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Cannulation Technique (cannulation + technique)
Selected AbstractsThe Influence of Cannulation Technique on Blood Flow to the Brain in Rats Undergoing Cardiopulmonary Bypass: A Cautionary "Tail"ARTIFICIAL ORGANS, Issue 6 2010Terence Gourlay Abstract Recently, there has been an increase in the use of rat models of cardiopulmonary bypass (CPB) for research purposes. Much of this work has focused on cerebral injury associated with CPB. Many of these studies employ a peripheral cannulation approach, often utilizing the caudal artery and internal or external jugular vein. The aim of the present study was to establish whether there is any alteration in blood flow to the brain associated with the use of different cannulation routes. Twenty-four adult male Sprague Dawley rats were allocated to one of three study groups: Group 1,caudal artery return, Group 2,open-chest aortic return, and Group 3,nonbypass control group. Colored microspheres were injected into all animals at four time points (postinduction, initiation of bypass, midbypass, and end bypass). After the termination of each experiment, the brains were excised, the tissue was digested, the microspheres were harvested, and the global blood flow to the brain was assessed using the reference flow method. There was a significant reduction in blood flow to the brain between both bypass groups and the control group. Additionally, cerebral blood flow was significantly lower in the caudal return group than in the aortic return group. There is a significant drop in blood flow to the brain associated with the initiation and continuation of CPB when compared to non-CPB controls. These results also confirm a considerable cerebral hypoperfusion associated with the peripheral cannulation technique, and suggest that peripheral bypass may exaggerate the influence CPB has on cerebral injury. This technique must therefore be employed with caution. [source] The salvage of aneurysmal fistulae utilizing a modified buttonhole cannulation technique and multiple cannulatorsHEMODIALYSIS INTERNATIONAL, Issue 2 2006Rosa M. MARTICORENA Abstract We describe the St Michael's Hospital (SMH) modified buttonhole (BH) cannulation technique as a method that offers a solution for fistulae with aneurysmal dilatation due to repetitive cannulation in a restricted area. This is a prospective cohort study of 14 chronic hemodialysis (HD) patients with problematic fistulae (marked aneurysmal formation and thinning of the overlying skin, bleeding during treatment, and prolonged hemostasis post-HD) because of repetitive, localized cannulation. Each patient was followed for 12 months. The protocol was as follows: creation of tunnel tracks by 1 to 3 experienced cannulators per patient, using sharp needles. After the tunnel tracks were established and cannulation was easily achieved with dull needles, additional cannulators were incorporated with the guidance of a mentor. Bleeding from cannulation sites during dialysis ceased within 2 weeks and skin damage resolved within 6 months in all patients. Hemostasis time postdialysis decreased from 24 to 15 min. Cannulation pain scores decreased significantly. Access flows and dynamic venous pressure measurements remained unchanged. No interventions were required to maintain access patency. In 2 cases, the aneurysms became much less evident. Complications included one episode of septic arthritis and one contact dermatitis. A third patient developed acute bacterial endocarditis 9 months following completion of her follow-up. The SMH modified BH cannulation technique can salvage problematic fistulae, prevent further damage, and induce healing of the skin in the areas of repetitive cannulation. This technique can be successfully achieved by multiple cannulators in a busy full-care HD unit. [source] Prevention of Limb Ischemia and Edema During Peripheral Venoarterial Extracorporeal Membrane Oxygenation in AdultsJOURNAL OF CARDIAC SURGERY, Issue 2 2009Claudio F. Russo M.D. The cannulation of the femoral vessels may be complicated by distal limb ischemia by arterial hypoperfusion and severe edema by venous obstruction. We describe a modified cannulation technique in order to prevent ischemia and edema of the inferior limb during VA-ECMO. [source] "EVERYONE SHOULD BUTTONHOLE": A NOVEL TECHNIQUE FOR A REGIONAL AUSTRALIAN RENAL SERVICEJOURNAL OF RENAL CARE, Issue 3 2009Vicki Hartig RN SUMMARY The buttonhole, or constant-site, cannulation technique, although used elsewhere, had not been used in North Queensland, Australia, prior to 2005. This paper reports the results from a survey of patients' and nurses' initial experiences with the buttonhole cannulation technique 20 months after its introduction into a renal service in North Queensland. The use of the buttonhole technique increased the ease and decreased the discomfort associated with access cannulation for both patients and nurses; both groups reported less anxiety associated with this technique. The patients were especially pleased with the improved cosmetic appearance and indicated that they would be more likely to become involved in self-care, including self-cannulation. The nursing service has implemented strategies to ensure that buttonhole cannulation continues to be used as one means of arteriovenous fistula access across the region. A current study is examining longer-term outcomes of using the buttonhole technique within this regional service. [source] The Influence of Cannulation Technique on Blood Flow to the Brain in Rats Undergoing Cardiopulmonary Bypass: A Cautionary "Tail"ARTIFICIAL ORGANS, Issue 6 2010Terence Gourlay Abstract Recently, there has been an increase in the use of rat models of cardiopulmonary bypass (CPB) for research purposes. Much of this work has focused on cerebral injury associated with CPB. Many of these studies employ a peripheral cannulation approach, often utilizing the caudal artery and internal or external jugular vein. The aim of the present study was to establish whether there is any alteration in blood flow to the brain associated with the use of different cannulation routes. Twenty-four adult male Sprague Dawley rats were allocated to one of three study groups: Group 1,caudal artery return, Group 2,open-chest aortic return, and Group 3,nonbypass control group. Colored microspheres were injected into all animals at four time points (postinduction, initiation of bypass, midbypass, and end bypass). After the termination of each experiment, the brains were excised, the tissue was digested, the microspheres were harvested, and the global blood flow to the brain was assessed using the reference flow method. There was a significant reduction in blood flow to the brain between both bypass groups and the control group. Additionally, cerebral blood flow was significantly lower in the caudal return group than in the aortic return group. There is a significant drop in blood flow to the brain associated with the initiation and continuation of CPB when compared to non-CPB controls. These results also confirm a considerable cerebral hypoperfusion associated with the peripheral cannulation technique, and suggest that peripheral bypass may exaggerate the influence CPB has on cerebral injury. This technique must therefore be employed with caution. 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