P1369ACUTE EXTRACORPOREAL DIALYSIS USING TWO-WAY PICC POWER INJECTABLE IN YOUNG CHILDREN

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Luigi Annicchiarico Petruzzelli ◽  
Vittorio Serio ◽  
Ilaria Luongo ◽  
Daniela Molino ◽  
Bruno Minale ◽  
...  
Keyword(s):  
Blood Flow ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Recycling Rate ◽  
Site Location ◽  
Central Venous ◽  
Dialysis Adequacy ◽  
Short Treatment ◽  
Wide Range ◽  
Extracorporeal Dialysis

Abstract Background and Aims Acute extracorporeal dialysis is a short treatment, performed by a central venous catheter of large size, ensuring high flow. These devices have limitations: high caliber, excessive length, impossibility of tunneling and exit-site location in the supraclavicular region, with a subsequent high risk of dislocation and contamination. The authors report a new approach to dialytic central venous catheters selection in children. Method From January 2013 to December 2017, 16 children weighing less than 15 kg needed acute extracorporeal dialysis. Patients received an ultrasound guided percutaneous implantation of a two-way PICC power injectable catheter, in the right internal jugular vein or in the anonymous right vein. The device size always respected the ratio of 1/3; the catheters were cut to be adapted to child height, and subclavear tunnelizations and stabilizations were ensured. The hemodialysis was performed with the Prismaflex Gambro system. The effectiveness of treatment was evaluated by recirculation test and by measuring the KT/Vat the third hour, expressing the dialysis adequacy. Results Two-way power injectable central venous catheter,sized from 5 to 7 Fr and long from 8 to 15 cm were used. The recorded blood flow ranged from 4.7ml/min/kg to 7ml/min/kg; a KT/V variable from 0.5 to 1 was detected; the recycling rate was between 32% and 40%. No catheter related complications were observed. Conclusion In children weighing less than 15 kg, PICC power injectable have lower blood flow and higher recirculation rate compared to traditional dialysis catheters. However, the dialytic adequacy was suitable for an acute hemodialysis treatment. In addition, these catheters are available in a wide range of calibers and result more adaptable to the venous system of younger children.

scholarly journals Effects of blood flow on the antibacterial efficacy of chlorhexidine and silver sulfadiazine coated central venous catheter

Medicine ◽  
2020 ◽  
Vol 99 (39) ◽  
pp. e22218
Author(s):  
Yong Huan Cui ◽  
Yoon Ji Choi ◽  
Eung Hwi Kim ◽  
Joon Ho Yu ◽  
Hyun Young Seong ◽  
...  
Keyword(s):  
Blood Flow ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Silver Sulfadiazine ◽  
Antibacterial Efficacy ◽  
Central Venous

scholarly journals P1154EFFECTS OF SHORT-TERM HEMODIALYSIS WITH CENTRAL VENOUS CATHETER(HD-CVC) ON PATIENTS WITH URGENT-START PERITONEAL DIALYSIS(USPD)

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Wenjing Zhang ◽  
Jia LV ◽  
Zhigang Wang ◽  
Lan Li ◽  
Jiping Sun
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Central Venous Catheter ◽  
Urine Volume ◽  
Venous Catheter ◽  
Residual Renal Function ◽  
Central Venous ◽  
Short Term ◽  
Dialysis Adequacy

Abstract Background and Aims Urgent-start peritoneal dialysis (USPD) has gained increasing worldwide attention. Studies have suggested that USPD has many advantages concerning the early complications, survival rates and medical expenses. Due to the lack of pre-dialysis education, most patients newly diagnosed with ESRD in China have less knowledge about the dialysis methods, whether HD or PD. So, some patients choose to receive the short-term hemodialysis with central venous catheter (HD-CVC) before USPD. Whether the HD-CVC affected USPD, and whether it was necessary for ESRD patients without indications of emergency dialysis to undergo HD-CVC transition before USPD, were addressed. So we investigate the effects of the HD-CVC on urgent-start peritoneal dialysis. Method Retrospective analysis was performed on patients who received USPD from August 2008 to March 2017 in the first affiliated hospital of Xi'an Jiaotong University. According to whether hemodialysis and central venous catheterization were performed before PD, these patients were divided into two groups: USPD group (HD-CVC was not performed before PD) and HD-PD group (HD-CVC was given after admission, and then the PD catheterization was performed within 2 weeks ). The follow-up time was 1 year. The differences in clinical biochemical indexes, dialysis dose, urine volume, residual renal function, dialysis adequacy, peritoneal dialysis complications and technical survival rate between the two groups were observed. Results 1.A total of 482 patients were enrolled in this study, including 315 in the USPD group (average age 48.56±14.92 years) and 167 in the HD-PD group (average age 48.87±14.49 years). The demographics and clinical biochemical indexes (including creatinine, glomerular filtration rate, and blood potassium before admission) were similar between the two groups, and the differences were not statistically significant(P>0.05).2. After PD for 1month, residual renal function, UKt/V and TKt/V in the USPD group were significantly higher than those in the HD-PD group, blood urea nitrogen and creatinine were significantly lower than those in the HD-PD group (USPD group: 4.41±4.0ml/min, 0.79±0.44, 2.17±1.39, 17.79±4.96mmol/L, 663.15±182.03umol/L; HD-PD group: 3.67±2.39ml/min, 0.64±0.42, 1.92±0.55, 19.08±8.21 mmol/L, 711.02±280.3umol/L), and the differences were statistically significant (P<0.05, respectively).After PD for 6months, the urine volume in the USPD group were significantly higher than those in the HD-PD group(USPD group:964.84±539.95ml/d; HD-PD group 794.39±569.17ml/d), and the difference was statistically significant (P=0.002). 3. During the whole follow-up period, the exit-site infection rate, peritonitis infection rate, mechanical complications and technical survival rate were similar between the two groups, with no statistically significant difference (P>0.05,respectively). Conclusion Hemodialysis with central venous catheter before USPD affected the residual renal function and dialysis adequacy. HD-CVC as a pretreatment is not recommended to the end-stage renal disease patients who required PD but without the indication of emergency dialysis.

Central Venous Catheter and the Hemodialysis Patient: A Difficult Symbiosis

2002 ◽  
Vol 3 (2) ◽  
pp. 64-73 ◽  
Author(s):  
S. Mandolfo ◽  
W. Piazza ◽  
F. Galli
Keyword(s):  
Blood Flow ◽  
Central Venous Catheter ◽  
Hemodialysis Patient ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Chronic Hemodialysis ◽  
Central Venous ◽  
Tip Position ◽  
Ultrasonographic Guidance

In the last ten years, tunneled central venous catheters (pCVCs) have been increasingly utilized in chronic hemodialysis patients, sometimes in the place of fistulas. They have gained popularity for their unquestioned advantages, such as the possibility for immediate use. However, several problems have emerged following their diffusion. In this paper we review the main complications of pCVCs. Complications connected with insertion are generally due to an inaccurate approach to the vein. Ultrasonographic guidance has partially solved this problem and EC-ECG (endocavitary ECG) allows an accurate positioning of the tip. Infections, venous and/or pCVCs) thrombosis and dysfunctions are the most important catheter-related complications. Infections may occur with and without symptoms of systemic illness. Early diagnosis and appropriate antibiotic treatment are essential for saving the catheter. The pathogenesis of infections and strategies for prevention are discussed. Thrombosis and stenosis are well known complications of subclavian and jugular catheterization. In uremic patients, for temporary use, we suggest using the femoral position. Protocols for application of thrombolytic agents in pCVCs are considered. Dysfunction, defined as the failure to maintain a blood flow of at least 250 ml/min, remains the Achilles’ heel of the system. Adequate look therapy and tip position are only two basic aspects. In conclusion, a pessimistic outlook on the matter could lead us to consider that the advantages of catheter use are far outweighed by the disadvantages. However, we cannot avoid using central venous catheters in our dialysis units and a great challenge awaits both physicians and manufactures in the coming years.

Inefficiency in 6-Set Requests for Blood Culture Analysis of Cancer Patients with the Central Venous Catheter

2013 ◽  
Vol 3 (3) ◽  
pp. 155
Author(s):  
Dong-Hyun Lee ◽  
Eun-ha Koh ◽  
Sunjoo Kim ◽  
In-Gyu Bae ◽  
Hoon-gu Kim ◽  
...  
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Venous
Sign in / Sign up

Export Citation Format

Share Document