Do plastic cannulae have better outcomes than metal needles in haemodialysis? A retrospective review

© 2016 Covidien Pty Ltd, A Medtronic company. All Rights Reserved. Introduction Plastic dialysis cannulae were introduced into Barwon Health Renal Services, Victoria, Australia, as a potential alternative to metal dialysis needles in 2012. After an initial, successful, 16-month trial and training period, they were used on all new (to haemodialysis) arteriovenous fistulae (AVF) for a minimum of six dialysis sessions. Miscannulation of either a metal needle or plastic cannula has the possibility of leading to further cannulation attempts, aborted dialysis sessions, extravasations, haematoma formation and pain and anxiety for the patient. Currently, there is no published data available to identify if plastic cannula use results in fewer adverse events. Aim To evaluate if the introduction of plastic cannulae for cannulation in the first six dialysis sessions have better outcomes than metal needles. Method Patient data were retrospectively collected from digital medical records. The time period of collection included the 16 months prior to the introduction of plastic cannulae and 16 months' post staff-training period. Data from the first six treatments of new patients were reviewed and adverse events such as extravasations and aborted dialysis sessions were noted. Results The use of plastic cannulae showed improved outcomes with no aborted dialysis sessions and no mid-dialysis extravasations compared to the traditional metal needles, where there were eight aborted dialysis treatments (dialysis was not commenced at all) and four mid-treatment extravasations, where two sessions were aborted all together. Conclusion Initial results are very promising towards plastic cannula use in haemodialysis leading to improved patient outcomes through fewer aborted dialysis sessions and adverse events.