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Central catheters for hemodialysis: a six month experience of 103 catheters
J Queirós1, A Cabrita, J Maximino
1Serviço de Nefrologia, Hospital Geral de Santo António, Porto, Portugal.
Insights
Central venous catheters provide safe temporary vascular access for hemodialysis. This study found no significant difference in complication rates between single and double lumen catheters.
Area of Science:
- Nephrology
- Vascular Surgery
Background:
- Hemodialysis requires reliable vascular access.
- Central venous catheters (CVCs) are commonly used for temporary access.
Purpose of the Study:
- To evaluate the number, function, placement, and complications of CVCs for hemodialysis.
- To compare complication rates between single and double lumen catheters.
Main Methods:
- Prospective study of 103 CVC placements over six months.
- Utilized the Seldinger technique for catheter insertion.
- Monitored immediate and late complications.
Main Results:
- Mean dwell time was 21 days.
- Immediate complications included hemothorax, arterial puncture, and malposition.
- Late complications included local infections, sepsis, and catheter occlusion.
Conclusions:
- Percutaneous CVC insertion is a simple and safe technique for temporary hemodialysis access.
- Double lumen catheters demonstrated no higher complication rate than single lumen catheters.
Unlabelled:
A prospective study was done during a six-month period to evaluate number, function, difficulties of placement and immediate and late complications of central venous catheters for hemodialysis. One hundred and three catheters were placed, 78 double lumen and 25 single lumen, using Seldinger technique. The places of implantation were: right subclavian in 79, left subclavian in 13, right jugular in 8 and 3 in the right femoral vein; 62 were first catheters. We needed a mean of 2 punctures to enter the goal vein, and in 4 the place of implantation had to be changed. Catheters remained in place for a mean of 21 days. Six catheters were lost to follow-up. Immediate complications were 2 hemothorax, 3 punctures of the artery and 3 malpositioned catheters. Late complications were 12 local infections, 7 associated with sepsis. Twenty catheters occluded but removal was only necessary in 10. There was no statistic difference in incidence of complications between single lumen and double lumen catheters (X2).
Conclusions:
1. Percutaneous central venous catheters is a simple and safe technique to obtain temporary vascular access for hemodialysis. 2. Double lumen catheters have no higher rate of complications than single lumen.