Document Detail

Central venous catheters as a vascular access modality for pediatric hemodialysis.
MedLine Citation:
PMID:  17978856     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The use of hemodialysis catheters is an essential component of dialysis practice. Children are particularly likely to require multiple courses of dialysis over their lifetime, hence the repeated need for vascular access. These catheters remain a significant source of morbidity and mortality. METHODS: All catheters inserted for hemodialysis at the Center of Pediatric Nephrology and Transplantation, Cairo University over a period of 40 months were studied. Patient data as well as data of catheter insertion, dwell, cause of removal and complications were reported. RESULTS: A total of 195 uncuffed central venous catheters were used for temporary access in 131 patients for a mean duration of 35.7 days. Of attempted insertions, 87.4% achieved successful access, of which 56% remained for the required period, 8.9% were accidentally dislodged, and 35.1% were removed due to complications--mostly infection. The overall rate of possible catheter-related bacteremia was 9.6 episodes/ 1,000 catheter days. Infection increased with longer catheter dwell. Nineteen cuffed tunneled catheters were surgically inserted and used for up to 11 months (mean 117 days). Loss of these catheters was attributed mainly to infection (ten episodes) and catheter thrombosis (six episodes). During the study, 317 femoral catheters were inserted. CONCLUSION: Uncuffed central venous catheters are both needed and useful for short-term hemodialysis. Vascular access for extended durations may be provided by cuffed tunneled catheters. Infection is the major serious concern with both uncuffed and cuffed catheters.
Fatina Ibrahim Fadel; Hesham Nabil Abdel Mooty; Hafez Mahmoud Bazaraa; Samar Mohamed Sabry
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International urology and nephrology     Volume:  40     ISSN:  0301-1623     ISO Abbreviation:  Int Urol Nephrol     Publication Date:  2008  
Date Detail:
Created Date:  2008-08-14     Completed Date:  2008-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  Hungary    
Other Details:
Languages:  eng     Pagination:  489-96     Citation Subset:  IM    
Pediatrics Department, Center of Pediatric Nephrology and Transplantation, Faculty of Medicine, Cairo University, Egypt.
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MeSH Terms
Bacteremia / etiology
Catheterization, Central Venous* / adverse effects
Child, Preschool
Equipment Design
Jugular Veins
Renal Dialysis / instrumentation*
Subclavian Vein

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