Practical Aspects of Nontunneled and Tunneled Hemodialysis Catheters

Clark, Edward G.; Kappel, Joanne; MacRae, Jennifer M.; Dipchand, Christine; Kiaii, Mercedeh; Moist, Louise; Oliver, Matthew J.; Miller, Lisa

doi:10.1177/2054358116669128

Cited by 41 publications

(35 citation statements)

References 64 publications

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“…Since the middle level of the right IJV was the largest location in this study and is the most preferred location when accessing the central vein via the IJV, the regression analysis was performed with the right IJV (middle level) [10]. Table 3 shows the results of univariate analysis for the factors associated with the right IJV (middle level) area divided into two groups according to the median area (190.8 mm 2 ).…”

Section: Resultsmentioning

confidence: 99%

Anatomical Morphology Analysis of Internal Jugular Veins and Factors Affecting Internal Jugular Vein Size

2020

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Background and objectives: There is a paucity of research on the shape of internal jugular vein (IJV) and their association with an individual’s morphology and various chronic diseases. Therefore, this study aimed to analyze the anatomy of the IJV across various patients and to relate the differences in anatomy to basic patient characteristics. Materials and Methods: This retrospective study included a total of 313 patients who underwent contrast-enhanced neck computed tomography between January 2017 and December 2018. The circumferences of the right and left IJVs were measured at three locations (hyoid bone, cricoid cartilage, and first thoracic vertebra) and parameters affecting the size of the IJV were analyzed. Results: The right IJV was significantly larger than the left IJV at each position (p < 0.001), and the area of the lumen was the largest at the cricoid cartilage level (p < 0.001). After dividing the right IJV data into two groups (above and below the median area), multivariate logistic regression analysis showed that age (odds ratio (OR) 1.040; 95% confidence interval (CI) 1.022–1.058, p < 0.001) and body mass index (BMI, OR 1.080; 95% CI 1.011–1.154, p = 0.0.23) affected size. Conclusions: The right IJV is larger than the left and has a rhomboid morphology. Age and BMI are significant factors affecting the IJV size.

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Section: Resultsmentioning

confidence: 99%

Anatomical Morphology Analysis of Internal Jugular Veins and Factors Affecting Internal Jugular Vein Size

2020

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“…A longer tunneled hemodialysis catheter (35 cm) reportedly causes more catheter-related problems than does a shorter catheter. 13 The short length of the tunneled hemodialysis catheter in this study may have also contributed to the improved primary patency rate and catheter-related problems in the right femoral vein. Another possibility is that the advice regarding catheter care provided by the medical staff and the performance of catheter care by the patients in this study might have also contributed to the improved catheter condition.…”

Section: Discussionmentioning

confidence: 84%

Availability of right femoral vein as a route for tunneled hemodialysis catheterization

Shindo

Takemae

Kubo

et al. 2018

MDER

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PurposeThis study was performed to investigate the primary patency rate and catheter-related problems associated with use of the femoral vein as a route for tunneled hemodialysis catheterization compared with those of the right internal jugular vein as the first-choice route in patients undergoing maintenance hemodialysis.Patients and methodsTwenty-two patients underwent placement of indwelling tunneled hemodialysis catheters in the right internal jugular vein as the first option for maintenance hemodialysis, and 20 patients underwent placement in the right femoral vein as the second option. The primary patency rate of the catheters and catheter-related problems at 1, 3, 6, and 12 months after placement were investigated.ResultsThe 1-, 3-, 6-, and 12-month primary patency rates of the tunneled hemodialysis catheters in the right internal jugular vein were 95.5%, 95.5%, 81.3%, and 58.3%. The primary patency rates of the catheters in the right femoral vein were 95.0%, 89.5%, 86.7%, and 66.7%. There were no statistically significant differences in the primary patency rates at 1, 3, 6, and 12 months or in catheter-related problems between the right internal jugular vein and right femoral vein.ConclusionThe primary patency rate and catheter-related problems of indwelling tunneled hemodialysis catheters placed in the right femoral vein were not different from those in the right internal jugular vein in patients undergoing maintenance hemodialysis. These results suggest that the right femoral vein might be a useful option for placement of indwelling tunneled hemodialysis catheters in patients undergoing maintenance hemodialysis.

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“…6 An AV fistula is the preferred permanent procedure for patients of renal failure who have to undergo dialysis frequently8 but a tunneled or non-tunneled catheter must be placed during the time the AV fistula is made and is ready for use or for patients who's condition is contraindicated for an AV fistula. 9,10 A Non-Tunneled double lumen hemodialysis catheter is kept outside the skin and inserted exactly at the point where it enters the vein under consideration, the catheter is not passed through a pathway under the skin as done in tunneled. Due to its efficiency Nephrologist in Canada have been using the Non tunneled catheter technique.11In patients of Acute Kidney Injury (AKI) non tunneled catheters are opted for immediate access to the vasculature.12It is an easier approach to providing medications and performing hemodialysis in emergency situations but it is not the type which is recommended due to increased number of complications it has caused therefore long term use of non-tunneled double lumen catheter is discouraged.…”

Section: Discussionmentioning

confidence: 99%

Cost effectiveness of tunneled double lumen to non-tunnel double lumen dialysis catheters.

Tahir¹,

Afzal

Khan³

et al. 2019

TPMJ

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ABSTRACT… Objectives: To ascertain the cost-effectiveness of tunneled catheters to nontunneled catheter in dialysis patients of a tertiary care hospital. Study Design: Retrospective cross-sectional study. Study Design: Department of Nephrology, Pak Emirates Military Hospital Rawalpindi. Period: Jan 2016 to Jan 2019. Material & Methods: The sample population comprised of 500 patients, being divided into two groups and followed over a period of 03 yrs. Group A had tunneled double lumen and group B had non tunneled double lumen. Dialysis was started on the same day in both groups. Both groups were compared in terms of cost effectiveness. Cost effectiveness included price of catheter, procedure cost, treatment of infection (if any), and change of catheter in case of catheter malfunction. The amount spent on each patient was added and then an average was calculated. Results: Out of 600 patients, 300 were in group A and 300 patients were in group B. The two groups were analogous in gender (male: 52.8% vs 57.8%, p=0.35)age (41 years vs 49 yrs, p=0.71) hypertension and diabetes as the main causes of ESRD (51% vs 39%, p=0.08 and 32% vs 34%, p=0.38, respectively). Total incurred cost of tunneled double lumen was Rs.19000.00, with average infection free patency time being three months during which Arteriovenous fistula formed. In comparison, non-tunneled double lumen in 300 patients, average cost incurred was Rs.30000.00 including cost incurred on treating sepsis and in two -three insertions in few cases . There was no procedure related mortality. Conclusion: The cost-effectiveness of Tunneled double lumen catheters and clinical benefit of reduction in patency failures and also access related infections make them the first choice for dialysis patients in majority of dialysis centers of our country but large randomized control trials needed as the sample size quite less to detect a difference from the newer agents.Article Citation: Tahir T, Afzal M, Khan MNA, Raja KM, Wahaj, Batool. Cost effectiveness of tunneled double lumen to non-tunnel double lumen dialysis catheters. Figure-I. Cost of tunneled vs non-tunneled cathetersProfessional Med J 2019;26(12):2192-2195. www.theprofesional.com NON-TUNNEL DOUBLE LUMEN DIALYSIS CATHETERS 2195 4 4 CONCLUSION Tunneled double lumen insertion in renal failure patients is not only safe with lower infection rate but also is cost effective for the patient in comparison to non-tunneled double lumen catheters. Copyright© 25 Oct, 2019.

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Practical Aspects of Nontunneled and Tunneled Hemodialysis Catheters

Cited by 41 publications

References 64 publications

Anatomical Morphology Analysis of Internal Jugular Veins and Factors Affecting Internal Jugular Vein Size

Anatomical Morphology Analysis of Internal Jugular Veins and Factors Affecting Internal Jugular Vein Size

Availability of right femoral vein as a route for tunneled hemodialysis catheterization

Cost effectiveness of tunneled double lumen to non-tunnel double lumen dialysis catheters.

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