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Rapid access for emergency dialysis.

G A Kozeny, L L Vertuno, V K Bansal

    American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
    |July 1, 1984
    PubMed
    Summary
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    A teflon catheter introducer sheath system (TIS) simplifies vascular access for critically ill patients needing acute hemodialysis. This method allows repeated dialysis catheter insertion without new vessel punctures, proving safe and effective.

    Area of Science:

    • Nephrology
    • Critical Care Medicine
    • Vascular Surgery

    Background:

    • Vascular access for acute hemodialysis in critically ill patients often involves repeated large vein cannulation.
    • This repeated access carries risks of hemorrhage and hematoma.
    • A novel approach using a teflon catheter introducer sheath system (TIS) offers a potential solution.

    Purpose of the Study:

    • To evaluate the safety and efficacy of using a TIS for acute hemodialysis in critically ill patients.
    • To assess the feasibility of adapting TIS for emergency hemodialysis when hemodynamic monitoring lines are already in place.

    Main Methods:

    • Forty-six acute hemodialysis procedures were performed in 25 critically ill patients.
    • A TIS was utilized for hemodynamic monitoring, with a femoral dialysis catheter inserted through the TIS for dialysis.

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  • The Swan-Ganz catheter was temporarily replaced by the dialysis catheter.

    • Main Results:

    • The TIS approach facilitated repeated vascular access for hemodialysis.
    • No complications were reported during the hemodialysis procedures using this method.
    • Adequate hemodialysis was successfully accomplished in all patients.

    Conclusions:

    • The TIS is a safe and effective method for providing acute hemodialysis in critically ill patients.
    • This technique minimizes vascular trauma by allowing repeated access through a single entry site.
    • TIS offers a valuable option for emergency hemodialysis, especially when hemodynamic monitoring is already established.