ABSTRACT
A presente carta ao Editor aborda os artigos de Silva et al. Õ e de Castro et al. ² que nos levam a dois tipos de comentários: o primeiro de ordem linguística, e o segundo referente a aspectos médicos.
The present letter to the Editor regards the articles by de Silva et al. Õ and de Castro et al. ² that lead us to two kinds of comments, the first refers to the language, and the second comment refers to the medical aspects.
Subject(s)
Humans , Needles , Arteriovenous Shunt, Surgical/methods , Inservice Training/methods , Catheterization/methods , Nursing, Team/methods , Renal Dialysis/methods , Terminology as TopicABSTRACT
The buttonhole technique of access of needle insertion into a single selected site in the arteriovenous fistula has proved to be a reliable alternative to older methods due to its overall low complication rates. Although the use of blunt needles improves the technique, the success rate of cannulation with these needles is difficult to predict. We analysed the short-term outcome of 16 patients receiving in-centre haemodialysis and compared clinical relevant parameters between patients with and without buttonhole technique failure. Our dialysis unit treats about 180 patients and is located in a tertiary hospital in Sao Paulo, Brazil. The variables as discussed in the paper were the same for both groups. The incidence of technique failure was 43.7%. Patients enrolled later in the study had a better buttonhole failure-free survival rates than patients enrolled at the beginning (p < 0.05). Patients' clinical characteristics did not predict the success rate of buttonhole tunnel tracks cannulation with blunt needles. This paper also reports on our successes and failures in buttonhole technique and gives some reasons and reflections for both.
