Adjustable Depth Guide for Hemodialysis Cannulation
Student Team: New Kidneys on the Block
Nabeel Aslam, MD, The Mayo Clinic
Shawn Oppegard, and Isaac Martis, Baxter International
As a person’s kidney fails, normal kidney function can be supplemented through the process of hemodialysis. Hemodialysis requires access to the patient’s blood, which is typically done by inserting a needle, or cannulating, either the arteriovenous fistula or graft in the patient’s arm. A major risk to patient health during hemodialysis is infiltration, which occurs when the needle is inserted incorrectly. Infiltration can lead to vessel collapse, missed treatments, catheter dependence, and even death, if not treated properly. There is a clear need for a solution that reduces the risk of major infiltrations. DialySafe was designed to decrease the rate of major infiltrations by implementing LED vein illumination technology and a mechanical depth guide, adjustable based on patient venous mapping data. DialySafe is designed to be used in dialysis clinics by nurses and technicians during cannulation. By standardizing the cannulation process, the device makes hemodialysis safer and improves patient confidence by reducing variation in the cannulation process. Critical design inputs considered in the creation of DialySafe are adjustability for unique patient physiology and fistula anatomy, effective decrease of the rate of infiltrations, and simplicity, as it should not disrupt technician workflow. Safety and material concerns were also considered, such as storage life of batteries, material deterioration during shipping, and the amount of heat produced by the LED system. The device solution created is adjustable across a wide range of fistula depths and illuminates and stabilizes the fistula, while conserving the workflow by minimally interrupting the existing process. Taking into account feedback from users, this device has the potential to improve the quality of care for up to 300,000 patients per year. Future work should focus on finalizing device design, conducting clinical trials to ensure efficacy, and preparing materials for production and translation of DialySafe into the hands of users.
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