Abstract: FR-PO498
Safety and Efficacy of a Novel Compression Hemostatic Device for Vascular Access: A Quality Improvement Study
Session Information
- Dialysis: Vascular Access
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Abidian, Mohamed Modar, Emory University School of Medicine, Atlanta, Georgia, United States
- Broxton-Key, Rodella, Emory Healthcare, Atlanta, Georgia, United States
- Rawls, Forest, Emory Healthcare, Atlanta, Georgia, United States
- Niyyar, Vandana Dua, Emory University School of Medicine, Atlanta, Georgia, United States
Background
Arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) are common types of vascular access for chronic hemodialysis (HD) patients that require frequent needle cannulations. Proper cannulation and decannulation techniques are important for achieving hemostasis and preventing complications from bleeding. After decannulation, most protocols require manual pressure at vascular access sites to prevent bleeding. A novel compression device with a simple manual inflation/deflation pump has been developed to achieve post decannulation hemostasis. The purpose of this quality improvement (QI) study was to assess the safety and effectiveness of such a device in our clinical practice.
Methods
Our protocol for using the device is detailed in Figure 1. All patients who had HD with either AVF or AVG and were holding manual pressure for hemostasis were eligible for the study. Efficacy outcome was achieving post decannulation homeostasis within 15 minutes. Safety outcome measures were prolonged bleeding (more than 15 minutes), access thrombosis, and local infection. Patient satisfaction surveys were performed using the Likert scale.
Results
We evaluated 166 HD sessions using the compression device in 28 patients. There were no access infections or thrombosis. Only 1 (0.03%) episode of prolonged bleeding post decannulation in a patient who was on warfarin therapy. Almost all patients preferred the device to manual compressions and the average satisfaction rate was 4.6/5.
Conclusion
This novel device was safe and effective in achieving post-cannulation hemostasis and was preferred to manual compression by patients at our center.
Table 1. Incidence Rate of Complications
| No. of patients | Total No. (average per patient) of HD sessions performed using the device | No. of prolonged bleeding >15 min per patient | No. of access thrombosis | No. of local infection | Average patient satisfaction (1-5) |
| 28 | 166 (5.8 per patient) | 1 (0.03%) | 0 (0%) | 0 (0%) | 4.6 |
Figure 1: Instructions
Funding
- Commercial Support – No financial payment was received by the manufacturing company Sun-Scientific as the device was donated free of cost