Factors influencing function and survival of temporary hemodialysis catheters.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:151A 1997
Non-cuffed hemodialysis catheters are frequently inserted at the bedside for patients with acute renal failure, or for patients with end-stage renal disease where definitive access has failed. Use of these catheters is appropriate for periods less than three weeks.
The authors of the present study attempted to identify factors that were associated with malfunction of these non-cuffed catheters. They prospectively followed the fate of 199 non-cuffed catheters in 124 patients. One hundred of these catheters were inserted in patient with end-stage renal disease. The catheters were followed until their removal was necessitated by malfunction (judged by a blood flow of less than 250 ml/min), infection, patient recovery, death, or discharge. The authors state that placement of jugular or subclavian catheters from the left side was a risk factor for malfunction, as was placement of these catheters with the tips proximal to the SVC or right atrium.
One brand of catheter (not named) with circumferential holes in the arterial port had a lower incidence of failure.
Comment: The study adds little to the current pool of knowledge on the subject. It should be pointed out that, as per the recommendations of the Dialysis Outcome Quality Initiative guidelines, subclavian catheters should not be used in patients with end-stage renal disease because of their propensity to cause subclavian vein stenosis, thereby rendering definitive access placement in that upper limb impossible. This study does not clearly identify which brand/brands of temporary catheters have better blood flow, or are less prone to infection. (Shahab Arfeen, M.D., Valparaiso, IN)
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ASN 30th Annual Meeting, San Antonio
Basic hemodialysis : Vascular Access: venous