ASDIN Clinical Case Focus: Timing of Secondary Arteriovenous Fistula Creation Avoids Tunneled Catheter Placement

2008 ◽  
Vol 21 (4) ◽  
pp. 364-366 ◽  
Author(s):  
Tushar J. Vachharajani ◽  
Naveen K. Atray ◽  
Sarjit Gill ◽  
Gazi Zibari ◽  
Kenneth D. Abreo
Keyword(s):  
Arteriovenous Fistula ◽  
Clinical Case ◽  
Catheter Placement ◽  
Tunneled Catheter

scholarly journals PC134. Tunneled Catheter Placement for Hemodialysis Should Be Paired With Evaluation for Arteriovenous Fistula or Graft Creation

2019 ◽  
Vol 69 (6) ◽  
pp. e241
Author(s):  
Hanna Barnes ◽  
Mark Bailey ◽  
Daniel K. Han ◽  
Amy Brito ◽  
Francis Nowakowski ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Catheter Placement ◽  
Tunneled Catheter

Tunneled Catheter Placement in a Pediatric Patient: A Novel Approach

2017 ◽  
Vol 22 (4) ◽  
pp. 205-209 ◽  
Author(s):  
Dewansh Goel ◽  
Bhupender Yadav ◽  
Paul Lewis ◽  
Karun Sharma ◽  
Ranjith Vellody
Keyword(s):  
Pediatric Patient ◽  
Central Venous Access ◽  
Venous Access ◽  
Catheter Placement ◽  
Behavioral History ◽  
Pull Out ◽  
Novel Approach ◽  
The Right ◽  
Tunneled Catheter

Abstract Establishing venous access can be an important and often complex aspect of care for pediatric patients. When stable central venous access is required for long-term intravenous infusions, several options are available including peripherally inserted central catheters (PICC), tunneled catheters and ports. Both PICC placement and tunneled catheter placement include an exposed external segment of catheter, either in an extremity or on the chest. We present a pediatric patient with complex behavioral history who required long-term intravenous therapy. After careful review, the best option for the patient was determined to be a tunneled catheter that exited the skin in the right upper back, making it difficult to grab and pull out. The catheter was successfully placed and the patient appropriately completed his intravenous antibiotic course. Upon completion, the catheter was removed without complications. This tunneling technique to the scapular region may be useful for patients with psychiatric or neurodegenerative disorders where purposeful dislodgement may be a problem.

Exchange over the guidewire from non-tunneled to tunneled hemodialysis catheters can be performed without patency loss

2018 ◽  
Vol 19 (3) ◽  
pp. 252-257
Author(s):  
Hoon Suk Park ◽  
Joonsung Choi ◽  
Hyung Wook Kim ◽  
Jun Hyun Baik ◽  
Cheol Whee Park ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
De Novo ◽  
Kidney Injury ◽  
Catheter Placement ◽  
Exchange Method ◽  
Hemodialysis Catheter ◽  
Catheter Survival ◽  
Catheter Group ◽  
To Receive ◽  
Tunneled Catheter

Purpose: The exchange from a non-tunneled hemodialysis catheter to a tunneled one over a guidewire using a previous venotomy has been reported to be safe. However, some concerns that it may increase infection risk prevent its clinical application. This approach seems particularly useful for acute kidney injury patients requiring initial renal replacement therapy, in whom we frequently worry about the choice of non-tunneled versus tunneled catheters. Materials and methods: From March 2012 to February 2016, 88 cases to receive the over-the-guidewire exchange method from a non-tunneled to a tunneled catheter and 521 cases to receive de novo tunneled catheter placement from the hemodialysis vascular access cohort were compared retrospectively. Results: The immediate complication, later catheter dysfunction requiring replacement, and infection rates were comparable between the two groups. Newly placed tunneled catheter survival in the over-the-guidewire exchange group was comparable with survival in the de novo tunneled catheter group (p = 0.24). In addition, when we compared the same two methods among only intensive care unit patients; they remained similar (p = 0.19). Conclusion: An exchange with the over-the-guidewire method from a non-tunneled to a tunneled catheter was comparable to a de novo catheter placement technique. Therefore, this method should be viewed more favorably and should especially be considered for acute kidney injury patients.

Successful tunneled catheter placement in a hemodialysis patient with idiopathic multiple central venous stenoses

2013 ◽  
Vol 18 (1) ◽  
pp. 200-204 ◽  
Author(s):  
Yuliang Zhao ◽  
Tianlei Cui ◽  
Yang Yu ◽  
Fang Liu ◽  
Ping Fu ◽  
...  
Keyword(s):  
Hemodialysis Patient ◽  
Catheter Placement ◽  
Central Venous ◽  
Tunneled Catheter

scholarly journals Vascular Access Use Among Hemodialysis Patients and Competency of Nurses at National Kidney Centre, Nepal

2021 ◽  
Vol 4 (1) ◽  
pp. 403-409
Author(s):  
Nabin Bahadur Basnet ◽  
Jeena Shrestha ◽  
Sangita Raj Ghatani ◽  
Subhadra Regmi ◽  
Shrijana Bhandari ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Long Run ◽  
Arteriovenous Access ◽  
History Of ◽  
Professional Information ◽  
The Cost ◽  
Tunneled Catheter

Introduction: Vascular access are a prerequisite for hemodialysis and good care by nurses is key to their longevity. A pattern of vascular access use has not been assessed previously nor the competency of nurses to identify the gaps in knowledge and skills. This study aims to describe vascular access use and nursing competency at National Kidney Centre. Materials and Methods: A cross-sectional study was done to obtain demographic information and history of vascular access of patients. Vascular access was examined. Demographic and professional information of nurses were collected. A quiz based on KDOQI Clinical Practice Guidelines and a visual analogue scale to indicate confidence in managing vascular access were administered to the nurses. Results: Four-hundred seventy-two patients and 70 nurses were recruited. The proportion of patients with an arteriovenous fistula, arteriovenous graft, tunneled catheter, and non-tunneled catheter at the time of initiation of hemodialysis were 24.36%, 0.64%, 1.27%, and 73.73%, respectively, and after conversion was 67.23%, 5.08%, 1.98%, and 19.77%, respectively. The cost at initiation was lower for catheters and the arteriovenous access in long run. Nurses had received vascular access training during their hemodialysis course (95.71%), but a few received further training (38.57%). They did well in sections related to preparation for permanent access and treatment of complications. Conclusions: Most of the patients initiated hemodialysis via a non-tunneled catheter. The prevalence of arteriovenous fistula was high. Continued training of nurses was lacking. Nurses were confident in managing arteriovenous fistula and non-tunneled catheters.

Midterm Results of Tunneled Catheter Placement in Hemodialysis Patients with Central Venous Stenosis or Occlusion

2021 ◽  
Vol 14 (1) ◽  
pp. 45-56
Author(s):  
Hassan Lotfy ◽  
Aly Elemam ◽  
Wael Shaalan ◽  
Ahmed El Mahdi ◽  
Akram Ibrahim ◽  
...  
Keyword(s):  
Hemodialysis Patients ◽  
Catheter Placement ◽  
Midterm Results ◽  
Central Venous ◽  
Central Venous Stenosis ◽  
Venous Stenosis ◽  
Tunneled Catheter

scholarly journals P1312EFFECT OF KIDNEY TRANSPLANTATION RATE ON THE ARTERIOVENOUS FISTULA RATE IN PREVALENT HEMODIALYSIS PATIENTS: ANALYSIS OF DATA FROM THE CATALAN RENAL REGISTRY (1997-2017)

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ramon Roca-Tey ◽  
Jordi Comas ◽  
Jaume Tort
Keyword(s):  
Kidney Transplantation ◽  
Arteriovenous Fistula ◽  
Kidney Graft ◽  
Fistula Rate ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Determining Factor ◽  
Tunneled Catheter ◽  
Over Time

Abstract Background Kidney transplantation (KT) is considered to be the best option of renal replacement therapy (RRT) for most end-stage renal disease (ESRD) patients (pts). Furthermore, arteriovenous fistula (AVF) is considered to be the best vascular access (VA) for most hemodialysis (HD) pts. Aims To analyze the effect of KT rate on the AVF rate in prevalent HD pts. In addition, the likelihood of receiving a kidney graft (KG) over time according to the first VA used to start HD program was also evaluated Method Data from the Catalan Registry of ESRD pts treated with either KT or HD were examined for a 20-year period Results The functioning KG rate increased progressively from 40.5% (n=2211) in 1997 to 57.0% (n=6149) in 2017 and, conversely, the AVF rate in prevalent HD patients decreased progressively from 86.0% (n=2609) to 63.2% (n=2546) during the same period (for both comparisons, p < 0.001). The characteristics of all prevalent HD pts dialyzed in 1997 (n=3104) vs 2017 (n=4205) were different regarding age 62.6±15.3 vs 70.3±14.2 yr, diabetic nephropathy (DN) 13.2% vs 21.8% and cardiovascular disease (CD) 67.6% vs 75.8% (for all comparisons, p<0.001). On December 31, 2017 (maximum KT rate), the characteristics of KG recipients were different compared with prevalent HD pts dialyzed through either an AVF or a tunneled catheter (n=1145): age 57.4±14.5 vs 69.9±13.8 vs 72.0±14.6 yr, DN 9.5% vs 21.7% vs 22.5%, CD 38.6% vs 74.3% vs 83.7% (for all comparisons, p<0.001). By analyzing the likelihood of prevalent pts performing HD through an AVF, we saw it was lower in pts with DN (OR: 0.86; 95% CI: 0.79-0.94, p=0.001) and it decreased progressively as they got older (reference >74 yr): <44 yr (OR:1.55, 95% CI: 1.41-1.70, p<0.001), 45-64 yr (OR: 1.47, 95% CI: 1.38-1.56, p<0.001) and 65-74 yr (OR: 1.22, 95% CI: 1.17-1.28, p<0.001). This probability was higher in males (OR: 1.84, 95% CI: 1.73-1.95, p<0.001), pts with polycystic kidney disease (OR: 1.54, 95% CI: 1.35-1.77, p<0.001) and pts without CD (OR: 1.32; 95% CI: 1.27-1.38, p<0.001) and it increased according to the time on RRT (reference < 1 month): >12 m (OR: 2.39, 95% CI: 2.17-2.64, p<0.001). In addition, this likelihood decreased progressively as the percentage of patients with a functioning KG increased (reference >55%): 40-45% (OR: 3.26, 95% CI: 3.05-3.48, p<0.001), 45-50% (OR: 1.82, 95% CI: 1.73-1.92, p<0.001) and 50-55% (OR: 1.27, 95% CI: 1.21-1.33, p<0.001). The rate of prevalent HD pts waitlisted for KT and dialyzed through AVF decreased progressively from 94.5% (639/676, 1997) to 77.9% (491/630, 2017). In parallel, but always remaining at a lower level, the rate of prevalent HD patients not waitlisted for KT and dialyzed through AVF also decreased progressively from 83.6% (1970/2357) to 60.5% (2055/3399) during the same period (for all comparisons, p<0.001). Considering the prevalent HD pts during the period 2014-2017 (n=4029), significant differences were observed between HD pts waitlisted (n=630, 15.6%) and not-waitlisted (n=3399, 84.4%) for KT regarding age (58.2±12.9 vs 72.8±13.1 yr), DN (16.2% vs 23.0%), CD (59.5% vs 80.5%) and distribution of AVF (77.9% vs 60.5%) or tunneled catheter (16.5% vs 30.6%) (for all comparisons, p<0.001). During the period 2012-2014, incident pts starting HD through an AVF (n=1026) had a significant higher likelihood of receiving a KG over time (HR: 1.68, 95% CI: 1.41-2.00, p<0.001) in comparison to pts who initiated HD through a catheter (n=1408). Conclusion 1) The fall of prevalent HD pts with AVF over time could be associated with a progressive worsening of their clinical profiles along with the increasing rate of KG recipients. 2) In addition to some demographic and clinical characteristics of prevalent HD pts, the annual KT rate was also a determining factor in their AVF rate. 3) Starting HD program through an AVF was independently associated with a greater likelihood of receiving a KG over time as compared to starting HD through a catheter.

Sign in / Sign up

Export Citation Format

Share Document