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 77
- Downloads 0
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...
A Study of Prostate Weight in the Pre-Operative and Post-Operative Transurethral Resection of the Prostate Cases and to Compare it with Western Scenario
Background: Benign Prostatic Hyperplasia (BPH) is the most common benign neoplasm of the aging male. The incidence of prostatomegaly increased with age. Enlargement of prostate is the disease of the advancing years and i...
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...
Jack Stone in the Bladder: Is it Really a Rare Entity in Tropical Countries Like India
Vesical calculus accounts for nearly 5% of urinary system calculus. Of these, jackstone constitutes a rare entity. Jackstones are stones that have a specific appearance resembling child’s toy. They consist of a dense cen...
Clinical Profile and Patient Outcomes of Crescentic Glomerulonephritis: A Descriptive Study in a Tertiary Care Hospital
Background: Crescentic glomerulonephritis (CSGN) requires early intervention which can make a significant impact on minimizing irreversible kidney damage and improving patient outcomes Data regarding the clinical and his...