CE: Continuing Education Article
VASCULAR ACCESS MANAGEMENT III: CENTRAL VENOUS CATHETERS

Abstract

This third article, the final part of a Continuing Education (CE) series on Vascular Access Management for patients with end stage renal disease (ESRD), focuses on central venous catheters. CVCs are considered the last choice in vascular access due to the numerous complications associated with their use. This CE article explores the incidence and prevalence of central venous catheters within the context of international guidelines, type and design of central venous catheters, insertion procedure, strategies for preventing infection and complications associated with their use.

Catheter-related complications and survival among incident hemodialysis patients in Singapore

“…Regardless of catheter type, central vascular catheters are associated with a greater risk of infection, thrombosis, need for rescue procedures, and increased mortality and hospitalization rates compared to AVFs. 3 In hemodialysis patients, catheters are responsible for almost half of all infections. 4 These catheter-related bloodstream infections (CRBSIs) are the most common cause of morbidity, the second most common cause of death, 5 and a major cause of catheter loss as well as metastatic infections.…”

Hemodialysis Catheter-related Infection: Prophylaxis, Diagnosis and Treatment

“…The prevalence of end-stage renal disease (ESRD) patients requiring renal replacement therapy (RRT) has increased in the last decade and it is expected that this increase will continue over the next 10 years. Hemodialysis (HD), the main modality of RRT (1, 2), depends on long-term and effective vascular access. Based on these characteristics, the vascular access of choice is the arteriovenous fistula (AVF), which should be used by at least 65% of the patients in a HD setting (3).…”

Hemodialysis Catheter-related Infections: Incidence, Microbiology and Outcome 5 years of Dubai Hospital Experience

“…Hemodialysis vascular catheters could be temporary, inserted mostly in the internal jugular or femoral vein and last for 2 weeks or tunnel cuffed catheters left for few months. Nevertheless, vascular catheters are associated with an increased risk of infection, thrombosis, need for rescue procedure, and increased hospitalization and mortality than AVF [7]. Catheters are responsible for half of the infections in hemodialysis patients, and Catheter-related bloodstream infections (CRBSIs) are the second most common cause of death, also a major cause of catheter loss and metastatic infection in hemodialysis population [8]- [10].…”