Tunneled Catheter for Hemodialysis: Denovo Insertion vs. Conversion of Uncuffed Catheter
Journal Title: Urology, Nephrology and Andrology International - Year 2017, Vol 2, Issue 1
Abstract
Aims and Objectives: To compare the two techniques of tunneled catheter (TC) insertion for hemodialysis; denovo and conversion of uncuffed catheter. Methods: The patients who underwent tunneled catheter insertion from August 2014 to December 2016 at EMS memorial cooperative hospital & research center, Perinthalmanna, Kerala, were included in the study. Technical success, complications, hemodialysis records and clinical outcomes were analyzed. Results: The study group consisted of 42 patients (26 males and 16 females) with age of 58.19±11.72 years. In 28 patients uncuffed catheters (UC) were placed initially &were converted later TC, with minor oozing in 3 (10.71%) subjects. The duration on UC ranged from 3296 days (Range: 3296, Mean: 52.82, SD: 66.36) prior to their conversion to TC. In 14 patients the TC were inserted denovo, with one (7.14%) of them developing pneumothorax and another (7.14%) having minor oozing.The total number of followup days with TC was 12,946 (Range: 3872, Mean: 308.24, SD: 245.30). Ten patients had blood culture proven sepsis, yielding a catheter infection rate of 0.77/1000 catheter days, one among them required TC removal due to unresponsive septicemia (0.08/1000 catheter days). The patency rate of TC was 97.62% at 30 days after insertion, with 20(47.62%) catheters functioning at the end of the study period. Sixteen(38.09%) patients died with working catheters of causes unrelated to catheter and one (2.38%) had CRBSI along with other comorbidities at time of death. The catheters removed in 5 (11.90%) patients when they were no longer needed. There was no statistically significant effect of technique of TC insertion (denovo insertion or conversion of uncuffed catheter) on its durability (p: 0.43), postprocedure complications (p:0.34), CRBSI (p:0.30) and (patient mortality (p:0.29). Conclusions: Thus both techniques of TC insertion are safe and effective. The conversion of a UC to a TC using the same venous insertion site is safe, does not increase the risk of infection, and allows conservation of other central venous access sites.
Authors and Affiliations
Lakshminarayana G. R
Keywords
Related Articles
- EP ID EP502592
- DOI -
- Views 86
- Downloads 0
Ureteropelvic Junction Obstruction in an Ectopic Pelvic Kidney
Introduction: The most common type of ectopic kidney is the pelvic kidney, whereby the organ remains in the pelvic cavity. In many patients the condition of renal ectopic remains undiagnosed throughout their life. UPJO i...
Outcomes of Initial Management and Follow-Up Procedure in Urethral Stricture Disease
ackground: Urethral Stricture Disease is a disease affecting middle-aged men. The causes of urethral stricturecan be categorized as congenital, traumatic, inflammatory, malignant, ischaemicand degenerative. The aim of th...
Indications and Long Term Outcomes of Plasmapheresis in Neurological Disorders
Background: Plasmapheresis is the treatment of choice in several immune mediated neurological disorders such as Guillain-Barré syndrome and myasthenia gravis. There are only a few studies from India that have looked in t...
Tunneled Catheter for Hemodialysis: Denovo Insertion vs. Conversion of Uncuffed Catheter
Aims and Objectives: To compare the two techniques of tunneled catheter (TC) insertion for hemodialysis; denovo and conversion of uncuffed catheter. Methods: The patients who underwent tunneled catheter insertion from Au...
Garrulitas Vulvae: A Rare Case of Young Female with Vaginal Flatulence
Vaginal flatulence is considered a pelvic floor disorder in females that is described as passage of odourless gas from the genital tract. It causes significant distress and embarrassment to sufferers. Vaginal flatus most...