Although hemodialysis has become a routine treatment all over the world, adverse side effects, and occasionally life-threatening clinical complications still happen.
VND is one of the most serious accidents that can happen during haemodialysis. If the blood pump is not stopped, either by activation of the protective system of the dialysis machine or manually, the patient can bleed to death within minutes.
According to figures from the “Nederlandse Nierstichting” in February 2016, the haemodialysis population worldwide has reached approximately 2.500.000 patients dialysing 3 times a week. That brings us to 7.500.000 dialysis sessions/week worldwide.
Therefore the introduction of technical and safety devices to make the treatment as safe as possible is extremely important. However, technological advances should be seen as complementary to the work of healthcare professionals to optimise safe and efficient haemodialysis treatments.
Dr. Sandroni published in 2009 that 0.0003% of VND incidents are fatal and 0.0008% are serious4. The Department of Veteran Affairs presented similar data in 2008, showing 0.0016% of VND´s are serious6. VND incident rates, from RPA in 2007 show 0.1282% incident rate and data from Dr. Ahlmén in 2008 show 0.1736%5,7.
Globally this would mean
EDTNA/ERCA questionnaire recordings of 283 VND incidents indicate that 23% of VND’s are serious and severe needing resuscitation to save patients lives and 5% either died or suffer from long term sequelae.
How do we Minimize the Risk of Venous Needle Dislodgement?
- Optimize patient safety during HD/HDF treatment
- Ensure that staff, patients and carers are aware of “Venous Needle Dislodgement risks” and the consequences
- Facilitate accessible tools for minimizing the risks of VND and to determine patients at risk According to the European Renal Care Providers Association, at the end of 2016 about 2.65 million patients received haemodialysis (HD) worldwide. In the EU, last year 329,000 patients received 49.8 million HD treatments.
Vascular access complications are a major cause of morbidity, leading to a high percentage of hospitalisation and in some cases even death.
Hurst J. A Costly Complication: Venous Needle Dislodgement. 2010.
Shander A, Hofmann A, Ozawa S, et al. Activity-based Costs of Blood Transfusions in Surgical Patients at Four Hospitals. Transfusion, 2010; 50(4):753-7654.
Sandroni, S, Shockerman, T, Hayes-Light, K, Catastrophic Hemorrhage from Venous Needle Dislodgement during Hemodialysis, Journal of the American Society of Nephrology, volume 9, November 2008, Abstract issue.
Ahlmén J, Gydell KH, Hadimeri H, Hernandez I, Rogland B, Strömbom U (2008) A new safety device for hemodialysis Hemodialysis International 12 (2), Page 264–267.
Patients Safety Advisory; Veteran Health Administration Warning System; Published by VA Central Office; October 21, 2008 http://www.patientsafety.gov/alerts.html#2010.20. RPA Penal Physicians Association, Health and Safety Survey to improve patient safety in end stage renal disease (2007).
RPA Penal Physicians Association, Health and Safety Survey to improve patient safety in end stage renal disease (2007).