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Vascular access for hemodialysis

R Vanholder1, S Ringoir

  • 1Nephrology Department, University Hospital, Ghent, Belgium.

Artificial Organs
|April 1, 1994
PubMed

Insights

Central venous catheters provide essential vascular access for hemodialysis and other critical treatments. Ongoing research addresses optimal insertion sites, catheter types, and techniques to improve patient outcomes and reduce complications.

Area of Science:

  • Nephrology
  • Vascular Access

Background:

  • Indwelling central venous catheters are crucial for various renal replacement therapies and critical care interventions.
  • Modifications in catheter design have enabled both acute and long-term use, including hemodialysis, plasmapheresis, and continuous renal replacement therapy.

Purpose of the Study:

  • To review the current applications of central venous catheters for hemodialysis and related procedures.
  • To identify and discuss unresolved questions regarding optimal catheter selection, insertion techniques, and management strategies.

Main Methods:

  • Review of existing literature and clinical practices concerning central venous catheter use.
  • Discussion of key controversies and areas requiring further investigation.

Main Results:

  • Central venous catheters are versatile for acute/chronic hemodialysis, fluid overload, intoxication, plasmapheresis, and continuous arteriovenous hemofiltration (CAVH).
  • Innovations allow long-term access via surgically inserted or blind-inserted soft, large-bore catheters.

Conclusions:

  • Key questions remain regarding preferred insertion sites (subclavian, femoral, jugular), catheter stiffness, surgical vs. blind insertion, utility of ultrasound guidance, material acceptability, and single vs. double lumen use.
  • Further research is needed to standardize best practices for central venous catheter utilization in hemodialysis and critical care.

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