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• W4240785509 abstract "Background In chronic hemodialysis patients with exhausted arteries and veins in whom AV fistula or AV graft can not be performed any more, hemodialysis catheters become the last resort, either tunneled, so called “permanent”, or non-tunneled, so called “temporary” catheters which can be usefully used for a longer period of time than a permanent vascular access. The aim of our clinical study was to asses temporary, precurved, jugular catheters as permanent vascular access in chronic hemodialysis patients. Methods Thirty chronic hemodialysis patients, 15 men, 16 women, mean age 65.3 ± 13.5 years (range 30–90), with average dialysis treatment time of 6.3 ± 8.1 years (range 1 month−30 years), have had single lumen, “temporary” precurved nontunneled jugular catheters (Medcomp, USA) as permanent vascular access. Catheters were placed into right internal jugular vein, by Seldinger's technique, in local anesthesia (2% lidocain), locking solution was 4% trisodium citrate. Catheters were placed by experienced nephrologists, with ultrasound assistance, dressing was performed by dialysis nurses. Mupirocin was applied at the exit site after each hemodialysis. In the case of malfunction, thrombosis or infection, the catheter was replaced with the new one, using a guidewire. Prophylactic ceftazidime in a single dose was used after the catheter`s exchange. Unfractionated or fractionated heparin was anticoagulant. Results Hemodialysis catheters were used for vascular access on average for 9.1 ± 6.5 months, range 1–22.7 months, total 271.7 months or 8151 days. Average catheter running time was 3.1 ± 1.9 months, range 0.5–10 months. Total number of side effects was 57, 7.0/1000 catheter days; 26 thrombosis, 3.2/ 1000 catheter days; 9 ruptures of the catheter, 1.1/1000 catheter days; 15 malfunction, 1.8/1000 catheter days; 2 exit site infections, 0.2/1000 catheter days; 2 bacteremias, 0.2/1000 catheter days; 1 avulsion of the catheter, 0.1/1000 catheter days; and 2 catheters were removed because AV fistula was successfully used. In 21 patients single needle hemodialysis was performed, mean blood flow 251 ± 16 mL/minute, range 250–300, mean KT/V 0.96 ± 0.16, range 0.72–1.27and in 9 patients double needle hemodialysis was performed (catheter and peripheral vein) with mean blood flow 252 ± 14 mL/minute, range 200–300, mean KT/V 1.63 ± 0.25, range 1.21–1.96. Conclusions ‘Temporary’ jugular single lumen non-tunneled hemodialysis catheters provide good long term vascular access with acceptable functioning time and low infection rate. KT/V for single needle hemodialysis was rather low, however it significantly improved when double needle hemodialysis was performed. The main reasons for catheter removal was thrombosis, malfunction, and mechanical damage of the catheter." @default.
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• W4240785509 date "2005-02-01" @default.
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• W4240785509 title "29 Temporary Hemodialysis Catheters as a Long Term Vascular Access in Chronic Hemodialysis Patients" @default.
• W4240785509 doi "https://doi.org/10.1111/j.1526-0968.2005.222_29_29.x" @default.
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