Temporary Access Catheter for Hemodialysis Complications and Follow up

Abstract

Objective:  To determine the acute and chronic complications of temporary access catheter insertion for hemodialysis.

Design; Cross-sectional study.

Place and duration of the study: This was a hospital based study carried out in the hemodialysis unit of Shalamar Hospital, Lahore. This study was conducted from June 2003 to December 2005.

Subjects and Methods: All patients who presented for hemodialysis were included in the study and   who were not fit were excluded from the study. Location of the catheters was subclavian vein, internal jugular and femoral vein. Acute complications were noted at the time of insertion of catheter. Patients were followed up for three months for long term complications. A blood sample was drawn for routine hematological and biochemical work up on presentation.

Results: A total of 177 patients were enrolled in the study who presented for hemodialysis. 227 temporary double lumen dialysis catheters were passed in these patients. Most common cause of catheter insertion was diabetic nephropathy followed by chronic glomerulonephritis. Acute complications were at the rate of arterial puncture 9 (4%), hematoma 1 (0.4%) and pneumothorax 1 (0.4%). Complications during hemodialysis were, fever at the rate of 19 (8.4%), hypotension 7 (3.1%), blood flow problem6 (2.6%) and miscellaneous 3 (1.2%). Mean duration of catheter insertion was 5 weeks and dialysis sessions were 9.5. Among late complications infection were at the rate of 27 (11.9 %), vascular stenosis 5 (2.2%) and thrombosis 3 (1.3%).

Conclusion: Complications at the time of catheter insertion are minimal even it is done blindly. Infections are most common late complication and complication during dialysis. Temporary access catheter insertion is very simple and free of life threatening complications .It is readily used on emergency basis when there is no permanent access for dialysis.

Key Words: Temporary access catheter, hemodialysis, complications.