Using plastic cannula for vascular access in haemodialysis
Abstract:
Background: Plastic cannulae were introduced into Australia over a decade ago as a safer alternative to metal dialysis needles for arteriovenous fistula cannulation, decreasing the risk of infiltration resulting in haematoma formation, bruising, and pain for patients.
Objectives: To explore the uptake and current practices for using plastic cannulae for vascular access in Australian dialysis units.
Design: A 31-item exploratory descriptive web-based cross-sectional survey.
Participants: Renal clinicians who cannulate arteriovenous fistulae or arteriovenous grafts for haemodialysis in Australian haemodialysis units.
Results: A total of 185 clinicians responded to the questionnaire, with the majority of respondents from the Australian east coast Australia, specifically Queensland (36%, n = 66), New South Wales (27%, n = 50) and Victoria (26%, n = 48). Sixty-five percent of respondents were either registered nurses (47%, n = 88) or clinical nurse specialists (18%, n = 34). Of 140 participants who reported plastic cannula availability, only 62 (44%) used them personally. Plastic cannulae were mainly used with new (n = 55/65, 85%) and established (n = 56/60, 90%) vascular access, but rarely in home haemodialysis (n = 7/60, 11%). Plastic cannula was commonly used for the first 2 weeks with new fistula, then switched to metal needles due to high cost, however 41% (n = 22/54) reported that decisions on long-term cannula use was based on patient clinical needs. Training and gauge of cannula varied by state, with 16-guage the most common.
Conclusion: Plastic cannula use is increasing across Australia, but cost and training barriers still exist. Nevertheless, plastic cannulae remain a viable alternative to metal needles.
Reference:
Smith V, Schoch M. Clinician Perspectives on Using Plastic Cannula for Vascular Access in Haemodialysis: Outcomes of a National Web-Based Survey. J Ren Care. 2025 Mar;51(1):e70011. doi: 10.1111/jorc.70011. PMID: 39949301.