Computer interaction: catheters

A computer interaction session conducted during the 14th Annual Peritoneal Dialysis Conference in Orlando, Florida, on January 24, 1994, revealed the preferences and practices of 650-690 respondents voting on questions related to peritoneal catheters. Compared to the surveys conducted in 1987 and 1989, the most striking change was an increase in the use of catheters with the bent intramural segment, particularly the Swan neck catheter, and an increase in the use of catheters with the coiled intraperitoneal segment. The Tenckhoff catheter continued to be the most popular, although its use was decreasing. The remaining catheters were used in small numbers. The vast majority of nephrologists remain convinced of the superiority of double cuff catheters over single cuff ones, and the use of the former continued to exceed 70%. Essentially no change occurred in the method of catheter placement; surgical dissection (72.7%) remained the most popular implantation method. Surgeons were primarily responsible for catheter implantations (87.4% of votes). The use of prophylactic antibiotics prior to catheter implantation seems to be increasing. The majority of respondents did not consider a Staphylococcus aureus nasal carrier status as important in the development of catheter-related infections, as indicated by the small number of centers where routine culture of nares was performed. The majority of institutions delayed ambulatory peritoneal dialysis after catheter implantation, but ambulatory peritoneal dialysis was started in some centers (5.7% of votes) in the immediate postimplantation period.