scholarly journals Vascular Access, Complications and Survival in Incident Hemodialysis Patients

2021 ◽  
Vol 1 (2) ◽  
pp. 88-99
Author(s):  
Massimo Torreggiani ◽  
Lucia Bernasconi ◽  
Marco Colucci ◽  
Simone Accarino ◽  
Ettore Pasquinucci ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Central Venous Catheter ◽  
Vascular Access ◽  
Hospital Admissions ◽  
Patient Survival ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous ◽  
Risk Of Death ◽  
Access Complications

The arteriovenous fistula (AVF) has long been considered the optimal vascular access. However, the evolving characteristics of the ageing dialysis population limit the creation of an AVF in all patients. Thus, more patients start hemodialysis (HD) with a central venous catheter (CVC) rather than an AVF, and the supremacy of the AVF has recently been questioned. The aim of this study was to analyze the incidence and rate of access complications in 100 patients between 2010 and 2015. A total of 63 patients started HD with an AVF, while 37 began HD with a CVC. We found no differences in patient survival according to the vascular access in use at the beginning of dialysis, but patients were more likely to die while undergoing dialysis by means of a CVC than an AVF. Patients started on dialysis with a CVC had more cardiovascular disease, while patients who began dialysis with an AVF presented more hypertension. Fistulas presented a longer survival time despite more hospital admissions, but CVCs bore a higher risk of infections. Our results suggest that starting dialysis with a CVC does not confer a greater risk of death.

A Stuck Hemodialysis Central venous Catheter

2008 ◽  
Vol 9 (4) ◽  
pp. 301-303 ◽  
Author(s):  
M. Field ◽  
J. Pugh ◽  
J. Asquith ◽  
S. Davies ◽  
A.D. Pherwani
Keyword(s):  
Case Report ◽  
Central Venous Catheter ◽  
Vascular Access ◽  
Insertion Site ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Central Venous

Background A growing number of hemodialysis patients are dependent upon central venous catheters (CVCs) for long-term vascular access. Although many complications of CVCs have been documented, the phenomenon of the stuck catheter is described relatively infrequently. Case report We describe a case where attempts to remove the line by exploration of the jugular insertion site in theater were unsuccessful and the line was internalized. Discussion The case is then discussed with all available cases in the literature to suggest principles of managing and preventing the stuck catheter phenomenon.

The association between vascular access type and depressive symptoms in geriatric hemodialysis population

Vascular ◽  
2020 ◽  
Vol 28 (4) ◽  
pp. 390-395
Author(s):  
Betul Nur Keser ◽  
Ulku Nur Kirman ◽  
Cemal Kocaaslan ◽  
Ebuzer Aydin
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Multiple Logistic Regression Analysis ◽  
Depression Scale ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous

Objectives A well-functioning vascular access is crucial for hemodialysis treatment, and arteriovenous fistula is the recommended vascular access type. Arteriovenous fistula is superior to other vascular access types in many aspects, but the effect of arteriovenous fistula on patients’ psychiatric state is not well described yet. The aim of this study is to determine whether there is an association between vascular access type and depression scores. Methods This cross-sectional study was conducted at two hemodialysis centers. Geriatric Depression Scale-15 was administered to geriatric hemodialysis patients, using ≥5 score as the cut-off value for the presence of depressive symptoms. Descriptive tests, Kolmogorov–Smirnov test, Pearson’s Chi-square test, Mann–Whitney test, Kruskal–Wallis test, Spearman’s rank correlation calculation, and multiple logistic regression analysis were performed accordingly to analyze the data. Results Of 75 participants, 34 (45.3%) were female and the mean age was 73.4 ± 5.9 years (range: 65–92). The prevalence of depressive symptoms in the geriatric hemodialysis population was 53.3%. Central venous catheter, hypertension, and increased time on hemodialysis have been found to be risk factors for higher depression scores (aOR 10.505 (95% CI 1.435–76.900), p = 0.021; aOR 9.783 (95% CI 2.508–38.169), p = 0.001; aOR 1.019 (95% CI 1.003–1.035), p = 0.017, respectively). Among patients with arteriovenous fistula, those with hypertension had higher depression scores ( p = 0.008). Conclusions Geriatric hemodialysis patients were found to have depressive symptoms commonly, and central venous catheter, hypertension, and increased time on hemodialysis have been found to be risk factors for presence of depressive symptoms. To the best of our knowledge, this is the first study highlighting that arteriovenous fistula is associated with lower depression scores and lower prevalence of depressive symptoms.

Hemodynamics Alterations Induced by Central Venous Catheter in Vascular Access for Hemodialysis

2021 ◽  
Author(s):  
Saulo Gonçalves ◽  
Mário Silva ◽  
Matheus Costa ◽  
Thabata Lucas ◽  
Rudolf Huebner
Keyword(s):  
Central Venous Catheter ◽  
Vascular Access ◽  
Venous Catheter ◽  
Central Venous

Timing of referral for vascular access for hemodialysis: Analysis of the current status and the barriers to timely referral

2019 ◽  
Vol 20 (6) ◽  
pp. 659-665
Author(s):  
Suh Min Kim ◽  
Ahram Han ◽  
Sanghyun Ahn ◽  
Sang-il Min ◽  
Jongwon Ha ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Vascular Access ◽  
Venous Catheter ◽  
Current Status ◽  
Rapid Progression ◽  
Central Venous ◽  
Progression Of Kidney Disease ◽  
Current Guidelines ◽  
Timely Referral ◽  
Late Referral

Introduction: Current guidelines recommend the placement of vascular access 6 months before the anticipated start of hemodialysis therapy; however, many patients start hemodialysis using a central venous catheter. We investigated the timing of referral for vascular access, the vascular access type at hemodialysis initiation, and the barriers to a timely referral. Methods: The study involved a retrospective review of 237 patients for whom the first vascular access for hemodialysis was created between January and November 2017. Results: Among the 237 patients, 58.2% were referred before hemodialysis initiation, while 41.8% were referred after hemodialysis initiation. Among the 138 patients, 55, 59, and 24 patients were referred more than 6 months, between 2 and 6 months, and within 2 months before hemodialysis initiation, respectively. Within these subgroups, 3.6%, 10.2%, and 75.0% patients underwent hemodialysis initiation with a central venous catheter, respectively. Among the 99 patients referred after hemodialysis initiation, the reasons for late referral were as follows: unexpected rapid progression of kidney disease (n = 23), noncompliance (n = 21), late visit to the nephrologist (initial visit within 2 months of hemodialysis initiation; n = 14), change of treatment strategy from peritoneal dialysis or transplants (n = 9), and unknown reasons (n = 32). Conclusion: Only 23% of patients were referred for vascular access 6 months before the anticipated hemodialysis therapy. In addition, 53% of patients initiated hemodialysis with a central venous catheter. Avoidance of catheter insertion was mostly successful in patients referred 2 months before hemodialysis initiation. The most common modifiable barrier to the timely referral was noncompliance.

scholarly journals Linezolid lock prophylaxis of central venous catheter infection

2008 ◽  
Vol 57 (4) ◽  
pp. 534-535 ◽  
Author(s):  
Jérôme Patrick Fennell ◽  
Martin O'Donohoe ◽  
Martin Cormican ◽  
Maureen Lynch
Keyword(s):  
Central Venous Catheter ◽  
Hospital Admissions ◽  
Blood Stream Infection ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Blood Stream ◽  
Central Venous ◽  
Central Venous Catheter Infection ◽  
The Impact

Central venous catheter (CVC)-related infections are a major problem for patients requiring long-term venous access and may result in frequent hospital admissions and difficulties in maintaining central venous access. CVC-related blood stream infections are associated with increased duration of inpatient stay and cost approximately \#8364;13 585 per patient [Blot, S. I., Depuydt, P., Annemans, L., Benoit, D., Hoste, E., De Waele, J. J., Decruyenaere, J., Vogelaers, D., Colardyn, F. & Vandewoude, K. H. (2005). Clin Infect Dis 41, 1591–1598]. Antimicrobial lock therapy may prevent CVC-related blood stream infection, preserve central venous access and reduce hospital admissions. In this paper, the impact of linezolid lock prophylaxis in a patient with short bowel syndrome is described.

Aneurysm of Arteriovenous Fistula in Uremic Patients: Is Endograft a Viable Therapeutic Approach?

2002 ◽  
Vol 3 (2) ◽  
pp. 85-88 ◽  
Author(s):  
P.M. Allaria ◽  
E. Costantini ◽  
A. Lucatello ◽  
E. Gandini ◽  
F. Caligara ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Venous Catheter ◽  
Good Alternative ◽  
Central Venous ◽  
Arteriovenous Fistulas ◽  
Risk Of Rupture ◽  
Arterial Aneurysms ◽  
Percutaneous Insertion

One of the complications of arteriovenous fistulas in chronic hemodialyzed patients is the onset of an aneurysm which can be at risk of rupture. Traditional surgical repair is not always feasible and may not be successful in these cases, leading therefore to the loss of a functioning vascular access and requiring in any case the temporary use of a central venous catheter to allow regular hemodialysis sessions. We applied to this kind of aneurysm the same experience developed in the management of major arterial aneurysms and we considered endografting repair a good alternative in this case. In this paper we present the successful treatment of an arteriovenous fistula aneurysm using that technique. A distal radio-cephalic arteriovenous fistula in one of our patients presented an aneurysm with high risk of rupture. The endografting repair with percutaneous insertion of a Wallgraft™ endoprosthesis was well tolerated and the vascular access could be used the day after, without the need for a central venous catheter insertion.

Clinical Performance of a New Transparent Chlorhexidine Gluconate Central Venous Catheter Dressing

2008 ◽  
Vol 13 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Carol Olson ◽  
James M. Heilman
Keyword(s):  
Health Care ◽  
Central Venous Catheter ◽  
Vascular Access ◽  
New Technologies ◽  
Insertion Site ◽  
Venous Catheter ◽  
Chlorhexidine Gluconate ◽  
Ease Of Use ◽  
Central Venous ◽  
Or Education

Abstract As the sciences of vascular access and infection prevention rapidly advance healthcare professionals are often faced with new technologies designed to help, but which are often so complicated to use that they cause unforeseen problems. As a vascular access team at a major mid-western hospital, we evaluated the ease-of-use and the performance characteristics of a new transparent catheter dressing, 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) containing the antimicrobial chlorhexidine gluconate (CHG), with a variety of central venous catheters insertion sites in comparison to a standard non-antimicrobial dressing Tegaderm® (3M Health Care™, St. Paul, MN). Following IRB approval, sixty-three consenting patients were enrolled and randomized; 33 in the CHG antimicrobial dressing group and 30 in the standard dressing group. Thirty six patients had peripherally inserted central catheters (PICCs), 20 had intrajugular insertions (IJ), and 7 had subclavian insertions. The new 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) was evaluated for its ability to permit visualization of the insertion site, ease of use, ease of using correctly, ability to secure the catheter and absorb exudates and remain transparent. The new 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) was found to be as easy to use in central venous catheter care clinical practice as the standard of care non-antimicrobial transparent adhesive dressing. No additional training or education was required to properly use it. This dressing was applied and removed like standard transparent adhesive dressings, but offered many advantages over standard dressings. Advantages include that it is antimicrobial, handles moderate bleeding, remains transparent and appears to offer greater catheter securement than the Tegaderm® (3M Health Care™, St. Paul, MN) standard dressing. The CHG gel pad also conformed well to the catheter.

Sign in / Sign up

Export Citation Format

Share Document