Complications Associated with Permanent Internal Jugular Hemodialysis Catheter: A Retrospective Study

Abstract

Introduction A significant increase in patients with end-stage renal disease has been observed currently in our community. Kidney transplantation is the most promising cure but the problem is that large numbers of people are not good candidates for transplantation. Hemodialysis is the next appropriate medication for such patients and for patients with end-stage renal disease, who have no chance for transplantation. Morbidity and mortality are the consequences of vascular access complications. Local data related to the complication rate of permanent hemodialysis catheters is not available. The current study examines the complication rate in people due to permanent intrajugular hemodialysis catheterization. Materials and methods The study has been conducted in Dr Ziauddin University Hospital, Karachi. The dataset consists of 212 patients who had gone through jugular catheterizations for hemodialysis at this hospital from the year 2014 to the year 2015. A descriptive method has been chosen for obtaining appropriate results. Complications have also been categorized as early or late. Results Complications have been detected in around 24% of the patients from the dataset. Among these complications, infection has the highest percentage (around 13%) while 4% percent of patients have a failed puncture. The others have venous thrombosis, catheter thrombosis, hematoma, wrong canulation, and hemothorax and pneumothorax problems. Conclusion The study concludes that the placement of a permanent hemodialysis catheter in the internal jugular vein has a low complication rate. In addition, the method is safe and easy. So, it can be said that the internal jugular vein is a reliable and preferred route for hemodialysis catheterization.

Internal Jugular Vein Thrombosis: Etiology, Symptomatology, Diagnosis and Current Treatment

“…The most frequent were neck swelling and erythema [ 2 , 3 , 5 , 6 , 11 , 12 , 13 , 14 , 15 , 17 , 23 , 24 , 25 , 26 , 27 ] and the palpable cord beneath the sternocleidomastoid muscle [ 2 , 3 , 6 , 28 ], frequently associated with fever [ 3 , 14 , 18 , 28 ]. Oedematous swelling of the face/scalp [ 17 , 18 , 26 , 29 , 30 ], papilledema [ 12 , 14 , 17 , 22 ] and intracranial hypertension [ 9 , 12 , 14 , 22 , 28 ] were also reported in several papers. These kinds of symptoms could be ascribed to a possible impairment of the cerebrospinal fluid dynamics, which is strictly connected to the cerebral venous outflow [ 31 ].…”

“…In those patients, vascular accesses are long-lasting, so an arteriovenous fistula (AVF) is the most appropriate technique. When an AVF is not technically feasible or when patients require dialysis during the maturation of the AVF, a hemodialysis catheter in the central veins represents the most widely used option [ 29 , 80 , 81 , 82 , 83 ].…”

“…Finally, truncular IJV malformation typical of CCSVI can be complicated by thrombosis ( Figure 2 ) [ 29 , 61 , 95 ]. However, in a wide retrospective case revision, in half of the cases IJVthr was considered idiopathic [ 2 ].…”

A rare complication following internal jugular vein catheterization to malposition: acute Budd Chiari syndrome

“…Compared to other catheter localizations, all complications associated with the IJV (infection, hematoma, malposition) have 2–5 times less complication rate [ 10 , 11 ]. Traumatic complications associated with IJV catheter insertion have been well described in the literature, such as Horner’s syndrome (a decreased pupil size, a drooping eyelid and decreased sweating on the affected side of your face with miosis, ptosis and enophthalmos), venous perforation, pneumothorax, and cardiac tamponade [ 20 – 23 ].…”

“…Additionally, all complications related to IJV (infection, hematoma, malposition) were found to have a lower rate in the literature [9][10][11].…”