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Tunneled Catheters in Hemodialysis

Yıl 2014, Cilt: 5 Sayı: 18, 19 - 25, 03.03.2015
https://doi.org/10.17944/mkutfd.55318

Öz

Aim: In this study, we aimed to evaluate, survival, and early and late complications of indwelling tunneled hemodialysis catheters used in hemodialysis patients. Material and Method: In our clinic, 154 patients catheters were retrospectively analyzed in terms of age, gender, indications for catheter, site of application, reasons for removal and complications between January 2010 and March 2012. Results: insertion causes as follows; 62.3% of patients (n = 96) had failed arteriovenous fistula (AVF) attempts, 24% (n = 37) 37 (24%) had waiting time for AVF maturation, 7.7% (n = 12) had a short life expectancy, 5.8% (n = 9) was because of patient’s preference. Tunelled hemodialysis catheter is inserted; in 83.1% (n = 128) of patients in right internal jugular vein, in 10.3% (n = 16) of patients in left internal jugular vein, in 3.2% (n = 4), 5 (3.2%) was left subclavian vein, 3.2% (n = 5) was femoral vein. catheters survival rate was 86.7% in 1 year follow-up and 82.4% in the second year for 2year follow-up duration. Conclusion: As a result, permanent tunnelled hemodialysis catheters are first preference for vascular access; because of high procedural success possibility of early use after operation, providing dialysis sufficient blood flow, allowing life expectancy is short and transplant candidates and the patient with not suitable vascular structures for AVF

Kaynakça

  • 2009 Annual Data Report: Atlas of chronic kidney disease and end – stage renal disease in
  • the United States. Am J Kidney Dis. 2010;55:S266–7.
  • Vascular Access Work Group. Clinical practice guidelines for vascular access. Am J
  • Kidney Dis.2006;48:S248–73.
  • Varughese S, John GT, Alexander S, Deborah MN, Nithya N, Ahamed I, et al. Pre-tertiary
  • hospital care of patients with chronic kidney disease in India. Indian J Med
  • Res. 2007;126:28–33.
  • Denys BG, Uretsky BF. Anatomical variations of internal jugular vein location: Impact on
  • central venous access. Crit Care Med. 1991;19:1516–9.
  • Denys BG, Uretsky BF, Reddy PS. Ultrasound-assisted cannulation of the internal jugular
  • vein.A prospective comparison to the external landmark-guided
  • technique. Circulation. 1993;87:1557–62.
  • Molinari AC, Haupt R, Saracco P, Di Marco M, Castagnola E, Fratino G. Urokinase for
  • restoring patency of malfunctioning or blocked central venous catheters in children with
  • hemato-oncological diseases. Support Care Cancer. 2004;12:840–3.
  • Fry AC, Stratton J, Farrington K, Mahna K, Selvakumar S, Thompson H, et al. Factors
  • affecting long-term survival of tunnelled haemodialysis catheters-a prospective audit of 812
  • tunnelled catheters. Nephrol Dial Transplant. 2008;23:275–81.
  • Quarello F, Forneris G, Borca M, Pozzato M. Do central venous catheters have advantages
  • over arteriovenous fistulas or grafts? J Nephrol. 2006;19:265–79.
  • Mandolfo S, Galli F, Costa S, Ravani P, Gaggia P, Imbasciati E. Factors influencing
  • permanent catheter performance. J Vasc Access. 2001;2:106–9.
  • O’Dwyer H, Fotheringham T, O’Kelly P, Doyle S, Haslam P, McGrath F, et al. A
  • prospective comparison of two types of tunneled hemodialysis catheters: The Ash Split versus
  • the PermCath.Cardiovasc Intervent Radiol. 2005;28:23–9.
  • Rao M, Juneja R, Shirly RB, Jacob CK. Haemodialysis for end-stage renal disease in
  • Southern India--a perspective from a tertiary referral care centre. Nephrol Dial
  • Transplant. 1998;13:2494–500.
  • Astor BC, Eustace JA, Powe NR, Klag MJ, Fink NE, Coresh J. for the CHOICE study.
  • Type of vascular access and survival among incident hemodialysis patients: The Choices for
  • Healthy Outcomes In Caring ESRD (CHOICE) study. J Am Soc Nephrol. 2005;16:1449–55.

HEMODİYALİZDE TÜNELLİ KATETERLER

Yıl 2014, Cilt: 5 Sayı: 18, 19 - 25, 03.03.2015
https://doi.org/10.17944/mkutfd.55318

Öz

Amaç: Bu çalışmada hemodiyaliz hastalarında
kullanılan tünelli kateterlerin erken ve geç
dönem komplikasyonları ve açık kalım
oranlarını değerlendirmeyi amaçladık.
Materyal ve Metod: Kliniğimizde ocak 2010-
mart 2012 tarihleri arasında 181 kalıcı tünelli
kateter takılan 154 hasta yaş, cinsiyet, kateter
takma endikasyonu, katater uygulama yerleri,
çıkartılma sebepleri ve komplikasyonlar
açısından retrospektif olarak incelendi.
Bulgular: Kalıcı tünelli kateter takılma
nedenleri; hastaların % 62.3 (n=96) ü başarısız
arterio-venöz fistül (AVF) girişimleri, % 24
(n=37) 37 (%24) si AVF maturasyonunun
beklenmesi, % 7.7 (n=12) si kısa yaşam
beklentisi, % 5.8 (n=9) i hasta tercihinden
dolayı idi. Kateter yerleştirme yerleri ise;
hastaların % 83.1 (n=128) ine sağ internal
juguler vene, % 10.3 (n=16) üne sol internal
juguler vene, % 3.2 (n=4) 5 (%3.2) sine sol
subclavian vene, % 3.2 (n=5) sine femoral
vene kateter takıldı. Takılan tünelli kalıcı
hemodiyaliz kateterlerin 2 yıllık takiplerinde
katater açık kalım oranılarının 1 yıllık % 86.7,
2 yıllık ise %82.4 olarak saptandı.
Sonuç: Sonuç olarak kalıcı tünelli hemodiyaliz
kateterleri, yüksek işlem başarısına ve düşük
erken dönem komplikasyonlarına sahip,
işlemden hemen sonra diyalize girebilme
imkanı sağlayan, diyaliz için yeterli kan
akımını sağlayan yaşam beklentisi kısa olan ve
transplantasyon adayları ve AVF için uygun
vasküler yapıları olmayan hastalar için ilk
tercih edilmesi gereken bir damar erişim
seçeneğidir.

Kaynakça

  • 2009 Annual Data Report: Atlas of chronic kidney disease and end – stage renal disease in
  • the United States. Am J Kidney Dis. 2010;55:S266–7.
  • Vascular Access Work Group. Clinical practice guidelines for vascular access. Am J
  • Kidney Dis.2006;48:S248–73.
  • Varughese S, John GT, Alexander S, Deborah MN, Nithya N, Ahamed I, et al. Pre-tertiary
  • hospital care of patients with chronic kidney disease in India. Indian J Med
  • Res. 2007;126:28–33.
  • Denys BG, Uretsky BF. Anatomical variations of internal jugular vein location: Impact on
  • central venous access. Crit Care Med. 1991;19:1516–9.
  • Denys BG, Uretsky BF, Reddy PS. Ultrasound-assisted cannulation of the internal jugular
  • vein.A prospective comparison to the external landmark-guided
  • technique. Circulation. 1993;87:1557–62.
  • Molinari AC, Haupt R, Saracco P, Di Marco M, Castagnola E, Fratino G. Urokinase for
  • restoring patency of malfunctioning or blocked central venous catheters in children with
  • hemato-oncological diseases. Support Care Cancer. 2004;12:840–3.
  • Fry AC, Stratton J, Farrington K, Mahna K, Selvakumar S, Thompson H, et al. Factors
  • affecting long-term survival of tunnelled haemodialysis catheters-a prospective audit of 812
  • tunnelled catheters. Nephrol Dial Transplant. 2008;23:275–81.
  • Quarello F, Forneris G, Borca M, Pozzato M. Do central venous catheters have advantages
  • over arteriovenous fistulas or grafts? J Nephrol. 2006;19:265–79.
  • Mandolfo S, Galli F, Costa S, Ravani P, Gaggia P, Imbasciati E. Factors influencing
  • permanent catheter performance. J Vasc Access. 2001;2:106–9.
  • O’Dwyer H, Fotheringham T, O’Kelly P, Doyle S, Haslam P, McGrath F, et al. A
  • prospective comparison of two types of tunneled hemodialysis catheters: The Ash Split versus
  • the PermCath.Cardiovasc Intervent Radiol. 2005;28:23–9.
  • Rao M, Juneja R, Shirly RB, Jacob CK. Haemodialysis for end-stage renal disease in
  • Southern India--a perspective from a tertiary referral care centre. Nephrol Dial
  • Transplant. 1998;13:2494–500.
  • Astor BC, Eustace JA, Powe NR, Klag MJ, Fink NE, Coresh J. for the CHOICE study.
  • Type of vascular access and survival among incident hemodialysis patients: The Choices for
  • Healthy Outcomes In Caring ESRD (CHOICE) study. J Am Soc Nephrol. 2005;16:1449–55.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Original Articles
Yazarlar

Celalettin Karatepe

Tülin Yetim Bu kişi benim

Cem Lale

Yayımlanma Tarihi 3 Mart 2015
Gönderilme Tarihi 2 Mart 2015
Yayımlandığı Sayı Yıl 2014 Cilt: 5 Sayı: 18

Kaynak Göster

Vancouver Karatepe C, Yetim T, Lale C. HEMODİYALİZDE TÜNELLİ KATETERLER. mkutfd. 2015;5(18):19-25.