A comparative study of central versus posterior approach for internal jugular hemodialysis catheter insertion

Mathur, Mohit; Dsouza, Amith; Prasad, D; Garsa, Rajesh Kumar; Bansal, Neha; Jhorawat, Rajesh; Sharma, Sohan Kumar; Beniwal, Pankaj; Agrawal, Deepak; Malhotra, Vinay

doi:10.4103/0971-4065.151356

Cited by 9 publications

(12 citation statements)

References 7 publications

(8 reference statements)

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“…A recent study specifically designed for patients requiring hemodialysis using dedicated CVCs (a double lumen pre-curved 11.5 Fr × 13 cm), suggests an advantage of the lateral approach over the vertical. This work, however, has the limitation of being conducted without ultrasound guidance, considerably reducing the significance of the different incidence rates of the complications of the two procedures (10). In another work with very large series, the lateral approach is recommended as the first choice for IJV access (11), but this is a survey also performed without ultrasound guidance and not specifically designed on hemodialysis catheters.…”

Section: Discussionmentioning

confidence: 99%

Retrospective comparison of two different approaches for ultrasound-guided internal jugular vein cannulation in hemodialysis patients

Treglia¹,

Musone²,

Amoroso³

2016

J Vasc Access

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Section: Discussionmentioning

confidence: 99%

Retrospective comparison of two different approaches for ultrasound-guided internal jugular vein cannulation in hemodialysis patients

Treglia¹,

Musone²,

Amoroso³

2016

J Vasc Access

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“…Con respecto al acceso yugular, el lado y el abordaje anatómico ha mostrado diferencias importantes. Mathur, et al en un ECCA asignaron a 104 pacientes a colocación de catéter yugular por abordaje posterior o abordaje central, presentando este último un mayor porcentaje de complicaciones relacionados al procedimiento incluyendo punción de carótida y neumotórax (14.8 vs. 6%, p = 0.04), no obstante, el abordaje posterior presentó mayor porcentaje de interrupciones en el tratamiento por obstrucción de flujo (46 vs. 9.25%, p < 0.01) 14 . Si bien cada uno de los abordajes puede representar una ventaja dependiendo de la situación anatómica entre vena yugular interna y arteria carótida (Fig.…”

Section: Sitio De Colocación Del Acceso Venosounclassified

Acceso vascular en apoyo renal agudo

Vázquez-Rangel¹

2023

GMM

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Vascular access is the first link for renal extracorporeal support therapy. Unlike renal replacement therapy for patients with end-stage renal disease where the arteriovenous fistula is the first option, followed by the tunneled catheter, in patients with acute kidney injury a temporary catheter is the first choice. The present article constitutes a narrative review summarizing the studies that analyze the choice, placement and care of temporary vascular access for acute renal support. In patients who have a pre-existing arteriovenous fistula, their puncture in patients with hemodynamic instability carries risks and cannot be recommended. The use of tunneled catheter as first option implies a complex, time-consuming procedure with higher cost that also limits its recommendation. The change of catheters by metal guide has shown to be a safe method in the absence of infection. Femoral access has been shown not to be inferior to right jugular access, while left jugular access reduces the life of the circuit and should be considered as a fourth option after right jugular, right femoral and left femoral sites. The length of the access should be evaluated according to the insertion site, while 20 cm catheters are usually suitable for right jugular puncture, the left jugular usually requires 25 cm for achieving the position inside the right atrium. On the other hand, the femoral access increases its performance with lengths of 25-35 cm. The low posterior jugular approach is considered a simple, safe technique that allows up to 5 cm further towards the right atrium. The interaction between central catheters must be anticipated or evaluated because of the risk of aspiration of infusions by the extracorporeal circuit. The use of heparin 1000 U/ml for sealing the ports reduces the risk of bleeding compared to heparin 5000 U/ml. The reasoning on the evolution of catheters in structural coating materials, the decision on using a suture, the differences among dressings or securement devices, and the controversy over the use of antibiotics for sealing ports and for dressings are also discussed. The review includes the positions of the guidelines by the Kidney Dialysis Improving Global Outcomes and the European Renal Best Practice, in addition to the information available mainly on the consensus of the acute dialysis quality initiative, systematic reviews, meta-analysis and controlled clinical trials.

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“…1 Until now, this technique is mainly utilized in the critical care setting, where it showed equivalent or better performance compared to the central approach. 7 Recently, we performed a posterior approach technique for TCC placement in our practice. The same success rate as that of central approach catheter placement is possible with this technique, and additionally, it can lower the risk of catheter dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…1 Until now, this technique is mainly utilized in the critical care setting, where it showed equivalent or better performance compared to the central approach. 7…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome of posterior approach insertion of tunneled cuffed catheter: A single clinic retrospective analysis

et al. 2020

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Background and objectives: For patients who rely on a tunneled cuffed catheter, the internal jugular vein is the preferred site of insertion. A few studies have suggested that the posterior approach for central lines is equivalent or better in comparison to the conventional central approach. However, there have been fewer studies examining tunneled cuffed catheter insertion using the posterior approach. We have performed many posterior insertions of tunneled cuffed catheters in our practice, and because the technique has not yet been comprehensively studied for long-term use, we performed a retrospective study to evaluate the safety and efficacy of posterior approach for tunneled cuffed catheter in maintained hemodialysis patients. Methods: A retrospective review was conducted of 200 hemodialysis patients who were treated with tunneled cuffed catheters over a period of 3 years. There were 104 patients in the study group, as well as a 96-patient control group, who underwent catheter insertion by central approach. The clinical follow-up data were collected and analyzed. Results: All catheters were successfully placed. The mean primary patency days per catheter were 712 catheter days for the study group and 585 catheter days for the control group. The episode of catheter infection was similar in both groups (p = 0.874), but the case of total catheter dysfunction was significantly lower in the study group compared to the control group (p = 0.006). The cumulative patency of catheters was higher in the study group than that in the control group (p = 0.02), while patient survival was the same in the two groups (p = 0.325). Conclusion: The posterior approach is safe, and similar infection rates were observed with lower dysfunction rates compared to tunneled catheter insertion by the conventional central approach.

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A comparative study of central versus posterior approach for internal jugular hemodialysis catheter insertion

Cited by 9 publications

References 7 publications

Retrospective comparison of two different approaches for ultrasound-guided internal jugular vein cannulation in hemodialysis patients

Retrospective comparison of two different approaches for ultrasound-guided internal jugular vein cannulation in hemodialysis patients

Acceso vascular en apoyo renal agudo

Long-term outcome of posterior approach insertion of tunneled cuffed catheter: A single clinic retrospective analysis

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