SUMMARYBackground: Silicone percutaneous endoscopic gastrostomy (PEG) tubes are associated with more short-term complications and possibly fail sooner than those made of polyurethane. Understanding the deterioration and long-term complications leading to tube failure has important clinical and cost implications. Aim: To compare dwell time and patterns of failure ofsilicone polymer and polyurethane PEG tubes. Methods: Participants randomized to receive a siliconepolymer (n ¼ 76) or polyurethane (n ¼ 62) PEG werevisited monthly for 540 days, until death or tube removal. Tube and exit site characteristics and reasons for removal were recorded. Results: Tube failure occurred in 25% of silicone PEGs and 12.9% of polyurethane PEGs. Mean tube survival

Preventing infections related to central venous catheters requires the integration of clinical, organisational and workforce factors.

SUMMARY: Endoluminal brushing, used to declot various types of central venous access lines, was undertaken in 19 haemodialysis catheters (vascaths) that were either totally occluded or produced flows inadequate for successful dialysis. Six (32%) were able to be used successfully immediately after the procedure, two after intracatheter urokinase following brushing and in a further three catheter patency was restored by rebrushing. Endoluminal brushing, with or without additional urokinase, restored patency in 42% of these catheters and dialysis was still successful in this group after 2 weeks. Endoluminal brushing did not change oxygen saturation, pulse rate, blood pressure or temperature in these patients and there were no episodes of clinical pulmonary embolism or sepsis. These findings suggest a role for endoluminal brushing in the early management of occluded haemodialysis catheters.

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