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Acute dialysis catheters.

M J Oliver1

  • 1Division of Nephrology, Department of Medicine, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada. mathew.oliver@swchsc.on.ca

Seminars in Dialysis
|February 20, 2002
PubMed
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Acute dialysis catheters provide immediate vascular access for acute renal failure patients. Proper insertion and site care minimize infection risks and catheter malfunction.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Medical Devices

Background:

  • Acute dialysis catheters offer immediate vascular access, crucial for patients with acute renal failure or malfunctioning permanent access.
  • While long-term use is discouraged, they are sometimes utilized in centers lacking tunnelled, cuffed options, with manageable infection rates.
  • Material advancements include silicone catheters with larger lumens, supporting higher blood flow rates exceeding 300 ml/min.

Purpose of the Study:

  • To review the characteristics, insertion techniques, complications, and management strategies for acute dialysis catheters.
  • To highlight best practices for optimizing function and preventing complications associated with acute catheter use.

Main Methods:

  • Review of existing literature on acute dialysis catheter use, focusing on insertion sites, materials, complications, and infection control.

Related Experiment Videos

  • Analysis of factors influencing catheter malfunction and strategies for blood flow improvement.

    • Main Results:

    • Internal jugular or femoral vein insertion under ultrasound guidance is recommended to minimize complications; subclavian insertion is associated with higher risks.
    • Catheter malfunction can occur, particularly with left-sided internal jugular placement or in female patients, but may be improved by lumen reversal or t-PA.
    • Effective infection prevention involves limiting catheter duration and meticulous exit site care with dry gauze and antiseptic ointments.

    Conclusions:

    • Acute dialysis catheters are valuable for short-term vascular access but require careful insertion and management.
    • Ultrasound-guided placement in specific veins and diligent infection control are key to safe and effective use.
    • Strategies exist to manage and improve function in cases of intermittent catheter malfunction.