Abstract: TH-PO293
Point-of-Care Ultrasound-Guided Cannulation of Arteriovenous Fistula Comparison with Standard Cannulation Technique: A Systematic Review and Meta-Analysis
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Santos Pinto, Luis Claudio, Metropolitan University Center of Amazon, Belem, Brazil
- Da Luz, Jiandra, Universidad Nacional de la Plata, La Plata, Argentina
- Barbosa, Lucas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Udoma-Udofa, Ofonime Chantal, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
- de Magalhães Leal Moreira, João Lucas, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil
- Luborrigueiro, Lucianna Borrigueiro, European Atlantic University, Santander, Spain
Background
Ultrasound-guided (US-guided) cannulation in arteriovenous fistulas (AVF) is a well-established practice for patients with kidney disease undergoing hemodialysis. Although there is no absolute consensus, studies demonstrated that US guidance increases cannulation success rates compared with conventional techniques. This meta-analysis aims to evaluate the effectiveness of US-guided compared with the standard cannulation technique.
Methods
We systematically searched PubMed, Embase, and Cochrane databases to identify randomized controlled trials (RCTs) comparing US-guided versus standard cannulation in hemodialysis patients. The primary outcome of interest was the cannulation success rate. The pain score was evaluated using the VAS score. We pooled risk ratios (RR) for binary outcomes, and mean difference (MD) for continuous endpoints with 95% confidence intervals (CI), employing a random-effects model. We used R version 4.3.2 for all statistical analysis.
Results
Our study included 5 RCTs comprising 224 patients who underwent either US-guided (40.6% ) or standard cannulation(40.2% ). US-guided and standard cannulation had a similar success rate (RR 1.33; 95%CI 0.96 to 1.84; p=0.09; I2=).US-guided cannulation was associated with a reduction in pain score (MD -0.61; 95%CI -1.07 to -0.15; p<0.05; I2=). There was no significant difference between groups in procedure length (MD -20.87 min; 95%CI -82.94 to 41.20; p=0.51; I2=) and complication rate (RR 0.89; 95%CI 0.55 to 1.44; p=0.64; I2=).
Conclusion
In patients undergoing hemodialysis, US-guided cannulation had a similar success rate compared with the standard technique. However, it showed a difference, albeit small, associated with reduced pain perception, providing greater comfort to the patient.