Initial and Extended Use of Femoral Versus Nonfemoral Double-Lumen Vascular Catheters and Catheter-Related Infection During Continuous Renal Replacement Therapy

Chua, Horng-Ruey; Schneider, Antoine; Sherry, Norelle L; Lotfy, Nadiah; Chan, Matthew J.; Galtieri, Jonathan; Wong, G.; Lipcsey, Miklós; Matte, Cauê de Araujo; Collins, Allison; García-Alvarez, Mercedes; Bellomo, Rinaldo

doi:10.1053/j.ajkd.2014.04.022

Cited by 25 publications

(20 citation statements)

References 26 publications

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“…A higher rate of placement failures and hematoma has been reported in jugular compared to femoral veins when using the landmark technique for HDC placement [18]. Rates of HDC-related colonization and CRBSI range from 9 to 28/1000 catheter-days [18][19][20] and 1-3/1000 catheter-days, respectively. While there is no difference of CRBSI between the femoral and the jugular insertion site, HDC colonization is reported to be higher at the femoral site in obese patients [18,19].…”

Section: Hemodialysis Cathetersmentioning

confidence: 99%

A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill

et al. 2018

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Intravascular catheters are inserted into almost all critically ill patients. This review provides up-to-date insight into available knowledge on epidemiology and diagnosis of complications of central vein and arterial catheters in ICU. It discusses the optimal therapy of catheter-related infections and thrombosis. Prevention of complications is a multidisciplinary task that combines both improvement of the process of care and introduction of new technologies. We emphasize the main component of the prevention strategies that should be used in critical care and propose areas of future investigation in this field.

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Section: Hemodialysis Cathetersmentioning

confidence: 99%

A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill

et al. 2018

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“…Furthermore, the increased catheter-related infections risk in heavier patients (>90 kg) with femoral dialysis catheters was recently confirmed in an observational study involving 458 patients [18] . It is therefore not surprising that RENAL study patients receiving right or left femoral catheterization [19] had a lower body weight than patients receiving non-femoral catheterization.…”

Section: Relationship To Previous Studiesmentioning

confidence: 84%

Femoral Access and Delivery of Continuous Renal Replacement Therapy Dose

Bellomo

Mårtensson

et al. 2015

Blood Purif

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Aims: The study aims to describe the use of dialysis catheters in critically ill patients treated with continuous renal replacement therapy (CRRT) and to study the impact of femoral versus non-femoral access on CRRT dose. Methods: Statistical analysis and predictive modelling of data from the Randomized Evaluation of Normal vs. Augmented Level renal replacement therapy trial. Results: The femoral vein was the first access site in 937 (67%) of 1,399 patients. These patients had higher Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores (p = 0.009) and lower pH (p < 0.001) but similar mortality to patients with non-femoral access (44 vs. 45%; p = 0.63). Lower body weight was independently associated with femoral access placement (OR 0.97, 95% CI 0.96-0.98). Femoral access was associated with a 1.03% lower CRRT dose (p = 0.05), but a 4.20% higher dose was achieved with 13.5 Fr catheters (p = 0.03). Conclusions: Femoral access was preferred in lighter and sicker patients. Catheter gauge had greater impact than catheter site in CRRT dose delivery. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=439581.

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“…Catheter‐related infection rate has been addressed in multiple studies but with inconsistent results. Chua et al showed an infection rate of 19 per 1000 catheter days , while that of Parienti's study showed 38.5 per 1000 catheter days . Moreover, a meta‐analysis conducted by Marik et al showed a significantly higher rate in the internal jugular vein than the femoral vein .…”

Section: Discussionmentioning

confidence: 94%

“…Parienti et al analyzed catheter malfunction with catheterization site and discovered lower occurrence in the femoral than the internal jugular veins, and subgroup analysis revealed the frequency in such ascending order: right internal jugular vein < femoral veins < left internal jugular vein (7). On the other hand, Chua et al discovered that femoral vein malfunction rate occurs substantially more frequently than internal jugular veins (9). Our study showed that malfunction rate of femoral vein at first catheterization was markedly higher than internal jugular vein, and the latter was featured with a significant right laterality.…”

Section: Discussionmentioning

confidence: 99%

Vascular Access in Patients Treated with Continuous Renal Replacement Therapy: A Report from a Single Center in China

Ren

et al. 2019

Ther Apher Dial

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Our aim was to analyze the practice pattern of vascular access use and complication rates in patients receiving continuous renal replacement therapy from a large Chinese urban medical center. Patients who had received continuous renal replacement therapy (CRRT) from April to October 2014 in our center were included in this study. Demographic data, primary disease, department for hospitalization, blood pressure, heart rate, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE II) score, presence of mechanical ventilation, CRRT modalities, choice of functioning vascular access, site and duration of catheter insertion, presence of recatheterization, cumulative catheter indwelling time, catheter malfunction and catheter‐related infections, as well as laboratory test results, were collected. A total of 292 patients were enrolled in our study, including 175 males (59.9%) and 117 females (40.1%), aged 50.8 ± 18.6 years (range, 12 to 94 years). Acute kidney injury, multiple organ dysfunction syndrome, and systemic inflammatory response syndrome were the main indications for treatment with CRRT. Initial vascular access was non‐cuffed temporary catheters in 280 patients and was preferentially obtained in the right internal jugular vein (54.3%). There were 32 (11.4%) patients requiring re‐catheterization. Catheter malfunction occurred in 7.14% of all patients, and the median time of catheter malfunction was found at the 5th day. By multivariate analysis, it was found that the main risk factors of catheter malfunction were cumulative treatment time of CRRT and the level of hemoglobin. The average time of catheter‐related infections was 10.7 days after insertion and the catheter‐related infections occurred at a rate of 7.19 per 1000 catheter days. The main risk factors for catheter‐related infections were cumulative time of catheterization and the level of serum albumin. In this cohort of critically ill patients, the main risk factors for catheter malfunction were cumulative CRRT time and the level of hemoglobin. In addition, the main risk factors for catheter‐related infections were cumulative time of catheterization and the level of serum albumin.

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Initial and Extended Use of Femoral Versus Nonfemoral Double-Lumen Vascular Catheters and Catheter-Related Infection During Continuous Renal Replacement Therapy

Cited by 25 publications

References 26 publications

A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill

A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill

Femoral Access and Delivery of Continuous Renal Replacement Therapy Dose

Vascular Access in Patients Treated with Continuous Renal Replacement Therapy: A Report from a Single Center in China

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