[Permanent central venous catheters for dialysis. The situation in Piedmont-Aosta Valley]

Permanent central venous catheters for hemodialysis have become increasingly important as vascular accesses for extracorporeal dialysis. The aim of this study was to evaluate the prevalence and various aspects of these catheters in the chronic dialysis population in Piedmont and Aosta Valley on 30-6-1998 using a multiple-choice questionnaire.

A total of 2389 patients were receiving chronic hemodialysis. Permanent central venous catheters were present in 6.2% of the population (149 patients), arteriovenous fistulas in 83.1%, vascular prostheses in 9.3% and temporary catheters in 1.4%. The site chosen for permanent catheters was the internal jugular vein in 88.6% of cases, the subclavian vein in 8.7% of cases and the femoral vein in 2.7% of cases. The double catheter is the most frequently used. In 76% of centres catheters are positioned by nephrologists. Thrombosis prophylaxis is performed in 98% of cases with heparin and the most frequently used disinfectant to dress the cutaneous exit is iodopovidone.

This study highlights the important role played by permanent catheters. The double catheter was used in 64.4% of the entire population, confirming the greater efficiency of these catheters as reported in the literature. Operating autonomy is relative in 76.2% of centres where catheters are positioned by nephrologists who often use the collaboration of other specialists.

The authors stress the need to reflect on the use of iodopovidone is to dress the cutaneous exit of catheters since this disinfectant is contraindicated by one of the largest manufacturers of silicone catheters owing to its harmful medium long-term effects.