Secondary Septicaemia from Intravenous Cannulae

Within a period of only seven months three patients in one hospital under treatment with antibiotics by intravenous infusion developed secondary bloodstream infection originating from the site of insertion of the cannula. Two of these infections were fatal. Precautions suggested include strict asepsis, the skin being sterilized with iodine in spirit solution; antibiotic spray; and changing the cannula site.     

Three Years' Experience with Bypass Cannulae for Chronic Hemodialysis

In 14 patients over the past three years, “bypass” cannulae have been inserted to relieve obstruction in cannulae used for chronic hemodialyses. Experience with these patients has prompted changes resulting in improved technique.Clotting was the major cause of cannulae failure and infection was the second most important cause. Other causes of failure included: venous atheroma, cannulae extrusion, aneurysms of the vessel at the cannulae tips, obstructive vegetation on the vessel wall, calcium deposits on the vessel wall, and thrombi on the vein walls.The mean survival time was improved from 1.9 months in 1963-1964 to over 9.0 months in 1965-1966. The longest surviving cannula set was two years and the shortest one week.It is considered that the most important factors contributing to increased cannula survival are improved cannula care by patients and staff, the use of angiography for accurate diagnosis, and prompt anticoagulation if atheromatous stenosis of the venous component is encountered.     

Four Years' Experience with Indwelling Silastic Cannulae for Long-term Peritoneal Dialysis

Indwelling silicone rubber cannulae have been used for peritoneal dialysis in 41 uraemic patients for periods of up to 46 months. The simplicity of this treatment is particularly suited to patients awaiting transplantation.