Exchange over the guidewire from non-tunneled to tunneled hemodialysis catheters can be performed without patency loss

Abstract

An exchange with the over-the-guidewire method from a non-tunneled to a tunneled catheter was comparable to a de novo catheter placement technique. Therefore, this method should be viewed more favorably and should especially be considered for acute kidney injury patients.

Insertion of Tunneled Hemodialysis Catheters by Exchange over the Guidewire and De Novo Puncture

“…Operative time during over the wire exchange (15.07 ± 1.98) minutes was markedly less than de novo technique (27.78 ± 5.71) minutes with a statistically significant P value < 0.001* that may be due to the already formed puncture and catheter track to the vein and also lesser pain to the patient as there is no puncture or repeated trials for cannulation, no need for hemostasis as the operation is often bloodless. This agree with Park et al [8].…”

“…As regard to the platelet count in the 2 groups, the mean platelet count in patients with over the wire group = 146714.29 ± 72924.04 , which is lesser in value than the mean platelet count in de novo group =219454.55 ± 66433.45 , with a statistically significant P value = 0.001*, this strengthens the recommendation of using the over the wire technique in critically ill patients with multiple co-morbidities that may lead to bleeding tendency this agree with the study done by Park et al [8] who recommended the over the wire technique in critically ill patients in the ICU.…”

“…As regard to the age factor in the 2 groups, the mean age in the de novo group 54.45 ± 16.86 and mean age in over the wire group 53.25 ± 14.84 with slightly older age group in the de novo group, and there was female predominance, 14 females (63.6%) in the de novo group and 18 females (64.3%) in the over the wire group but with statistically insignificant P value for both demographic factors which is in context with a study done by Park et al2017 [8].…”

Placement of cuffed tunnelled permanent hemodialysis catheter in patients with end stage renal disease: A cross sectional study

“…In cases where an existing IJ catheter was present, we inserted guidewire via the IJ catheter and avoided separate cannulation. This technique has been documented as the “over-the-guidewire exchange method” and considered as a safe technique in terms of patency, chances of infection [ 8 ]. However, if IJ is placed high up, we prefer re-puncture of the internal jugular vein in the lower favourable site.…”

“…The procedure was done on a daycare basis. In the case of an existing temporary internal jugular catheter, a guidewire of 4F size and 15 cm length was inserted via one of the ports as mentioned in the “over-the guidewire exchange” technique [ 8 ]. If the existing IJ catheter is high up, cannulation in a favourable site in the internal jugular vein is done.…”