Pros and cons of early cannulation prosthetic grafts скачать в хорошем качестве

Pros and cons of early cannulation prosthetic grafts

The early cannulation grafts did not appear with the Acuseal but many years ago with grafts that we have already forgotten. During the years I have seen devices that appeared like comets and suddenly disappeared. Always be careful with new grafts and do not be tempted to use them without sufficient data. Always remember that patient safety and patient wellness are the most important issue for us as a physician. We all took the Hippocratic Oath of ethics and we should respect it starting with "Primum non nocere", first do not harm. The Diastat, Vectra, AVflo and Rapidax caused significant damage to the patients. When we look at the studies in the literature, we can find poor quality studies. for example, a systematic review concluded "that early cannulation graft is possible without detrimental" including Avflo, Vectra and Rapidax that already removed from the shelf due to multiple problems, but despite that, the authors claim that they are adequate graft for hemodialysis. 80% of the patients with end stage renal failure patients start hemodialysis via a central vein catheter or hopefully via a tunneled dialysis catheter. 50% of the early cannulation grafts are cannulated after one week and we can do it with a standard graft as well. Thus, I cannot see any significant difference between the early cannulation and standard grafts. Facing the poor-quality data on early cannulation grafts I would recommend to wait for a real high-quality study proving the use of early cannulation graft only for saving one week of tunneled dialysis catheter that already have been there.