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NCT Number: NCT05410691

Handheld Ultrasound-guided Cannulation of Difficult Haemodialysis Arteriovenous Access by Renal Nurses

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.

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Key information

Conditions

Hemodialysis Complication Arteriovenous Fistula Arteriovenous Malformations Cardiovascular Abnormalities Cardiovascular Diseases Congenital Abnormalities Congenital, Hereditary, and Neonatal Diseases and Abnormalities Dialysis Access Malfunction Dialysis; Complications Fistula Graft Av Pathological Conditions, Anatomical Pathological Conditions, Signs and Symptoms Vascular Access Complication Vascular Access Site Haematoma Vascular Diseases Vascular Fistula Vascular Malformations

Age range

21 year–90 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Allen Liu

Singapore

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • First-time cannulation, 2. Post-angioplasty or thrombectomy, 3. Partial stenosis confirmed with imaging or by vascular surgeons/interventional radiologists, 4. Failed cannulation by dialysis nurses at community centres, 5. Bruises or haematoma around AVF/AVG, 6. Presence of clots in AVF/AVG and 7. Deep-seated access by physical examination.

Exclusion criteria

complex access with a high risk of complications (calibre ≤0.4cm or vessels ≥0.8cm in depth from skin)

Treatment and study plan

Handheld US device

Device

Handheld US-guided AVF/AVG cannulation

Primary outcomes

  1. percentage of successful cannulation

    Time frame: from skin contact to actual start of dialysis

Secondary outcomes

  1. pre-cannulation assessment time

    Time frame: from patient physical contact to the time before needling thru skin

    time taken to assess the AVF/AVG with either US or clinical examination before cannulation

  2. cannulation time

    Time frame: skin contact by needle to succesful aspiration of blood from needle

  3. patients' pain score

    Time frame: needle to skin to end of dialysis session

    10cm visual analogue scale

  4. complications

    Time frame: from skin contact to actual start of dialysis

    need for a temporary central venous catheter, single-needle dialysis, or infiltration (e.g. haematoma) that hastened the use of AVF/AVG for the same dialysis session

Sponsors and collaborators

Lead sponsor

National Healthcare Group, Singapore

Other Gov

Registry information

Official study title

Handheld Ultrasound-guided Cannulation of Difficult Haemodialysis Arteriovenous Access by Renal Nurses - A Randomised Controlled Trial

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Jun 8, 2022
Registry last updated
Jun 8, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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