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Size of needles

By William Knoer posted 04-26-2010 18:39

  
Hello everyone,
I was wondering if anyone had any articles or EBP that supported the use of larger needles in the dialysis setting.  We have recently gone from having 15 guage needles to 14 guage needles.  So far I haven't found that they necessarily have improved URR's but we are able to achieve higher pump speeds, higher blood flow rates and lower venous and arterial pressures.  If there are any articles out there I would appreciate it, some of my co-workers are a little skeptical in using them because they feel that they cause to much damage to the AVF.  Thanks in advance for any help!

Bill
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Dolores Baker
06-19-2010 13:19

I do not know the long term effects of 14 g fistula needles. We have been using them for quite some time at our clinic, both with fistulas and grafts. We have several patients who use the 14g fistula blunt needles. As far as clearances, increasing the size has made a big difference with our numbers- for the better.

Karen Robbins
05-15-2010 13:42

Like Anne, I don't know the answer either but I do share Bill's concern about possible long term damage to AVFs. I have perhaps a greater concern for AVGs that are PTFE as the graft material may be more damaged (bigger holes in the PTFE itself). Have you seen the image of a PTFE graft that was explanted during a post mortem exam? It was in shreds! I can only imagine that such damage would occur sooner with a larger bore needle.

R. Webber
05-06-2010 16:14

I don't know the answer, but I am sure that the hemodialysis SIG could help you. Please consider posting your inquiry to the Hemo SIG eGROUP on this site. I certainly look forward to reading the answer!