A multicenter, prospective, randomized, comparative evaluation of dual- versus triple-lumen catheters for hemodialysis and apheresis in 485 patients

Contreras, Gabriel; Liu, Ping Yu; Elzinga, Lawrence W.; Anger, Michael; Lee, Jean; Robert, Nurian E.; Chvala, Robert; MARS, RONALD; Vesely, Thomas M.; Taber, Tim E.; Shemin, Douglas; Shafritz, Randy; Pulliam, Joseph

doi:10.1016/s0272-6386(03)00657-7

Cited by 18 publications

(13 citation statements)

References 11 publications

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“…We did not observe any significantly different incidence rate of infectious CR complications between SL and DL catheters, which is in line with previous studies (9,13–15).…”

Section: Discussionsupporting

confidence: 93%

“…Studies comparing CR complications in single lumen (SL) vs. double lumen (DL)/multilumen catheters are scarce. In the largest prospective randomized study comparing mechanical, thrombotic and infectious CR complications in DL vs. triple lumen HD and apheresis catheters, no significantly different risks were observed (9). Several studies comparing SL vs. DL/multilumen CV catheters in critically ill ICU patients also did not report any significantly different risks of CR infections between different catheter types (13–15).…”

mentioning

confidence: 96%

“…Several studies have reported a significantly higher risk of long‐term CR complications in HD and other central venous (CV) catheters inserted in critically ill ICU patients at femoral vs. jugular and subclavian sites (6–9). On the contrary, other studies did not observe any significantly different risks of CR infections between different catheter insertion sites (10–13).…”

mentioning

confidence: 99%

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Hemodialysis Catheters With Citrate Locking in Critically Ill Patients With Acute Kidney Injury Treated With Intermittent Online Hemofiltration or Hemodialysis

et al. 2009

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The purpose of the study was to compare the long-term catheter-related complications associated with temporary untunneled hemodialysis catheters, locked with citrate in the interdialysis period, inserted in critically ill patients with acute kidney injury, between different catheter insertion sites (femoral vs. jugular and subclavian) and catheter types (single-lumen [SL] vs. double-lumen [DL]). In a retrospective clinical study, the long-term catheter-related complications in 290 critically ill patients treated with intermittent high-volume online hemofiltration or hemodialysis between December 2004 and January 2008 were analyzed. Among 534 inserted catheters, 493 (92.3%) were femoral, 29 (5.4%) jugular, and 12 (2.3%) subclavian; 304 (56.9%) were SL and 230 (43.1%) were DL. There were 125 (20.3/1000 catheter days [c.d.]) thrombotic complications, while infectious complications were exceptionally rare, that is, only 13 (2.1/1000 c.d.), of which 10 (1.6/1000 c.d.) were possible catheter-related bloodstream infections and 3 (0.5/1000 c.d.) exit-site infections. The incidence rate of all thrombotic complications was significantly lower in all jugular and subclavian vs. all femoral catheters (7.7/1000 c.d. vs. 21.8/1000 c.d., P = 0.01), and in all SL vs. DL catheters (11.4/1000 c.d. vs. 32.2/1000 c.d., P < 0.001). The incidence rate of any possible catheter-related bloodstream and exit-site infections was not significantly different in all jugular and subclavian vs. all femoral catheters, neither in femoral SL vs. DL catheters. The major long-term catheter-related complications were thrombotic, and significantly more frequent in DL vs. SL catheters. Infectious complications were exceptionally rare, most probably due to the strict catheter care protocol, as well as the routine use of a citrate catheter lock and antibiotic ointment at the catheter exit-site.

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“…We did not observe any significantly different incidence rate of infectious CR complications between SL and DL catheters, which is in line with previous studies (9,13–15).…”

Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 96%

mentioning

confidence: 99%

See 1 more Smart Citation

Hemodialysis Catheters With Citrate Locking in Critically Ill Patients With Acute Kidney Injury Treated With Intermittent Online Hemofiltration or Hemodialysis

et al. 2009

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“…The purpose for third lumen is blood drawing and intravenous administration of drugs and fluid. In a multicenter, prospective study, blood flow rates and infectious complications were similar with double lumen catheter [49]. Infectious complications are the principal reason for catheter removal.…”

Section: Acute Hemodialysis Vascular Accessmentioning

confidence: 82%

Vascular Access for Hemodialysis

Pantelias¹,

Grapsa²

2011

Technical Problems in Patients on Hemodialysis

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“…Usual practice is for dialysis catheters to be reserved solely for renal support. However, a multicenter randomized trial of triple‐lumen CVCs used for either acute HD or apheresis showed no significant difference in CR‐BSI in comparison with standard, dual‐lumen devices (37). Use of these as upper body access may circumvent the problem of “crowding” of insertion sites and avoid the need for femoral placement, noted to carry a significantly higher risk of CR‐BSI in this trial.…”

Section: Prevention Of Dialysis Crimentioning

confidence: 99%

Microbial Control in Renal Support for Acute Kidney Injury

Luo¹,

Kanagasundaram²

2011

Seminars in Dialysis

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Renal support offers a lifeline for our patients with acute kidney injury but the decision to start it requires a careful evaluation of both its benefits and its risks. Among the latter must be included the threat from microorganisms. The hazards associated with vascular access are real, accepted but also reducible. We discuss the nature of the problem and measures that might reduce the risk. We also discuss a different potential hazard--that of bacterial contamination of the fluids used in our renal therapies. Although a well-established fact of chronic hemodialysis practice, its scale and relevance in acute renal support has only just started to be defined.

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A multicenter, prospective, randomized, comparative evaluation of dual- versus triple-lumen catheters for hemodialysis and apheresis in 485 patients

Cited by 18 publications

References 11 publications

Hemodialysis Catheters With Citrate Locking in Critically Ill Patients With Acute Kidney Injury Treated With Intermittent Online Hemofiltration or Hemodialysis

Hemodialysis Catheters With Citrate Locking in Critically Ill Patients With Acute Kidney Injury Treated With Intermittent Online Hemofiltration or Hemodialysis

Vascular Access for Hemodialysis

Microbial Control in Renal Support for Acute Kidney Injury

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