Prospective follow-up of a novel design haemodialysis catheter; lower infection rates and improved survival

Weijmer, Marcel C.; Vervloet, Marc G.; Wee, Piet M. ter

doi:10.1093/ndt/gfm767

Cited by 23 publications

(17 citation statements)

References 17 publications

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“…Newly designed non‐tunneled precurved jugular catheters, introduced some years ago, were comparable to tunneled, or were even better, in terms of incidence of exit site infections and bacteremias. Excellent results were also observed in our precurved catheters: only 0.2 exit site infections and 0.2 bacteremias per 1000 catheter days confirmed excellent results observed by others in precurved catheters (4). Our bacteremia rate was much lower even when compared to tunneled cuffed catheters (1.6–5.5 bacteremias/1000 catheter days) (15–17).…”

Section: Discussionsupporting

confidence: 90%

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Temporary Hemodialysis Catheters as a Long‐term Vascular Access in Chronic Hemodialysis Patients

Ponikvar

Buturović‐Ponikvar

2005

Ther Apher Dial

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The objective was to review our experience with temporary, precurved, jugular catheters used for long-term vascular access in chronic hemodialysis patients. Thirty chronic hemodialysis patients, 14 men and 16 women, with an average age of 65.3 +/- 13.5 years (30-90 years), treated by dialysis for 1 month to 30 years (average +/- SD, 6.3 +/- 8.1 years), had single lumen, 'temporary' precurved non-tunneled jugular catheters placed into the right jugular vein as permanent vascular access, with 4% trisodium citrate as a locking solution and mupirocin at the exit site. Hemodialysis catheters were used for vascular access on average for 9.1 +/- 6.5 months, (1-22.7 months), and for a total of 271.7 months (8151 days). Average catheter functioning time was 3.1 +/- 1.9 months (0.5-10 months). The total number of side-effects was 55 (6.7/1000 catheter days), including 26 cases of thrombosis (3.2/1000 catheter days), 9 ruptures of the catheter (1.1/1000 catheter days), 15 catheter malfunctions (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 an AV fistula was successfully used. In 21 patients single-needle hemodialysis was performed, mean blood flow 251 +/- 16 mL/min (250-300), mean Kt/V 0.96 +/- 0.16 (0.72-1.27) and in 9 patients double-needle hemodialysis was performed (catheter and peripheral vein) with mean blood flow 252 +/- 14 mL/min (200-300), mean Kt/V 1.63 +/- 0.25 (1.21-1.96). 'Temporary' jugular single lumen non-tunneled hemodialysis catheters, with 4% citrate as locking solution and mupirocin ointment at the exit site provided good long-term vascular access with acceptable functioning time and low infection rate. The main reasons for catheter exchange or removal were malfunction and mechanical damage of the catheter.

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Section: Discussionsupporting

confidence: 90%

“…New design of precurved jugular catheters, which are bent over the clavicle and fixed to the chest wall, reduced the movement of the catheter at the exit site, thus reducing microinjury of the adjacent tissue and consequently improving resistance of the tissue against infection (4).…”

mentioning

confidence: 99%

Temporary Hemodialysis Catheters as a Long‐term Vascular Access in Chronic Hemodialysis Patients

Ponikvar

Buturović‐Ponikvar

2005

Ther Apher Dial

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“…According to Caylan et al 20 the position of temporary catheters in femoral vein creates 2.14 times bigger risk for catheter-related infections occurrence. However, the results of recent studies do not link the insertion spot of temporary and permanent catheters to a higher risk of infections [36][37][38] .…”

Section: Avf -Arteriovenous Fistula; Avg-arteriovenous Graft; а Permamentioning

confidence: 99%

Risk factors for catheter-related infections in patients on hemodialysis

et al. 2018

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Background/Aim. Catheter-related infections are a significant morbidity and mortality cause in patients on hemodialysis. The objective of this study was to determine the incidence, to analyze risk factors and to identify etiological causes of catheter-related infections in these patients. Methods. The study was carried out at the Clinic for Nephrology and Clinical Immunology of the Clinical Centre of Vojvodina, from August, 2012 to May, 2015. One hundred and thirteen patients on chronic hemodialysis participated in the study. The risk factors of catheterrelated infections in the infected patients were to those in the control group, as follows: demographic and laboratory parameters, co-morbidities and the use of immunosuppressive therapy, the length of hemodialysis treatment, urgent catheter placement, the position and placement difficulties, the number of insertions and catheter maneuvering, the existence of permanent vascular access in maturation or without a vascular access in the course of catheter positioning, catheter life, surgical procedures (≤ 30 days from catheter placing), the length of hospitalization and isolated infection causes. Results. One hundred and Key words: renal dialysis; catheter-related infections; risk factors.Apstrakt Uvod/Cilj. Infekcije povezane sa kateterom i dalje predstavljaju značajan uzrok morbiditeta i mortaliteta kod bolesnika na hemodijalizi. Cilj ovog ispitivanja je bio da se utvrdi incidencija, analiziraju faktori rizika i identifikuju etiološki uzročnici kateter infekcija kod ovih bolesnika. Metode. Ispitivanje je sprovedeno na Klinici za nefrologiju i kliničku imunologiju Kliničkog centra Vojvodine u periodu od avgusta 2012. do maja 2015. godine. Ispitivanjem je bilo obuhvaćeno 113 bolesnika lečenih hroničnim hemodijalizama. Upoređivani su faktori rizika od infekcija povezanih sa kateterom kod bolesnika sa dokazanom infekcijom u odnosu na kontrolnu grupu. Analizirani su demografski i laboratorijski parametri, komorbiditeti i upotreba imunosupresivne terapije, dužina dijaliziranja, urgent-no plasiranje, pozicija i otežano plasiranje katetera, broj mesta insercije i manipulacija kateterom, postojanje trajnog vaskularnog pristupa u maturaciji ili bez vaskularnog pristupa tokom plasiranja katetera, dužina trajanja katetera, hiruške intervencije (≤ 30 dana od plasiranog katetera), dužina hospitalizacije i izolovani uzročnici infekcija. Rezultati. Kod 113 bolesnika plasirano je 197 katetera, od kojih su 182 bila privremena. Ukupni broj dana katetera iznosio je 17,842, a incidencija infekcija je bila 3.53 slučajeva na 1,000 kateter dana. Tokom perioda praćenja potvrđene su 63 kateter-povezane infekcije, 54 (85.7%) privremenih i 9 (14.3%) trajnih katetera. Multivarijantnom logistističkom regresionom analizom (granične vrednosti određene receiver operating curve -ROC analizom), kao nezavisni prediktori kateter-povezanih infekcija dobijeni su: vrednost hemoglobina < 95 g/l (p < 0.001) i albumina < VOJNOSANITETSKI PREGLED Vol. 75,No 2 33g/l (p = 0.041), trajanje katetera > 90 dana (p...

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“…NKF‐K/DOQI) limited the use of ‘temporary’ catheters to less than a week, clinical practice has taught us that catheters could have been used for much longer periods of time, even for several months or years, without serious complications, usually comparable to those in tunneled, silastic, atrial (permanent) HD catheters. Newly designed, precurved, jugular ‘temporary’ catheters became comparable to the tunneled, cuffed, silastic ones: 1.8 bacteremia/1000 catheter days and 11 exit site infections in silastic tunneled catheters and no bacteremias, and only one exit site infection in precurved jugular catheters (4).…”

Section: Catheters As Temporary Vascular Accessmentioning

confidence: 99%

Hemodialysis Catheters

Ponikvar

2005

Ther Apher Dial

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As a busy dialysis and apheresis unit and a referral center for vascular access, we had 850 hemodialysis catheter insertions in 2004, and >16 000 since 1976. According to data from literature and our experience, insertion should be guided by real-time ultrasonography whenever possible. Trisodium citrate in various concentrations (4-30%) seems to be a preferable locking solution (local anticoagulant and antimicrobial activity, no systemic anticoagulation, low price). Mupirocin at the exit site decreases the incidence of local infection and sepsis. The possible additive beneficial effects of the locking solution (citrate) and exit-site care with antibiotic (mupirocin, gentamycin) should be explored. According to our experience, temporary non-tunneled single-lumen catheters (one or two), with citrate locking and mupirocin at exit site, can be successfully used as a long-term vascular access in selected patients. The complications rate (malfunction and infection) of these catheters is comparable to tunneled, permanent catheters, but with the important advantage of easier insertion, exchange and removal.

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Prospective follow-up of a novel design haemodialysis catheter; lower infection rates and improved survival

Cited by 23 publications

References 17 publications

Temporary Hemodialysis Catheters as a Long‐term Vascular Access in Chronic Hemodialysis Patients

Temporary Hemodialysis Catheters as a Long‐term Vascular Access in Chronic Hemodialysis Patients

Risk factors for catheter-related infections in patients on hemodialysis

Hemodialysis Catheters

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