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Right versus left internal jugular vein catheterization for hemodialysis: complications and impact on ipsilateral

Octavio J Salgado1, Bella Urdaneta, Berkis Colmenares

  • 1Center of Experimental Surgery and Medicine, University of Zulia, Maracaibo, Venezuela. ojsalg@hotmail.com

Artificial Organs
|July 24, 2004
PubMed

Insights

Left internal jugular vein catheterization (LJVC) is linked to higher infection rates and central vein occlusion (CVO) risk, particularly in diabetic hemodialysis patients, compared to right-sided procedures.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Internal Medicine

Background:

  • Internal jugular vein catheterization is a common procedure for hemodialysis access.
  • Anatomical differences between right and left internal jugular vein catheterization may influence complication rates.

Purpose of the Study:

  • To compare the frequency of complications, specifically central vein occlusion (CVO), between right internal jugular vein catheterization (RJVC) and left internal jugular vein catheterization (LJVC).

Main Methods:

  • Analysis of 479 jugular vein catheterizations (403 RJVC, 77 LJVC) in 294 hemodialysis patients.
  • Comparison of complication rates, including infection and CVO, between RJVC and LJVC groups.
  • Evaluation of CVO incidence in patients with prior catheterizations and ipsilateral arteriovenous access.

Main Results:

  • Higher infection-related removal rates for LJVC (20.8%) compared to RJVC (10.9%).
  • Increased incidence of infections per 1000 catheter days for LJVC (3.72) versus RJVC (1.57).
  • Four diabetic patients with prior LJVC and ipsilateral arteriovenous access developed severe arm swelling due to CVO, leading to access ligation, while no RJVC+ patients experienced this.

Conclusions:

  • LJVC is associated with a significantly higher risk of infection compared to RJVC.
  • LJVC may contribute to central vein occlusion (CVO) in diabetic patients with ipsilateral arteriovenous access, potentially leading to access loss.

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