Prospective Analysis of Arteriovenous Access Use in Continuous Renal Replacement Therapy, a Feasibility Project

East Carolina University

Summary

This study will test whether patients who already have a permanent dialysis access (an arteriovenous fistula or graft) can safely use that access for continuous dialysis (CRRT) while they are critically ill in the intensive care unit, instead of requiring a temporary central venous catheter. About 50 patients will participate. Researchers will monitor how well the access works, whether any complications occur, and whether there are differences between fistulas and grafts. The goal is to determine whether using a patient's existing dialysis access is a safe and practical option that could reduce the need for temporary catheters and their associated risks, such as infection and bleeding.

Description

Synopsis: This is a single-arm, single-center, pragmatic prospective study evaluating the safety and feasibility of using existing arteriovenous access (arteriovenous fistulas or arteriovenous grafts) to deliver continuous renal replacement therapy in critically ill end-stage kidney disease patients admitted to the intensive care unit. A target of 50 patients will be enrolled consecutively. The study intervention consists of CRRT delivery via AVA using standard steel hemodialysis needles (14-17 gauge) with continuous bedside monitoring by ICU nursing staff and dialysis nurse support for cannul…

Eligibility

Age range: 18+ years
Sex: All
Healthy volunteers: No

Detailed criteria

Inclusion Criteria: 1. Age ≥18 years. 2. ESKD patients on chronic hemodialysis for \>1 year in duration who are admitted to the ICU and in need of CRRT. 3. Anticipated CRRT duration ≥24 hours, based on clinical assessment of the renal trajectory. 4. Patient with functioning arteriovenous access, either arteriovenous fistula or arteriovenous graft. 5. Expected mechanical ventilation for a minimum of 12 hours, based on clinical assessment of the underlying diagnosis. 6. Expected Richmond Agitation Sedation Scale (RASS) goal of 0 or less for a minimum of 12 hours, based on clinical assessment of…

Interventions

Other
Cannulation of permanent dialysis access, for the purpose of delivering continuous renal replacement therapy.
Permanent dialysis access, including arteriovenous fistulas or grafts, will be cannulated using standard dialysis needles for the purpose of delivering continuous renal replacement therapy. CRRT via arteriovenous access will only be performed in ICU settings where nursing staff have at least one year of ICU experience and have completed both study-specific training and institutional CRRT training. Dialysis nurses will perform cannulation of the arteriovenous access according to the standardized operating procedure.

Location

East Carolina University Medical Center
Greenville, North Carolina
rodriguezlopeza23@ecu.edu 9392750483

Summary

Description

Eligibility

Age range

18+ years

Sex

All

Healthy volunteers

Detailed criteria

Interventions

Other

Cannulation of permanent dialysis access, for the purpose of delivering continuous renal replacement therapy.

Permanent dialysis access, including arteriovenous fistulas or grafts, will be cannulated using standard dialysis needles for the purpose of delivering continuous renal replacement therapy. CRRT via arteriovenous access will only be performed in ICU settings where nursing staff have at least one year of ICU experience and have completed both study-specific training and institutional CRRT training. Dialysis nurses will perform cannulation of the arteriovenous access according to the standardized operating procedure.