The Use of Plastic Cannula in Hemodialysis Patients: Singapore’s Experience

Introduction: During haemodialysis treatment, patients with Arterio Venous Fistula (AVF) or Arterio Venous Graft (AVG) will require two needles to initiate the treatment. Infiltrations from fistula or graft cannulation are one of the commonest complications to patients with permanent vascular access. Although, there is not much literature available regarding plastic cannula needles (similar to peripheral intra venous (IV) cannula) for haemodialysis but it has been available in Japan for > 20 years and now available in Australia and Singapore which seemed to have positive feedback with regards to prevent infiltration for patients during dialysis.

Method: In SGH dialysis center, we perform a trial using the plastic cannula (Argyle Needle) to replace the sharp metal needle for patients with short, deep and swollen AVF/ AVG (after endovascular procedure).

Result: A total of 23 patients (convenience sampling) used the plastic cannula needles during dialysis. 85% success rate of first attempt on both Arterial and Venous sites using ultrasound guided approach. During the 24 sessions of haemodialysis sessions, 90% of the cases has their blood flow rate (Qb) ≥ 200 mmHg/ min (Qb ranged from 200-250 mmHg/ min) with stable Venous Pressure (VP ranged 110-150 mmHg). There were no machines’ alarms and infiltrations reported.

Conclusion: Infiltrations caused by dialysis needles is an under-reported event and Further research is recommended to compare the use of the traditional mental needles versus the plastic cannula needles in ensuring safe patient care during haemodialysis.