One-Cannula Hæmodialysis

Twiss, E.E.

doi:10.1016/s0140-6736(64)92620-0

Cited by 13 publications

(6 citation statements)

References 2 publications

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“…In 1964, my former associate, Twiss [27] in the Netherlands applied a single cannula principle using a Shaldon cannula. Few people paid attention.…”

Section: K Olffmentioning

confidence: 99%

Artificial Kidneys in the Seventies

Wj¹

1972

Nephron

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There is no statistical improvement in the results of kidney transplantations in the last 4 years, but a successful kidney recipient is easier to rehabilitate than a person maintained on dialysis. ‘The uremic toxin’ has not been found, and it behooves us to remove all that is retained. The KG liter concept should be considered next to the square meter hour concept. Kidneys with inexpensive inserts (E.Z.S. kidney) andsingle needle dialysis are now practical. Coated charcoal kidneys soon will be practical. Speculations for thefuture are presented. The wearable kidney is one.

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“…In 1964, my former associate, Twiss [27] in the Netherlands applied a single cannula principle using a Shaldon cannula. Few people paid attention.…”

Section: K Olffmentioning

confidence: 99%

Artificial Kidneys in the Seventies

Wj¹

1972

Nephron

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“…Typically, two needles are inserted and used during hemodialysis treatments; however, there are situations where a single-needle technique has been used. First described by Twiss in 1964, some centers encourage the use of this when new fistulas are first being cannulated [5,6]. Also, many home hemodialysis centers use the single-needle technique for safety reasons.…”

Section: Introductionmentioning

confidence: 99%

What Is Single Needle Cannulation Hemodialysis: Is It Adequate?

Huang¹,

Shah²,

Thomson³

et al. 2014

Blood Purif

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Background: It is important to know the relative clearances obtained when using single-needle versus double-needle cannulation techniques. Method: Twelve hemodialysis treatments were conducted using a machine that is capable of single-needle as well as double-needle cannulation. Single-needle and double-needle blood flow rates, as well as urea clearance, were compared. Results: The measured blood flow rates were 368 ± 11 ml/min, 294 ± 4 ml/min, 200 ± 0 ml/min, and 100 ± 0 ml/min during double-needle hemodialysis and were 201 ± 10.9 ml/min, 173 ± 44.9 ml/min, 103 ± 4.1 ml/min, and 45 ± 4.9 ml/min during single-needle hemodialysis. The hemodialysis urea clearances at similar blood flow rate (approximately 200 ml/min) were 167 ± 4 ml/min and 161 ± 9 ml/min (paired t test; p > 0.05), respectively. Conclusion: The measured blood flow rates and urea clearances during single-needle hemodialysis were approximately half of the measured blood flow rate during double-needle hemodialysis, and should be used in selected settings.

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“…Single-needle (SN) dialysis was first described in 1964 by Twiss, who used a time-activated mechanism with a pump and a double clamp to alternate blood through a caval catheter. [1] In the 1980s, Belgian researchers using a specific canula and a twin pump-head SN system showed that dialysis efficiency was at least as good as Address correspondence to Guy Rostoker, Clinical Investigation Laboratory (Association Quincy Recherche Clinique et Thérapeutique), Centre Hospitalier Privé Claude Galien, 20 route de Boussy Saint-Antoine, 91480 Quincy sous Senart, France; Tel. : 01 69 39 92 00; Fax: 01 69 39 91 84; E-mail: rostotom@ orange.fr with conventional DN hemodialysis, based on Kt/V, the hematocrit, and nerve conduction.…”

Section: Introductionmentioning

confidence: 99%

Improving the Efficiency of Short-Term Single-Needle Hemodialysis

et al. 2009

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It is widely believed that single-needle (SN) hemodialysis is inferior to conventional double-needle (DN) hemodialysis. The purpose of this study was to compare two SN dialysis regimens using different blood flow rates with conventional DN hemodialysis. The primary outcome measure was ionic dialysance. We studied eight patients (two women, six men) undergoing chronic intermittent DN bicarbonate hemodialysis three times per week on a Cimino-Brescia fistula for at least three months. The study had a prospective four-period design and lasted four weeks. During weeks 1 and 3, the participants had standard DN hemodialysis sessions, with Wallace needles at a blood flow rate of 250-300 mL/min. During week 2, they had single-needle dialysis sessions with a short 15-gauge stainless-steel needle, an effective blood flow rate of 180 mL/min (360 mL/min for each of the two pumps), and venous pressure below 200 mmHg. During week 4, they had SN dialysis sessions with a short 15-gauge stainless-steel needle, an effective blood flow rate of 250 mL/min (500 mL/min for each of the two pumps), and a venous pressure below 200 mmHg. Ionic dialysance recorded 45 minutes after the beginning of the dialysis session and 30 minutes before the end of the session were used for statistical analysis. The effective blood flow target of 250 mL/min was achieved in six of the eight patients. Ionic dialysance 45 minutes after the beginning of the session differed among the four periods (p < 0.001, Friedman test). Ionic dialysance was better during each DN dialysis period than during the 180 mL/min SN period (p < 0.01, Dunn's multiple comparison tests), but there was no difference with the 250 mL/min SN period. Ionic dialysance 30 minutes before the end of the dialysis session differed among the four periods (p < 0.001, Friedman test). Ionic dialysance was far better during each DN period than during the 180 mL/min SN period (p < 0.001, Dunn's multiple comparison test) and slightly better than during the 250 mL/min SN period (p < 0.05, Dunn's multiple comparison test). The single-pool Kt/V ratio differed among the four periods (p < 0.0001, Friedman test). The Kt/V ratios were far better during each DN period than during the 180 mL/min SN period (p < 0.001, Dunn's multiple comparison test) and slightly better than during the 250 mL/min SN period (p < 0.01, Dunn's multiple comparison test). The Kt/v provided by the dialysis monitor gave identical results to single pool Kt/v. We conclude that single-needle dialysis with an effective blood flow rate of 180 mL/min delivers an inadequate dialysis dose, which may be harmful. In contrast, an effective blood flow rate of 250 mL/min appears acceptable for brief periods of single-needle dialysis lasting one or two weeks. Otherwise, an increase in the length of the dialysis session and/or the use of a larger membrane surface area and even higher blood flow is required to obtain the same quality of dialysis as with conventional double-needle hemodialysis. Careful monitoring of the dialysis dose delivered is mand...

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One-Cannula Hæmodialysis

Cited by 13 publications

References 2 publications

Artificial Kidneys in the Seventies

Artificial Kidneys in the Seventies

What Is Single Needle Cannulation Hemodialysis: Is It Adequate?

Improving the Efficiency of Short-Term Single-Needle Hemodialysis

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