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Is ultrasonography useful in predicting catheter loss?
J Domico1, M Warman, S Jaykamur
1West Virginia University, Morgantown.
Summary
Ultrasonographic examination (UE) can predict peritoneal dialysis catheter loss due to exit-site infections (ESI) or tunnel infections (TI). A positive UE finding of fluid collection strongly indicates the need for catheter removal.
Area of Science:
- Nephrology
- Infectious Diseases
- Medical Imaging
Background:
- Exit-site infections (ESI) and tunnel infections (TI) frequently lead to peritoneal dialysis catheter loss.
- Ultrasonographic examination (UE) is a diagnostic tool for assessing these infections.
Purpose of the Study:
- To evaluate the utility of ultrasonographic examination (UE) in predicting peritoneal dialysis catheter loss in patients with ESI or TI.
Main Methods:
- Retrospective review of continuous ambulatory peritoneal dialysis (CAPD) patients with ESI or TI from 1990-1992.
- Analysis of causative organisms, catheter loss, and infection resolution following antibiotic therapy.
- Categorization of UE findings as positive (+) for pericatheter fluid collection or negative (-) for its absence.
Main Results:
- Twelve UEs were performed on 11 CAPD patients within a week of antibiotic treatment initiation.
- Ten UEs were positive (+), and 2 were negative (-).
- Seven catheters were removed, all associated with positive UE findings; 6 due to S. aureus and 1 to mycobacterial infection.
- Of 3 positive UE cases not removed, 2 infections resolved clinically and reverted to negative UE findings post-treatment.
Conclusions:
- A positive ultrasonographic examination (UE) finding of pericatheter fluid collection is a significant predictor of peritoneal dialysis catheter loss.
- Ultrasonography can aid in clinical decision-making regarding catheter management in the context of infection.