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Hemodialysis Catheters in Infants: A Retrospective Single-Center Cohort Study
Grace M Y Ma1, Luís Marcelo Ventura1, Afsaneh Amiribadi1
1Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
Journal of Vascular and Interventional Radiology : JVIR
|April 20, 2020
Summary
Infant hemodialysis (HD) central venous catheter (CVC) placement requires technical modifications and interventional radiology (IR) maintenance. Tunneled HD-CVCs showed fewer infections than nontunneled ones, highlighting the need for specialized care.
Area of Science:
- Pediatric Nephrology
- Interventional Radiology
- Vascular Access
Background:
- Hemodialysis central venous catheters (HD-CVCs) are crucial for infants requiring renal replacement therapy (RRT).
- Infant anatomy presents unique challenges for CVC insertion and maintenance.
Purpose of the Study:
- To evaluate the technical aspects and outcomes of HD-CVC insertion and maintenance in infants.
- To identify complications and necessary modifications for successful HD-CVC use in this population.
Main Methods:
- Retrospective single-center study of 29 infants undergoing 49 HD-CVC insertions (2002-2016).
- Analysis of demographics, procedural details, technical modifications, interventional radiology (IR) maintenance, complications, and outcomes.
- Comparison of nontunneled versus tunneled HD-CVCs.
Main Results:
- 51% of HD-CVCs required technical modifications for appropriate length. 53% required IR-maintenance procedures.
- Tunneled HD-CVCs had significantly lower catheter-related bloodstream infections (0.85/1,000 catheter-days) compared to nontunneled (9.25/1,000 catheter-days).
- 65% of patients survived over 1 year, with outcomes including transplantation, ongoing RRT, or recovery.
Conclusions:
- HD-CVC placement and maintenance in infants necessitate specific technical modifications and IR interventions.
- Tunneled catheters are associated with better infection control outcomes in pediatric hemodialysis.
- Optimized CVC management is vital for improving outcomes in infants with kidney failure.
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