Pulsatile Flushing Technique in Reducing Blockage of T-CVAD for Haemodialysis Patients

Summary

This study investigates the effectiveness of pulsatile flushing techniques in reducing blockage in Tunnelled Central Venous Access Device (T-CVAD) among patients undergoing haemodialysis (HD) treatment at multiple renal centres within the Hospital Authority (HA) in Hong Kong. With limitation in single service protocol for each cluster of renal units, it is designed as a prospective, parallel, cluster non-randomised controlled trial involving 591 patients from 14 renal units. In order to identify the most effective flushing technique for T-CVAD maintenance, survival analysis on clinical effectiveness, in terms time-to-event blockage of the T-CVAD, among three trial arms: 1) Intervention Group A (IG-A) using pulsatile flushing technique with 0.4 second pause time interval; 2) Intervention Group B (IG-B) using pulsatile flushing technique with 1 second pause time interval; 3) Control Group (Con) using standard bolus flushing technique. The findings facilitate development of best practice for T-CVAD maintenance, optimise T-CVAD maintenance protocols, and ultimately improve patient outcomes. This groundbreaking study is expected to signify substantial progression in the nursing management of HD and T-CVAD.

Conditions

• Haemodialysis Patients
• Blockage of Tunnelled Central Venous Access Device
• Pulsatile Flushing Technique

Interventions

DEVICE

Pulsatile Flushing Technique (0.4s pause interval)

Pulsatile flushing technique consists of multiple small boluses injected intermittently with 0.4-second pauses between each bolus resulting in unsteady turbulent flow, performed by a renal nurse who passed a formal train-the-trainer program on "pulsatile flushing technique" taught and assessed by designated nurse consultant (renal care).

OTHER

Pulsatile Flushing Technique (1s pause interval)

Pulsatile flushing technique consists of multiple small boluses injected intermittently with 1-second pauses between each bolus resulting in unsteady turbulent flow, performed by a renal nurse who passed a formal train-the-trainer program on "pulsatile flushing technique" taught and assessed by designated nurse consultant (renal care).

DEVICE

Bolus Flushing Technique

Bolus flushing technique involves the continuous administration of a single, concentrated volume of flush solution resulting in consistent laminar flow

Sponsors & Collaborators

• Kwong Wah Hospital

  collaborator OTHER

• Prince of Wales Hospital, Shatin, Hong Kong

  collaborator OTHER

• Alice Ho Miu Ling Nethersole Hospital

  collaborator OTHER

• North District Hospital, Hong Kong

  collaborator UNKNOWN

• Caritas Medical Centre, Hong Kong

  collaborator OTHER

• Queen Mary Hospital, Hong Kong

  collaborator OTHER

• Tseung Kwan O Hospital, Hong Kong

  collaborator OTHER

• Tin Shui Wai Hospital

  collaborator UNKNOWN

• Yan Chai Hospital

  collaborator OTHER

• Tung Wah Hospital

  collaborator OTHER

• Pamela Youde Nethersole Eastern Hospital

  collaborator OTHER

• Tuen Mun Hospital

  collaborator OTHER_GOV

• Princess Margaret Hospital, Hong Kong

  collaborator OTHER_GOV

• Queen Elizabeth Hospital, Hong Kong

  lead OTHER

Study Design

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-02-02

Primary Completion

2027-12-31

Completion

2027-12-31

Countries

• Hong Kong

Study Locations