Effects of different catheter replacement methods on catheter service time and complications in hemodialysis patients: A cohort study.

Abstract

INTRODUCTION:

Central venous catheter insertion for long-term vascular access is not recommended in clinical practice. However, since arteriovenous fistula creation is difficult to perform in some patients, central venous catheter insertion for long-term vascular access is performed. This study aimed to assess the complications and service time of central venous catheters replaced using different methods and to determine the influencing factors of service time.

METHODS:

Study design: A retrospective observational cohort study. Setting and participants: Patients who underwent tunneled dialysis catheter malfunction (2009-2019) and had to undergo another dialysis catheter insertion were enrolled. Exposures: Ectopic replacement and in situ replacement. Outcomes: Factors such as age, sex, primary patency rate, secondary patency rate, early complications, and late complications were considered. Analytical approach: This study used a Cox proportional hazards regression model.

RESULTS:

The first and the newly replaced catheter service time were 37.779 ± 24.563 months and 32.468 ± 26.638 (25) months in the ectopic group and 37.075 ± 20.550 months and 26.349 ± 22.672 months in the in situ group, respectively. In the early service time, the newly replaced catheter resulted in significant bleeding from the tunnel. The first catheter had the least complications, most adequate blood flow, and longest service time. Ectopic catheter replacement and the tip shape of the catheter were the independent factors for catheter service time. Catheter service time increased with age.

CONCLUSION:

Ectopic catheter replacement can improve the primary patency rate and auxiliary primary patency rate of catheters. Ectopic catheter replacement may require sufficient surgical skills with digital subtraction angiography, resulting in a better prognosis.

• Authors: Haibo Yu, Qi Xin, Xuewen Wang, Lan Jia, Junming Wang, Xianhai Meng, Bo Li, Fang Wei, Aili Jiang
• Journal: The journal of vascular access (J Vasc Access) Vol. 21 Issue 4 Pg. 497-503 (Jul 2020) ISSN: 1724-6032 [Electronic] United States
• PMID: 31820667 (Publication Type: Comparative Study, Journal Article, Observational Study)

Topics

• Aged
• Catheter Obstruction (etiology)
• Catheterization, Central Venous (adverse effects, instrumentation)
• Catheters, Indwelling
• Central Venous Catheters
• Device Removal (adverse effects, methods)
• Female
• Humans
• Male
• Middle Aged
• Renal Dialysis
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Time Factors
• Treatment Outcome