Adequacy of haemodialysis with cuffed central-vein catheters

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
K AtherikulP Conlon

Abstract

Cuffed central-venous haemodialysis catheters are emerging as an alternative permanent haemodialysis vascular access. There is limited data regarding the adequacy of dialysis with prolonged used of these catheters. We conducted a prospective study comparing three commonly used cuffed central-venous haemodialysis catheters: (1) PermCath, Quinton Instrument Co, Seattle; (2) Tesio, Med Comp, Inc, Harleysville PA; (3) VasCath Soft Cell, Bard Instrument Company, Toronto, and compared them with control patients dialysing with arteriovenous access (AV) access. We randomly assigned 64 patients who needed prolonged temporary vascular access to placement of one of three catheters. The control group comprised 222 patients dialysing simultaneously in the same units with AV access. All patients were dialysed with identical machines and kidneys. Maximal effort were made with every catheter to optimize achievable blood flow. Catheters with mechanical problems were treated first with urokinase and then fibrin sheath catheter stripping. The mean blood flow was determined by averaging mean blood flows from 30 consecutive treatments. Reliability of catheter was defined as percentage of treatments that were performed at a median blood flow of 350 ...Continue Reading

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