Intra & inter-operator variability of AVF 'inflow' volume measurements

  • Research type

    Research Study

  • Full title

    Intra- and inter–operator variability of inflow volume-flow measurements in the haemodialysis access patient cohort with arteriovenous fistuli.

  • IRAS ID

    148185

  • Contact name

    Philip Hickman

  • Contact email

    philip.hickman@nbt.nhs.uk

  • Sponsor organisation

    North Bristol NHS Trust

  • Duration of Study in the UK

    0 years, 6 months, 23 days

  • Research summary

    Patients with severe renal impairment undergo haemodialysis as a means to filter impurities from their blood. Haemodialysis can be achieved via the formation of a haemodialysis access site, namely an arteriovenous fistula (AVF). AVF formation involves surgically connecting an artery to a vein. In the local hospital, renal patients with newly created arteriovenous fistulas (AVF’s) are entered in to a surveillance programme incorporating a vascular ultrasound scan that evaluates the AVF function. An ultrasound measurement of interest that is routinely performed is ‘volume-flow'. Volume-flow describes the volume of blood flowing through a vessel over a specified time frame; commonly expressed in millilitres per minute. This project focuses on volume flow measurements with respect to the “inflow” of blood through the artery proximal to the surgically-induced connection (anastomosis) with the vein. The primary aim of the study is to determine the intra- and inter-operator variability of volume-flow measurements of the AVF 'inflow'. Secondary aims include how variability changes over different flow rates. Previous studies have assessed the intra- and inter operator variability of volume-flow measurements within laboratory settings (artificial phantoms) or in other named vessels and/or patient populations that do not encompass the unique nature that haemodialysis arteriovenous fistulae provide.'Inflow' volume-flow measurements are utilised by clinicians in their assessment of fistula function, with unknown degrees of variability. I therefore believe there is a real need for this research question to be addressed. The research involves one lone operator conducting the full routine surveillance ultrasound scan as per protocol before removing oneself from the room (blinding), whilst a different operator enters to repeat only the “inflow” volume-flow measurements. I intend to recruit 40 patients from the North Bristol NHS Trust haemodialysis access population over 5 months. This research forms the basis of Master’s Degree project at Newcastle University.

  • REC name

    North East - York Research Ethics Committee

  • REC reference

    14/NE/1198

  • Date of REC Opinion

    30 Oct 2014

  • REC opinion

    Favourable Opinion