannulation , cannulation technique , dialysis access , hemodialysis

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. ANZDATA  . ANZDATA Registry . Available at www.anzdata.org.au Published 2008. [Date accessed: January 23, 2010]
  2. Schwab SJ . Hemodialysis vascular access: an ounce of prevention . Kidney Int . 1997;52:1704–1705
  3. Lundin PA . A personal experience with hemodialysis: 1966 to 1991 . Artif Organs . 1996;20:1330–1332
  4. Besarab A . Intervention for intra-access stenosis . Semin Dial . 2001;14:401–402
  5. Toma S, Shinzato T, Fukui H, Nakai S, Miwa M, Takai I, et al. A timesaving method to create a fixed puncture route for the buttonhole technique . Nephrol Dial Transplant . 2003;18:2118–2121
  6. Twardowski Z , Lebek R , Kubara H . Six year experience with the creation and use of internal arteriovenous fistulae in patients treated with repeated hemodialysis . Pol Arch Med (Warsaw) . 1977;57:205–214
  7. Kronung G . Plastic deformation of Cimino fistula by repeated puncture . Dial Transplant . 1984;13:635–638
  8. VAS  . Vascular Access Society Guidelines . Available at www.vascular-accesssociety.com Published 2002. [Date accessed: December 12, 2009]
  9. Verhallen AM , Kooistra MP , Van Jaarsveld BC . Cannulating in haemodialysis: rope-ladder or buttonhole technique? . Nephrol Dial Transplant . 2007;22:2601–2604
  10. Doss S , Schiller B , Moran J . Buttonhole cannulation-an unexpected outcome . Nephrol Nurs J . 2008;35:417–419
  11. Mccaffery M . Choosing a faces pain scale . Nursing . 2002;32:68
  12. CARI (Caring for Australasians with Renal Impairment)  . Vascular Access, Surveillance of Vascular Access . Available at www.cari.org.au Published 2000. [Date accessed: January 23, 2010]

PII: S1561-5413(10)60021-X

doi:10.1016/S1561-5413(10)60021-X

Hong Kong Journal of Nephrology
Volume 12, Issue 2 , Pages 105-109, October 2010

Article Tools