			Home About us Contact

Hemodialysis Catheters (hemodialysis + catheter)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Extracorporeal photopheresis with permanent subcutaneous right atrial catheters

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 12 2007
Hartmut Ständer
Summary Background: Adequate peripheral venous access is crucial for successful extracorporeal photopheresis (ECP). As this approach is not always feasible in older patients and patients with graft-versus-host disease, central venous catheters play an increasing role in providing long-term vascular access for ECP.However, not all catheters are able to deliver the minimum flow rate of 7 ml/min for ECP. Patients and Methods: Eight different permanent subcutaneous right atrial catheters were connected in vitro to the UVAR® -XTSÔ photopheresis system and median flow rates were determined. In addition, in vivo flow rates of patients who received ECP, using either peripheral or central venous access, were determined. Results: Hemodialysis catheters with an internal diameter of 2.0 or 1.5 × 3.5 mm and a length up to 48 cm provided in vitro flow rates of 27,28 ml/min, almost identical to a peripheral access needle. Central venous catheters with a length of over 90 cm reached flow rates below 7 ml/min and are impractical for ECP. The analysis of 308 ECP collection cycles with peripheral vascular access revealed an average flow rate of 31.5 ± 6.4 ml/min. Only permanent subcutaneous right atrial catheters made for hemodialysis provided similar flow rates (Quinton PermCath Dual Lumen) (33.7 ± 4.7 ml/min, n = 198). Conclusions: Permanent subcutaneous hemodialysis catheters with a length of maximally 48 cm achieve optimal flow rates for ECP. They represent therefore the central venous access of choice in patients with inadequate peripheral vascular access. [source]

Determinants of C-reactive protein in chronic hemodialysis patients: Relevance of dialysis catheter utilization

HEMODIALYSIS INTERNATIONAL, Issue 2 2008
Adriana HUNG
Abstract Biomarkers of inflammation, especially C-reactive protein (CRP), have been consistently shown to predict poor outcomes in chronic hemodialysis (CHD) patients. However, the determinants of CRP and the value of its monitoring in CHD patients have not been well defined. We conducted a retrospective cohort study to evaluate possible determinants of the inflammatory response in CHD patients with a focus on dialysis catheter utilization. Monthly CRP were measured in 128 prevalent CHD patients (mean age 56.6 years [range 19,90], 68% African Americans, 39% diabetics [DM]) over a mean follow-up of 12 months (range 2,26 months). There were a total of 2405 CRP measurements (median 5.7 mg/L; interquartile range [IQR] 2.4,16.6 mg/L). The presence of a dialysis catheter (p<0.002), cardiovascular disease (p=0.01), male gender (p=0.005), higher white blood cell count (p<0.0001), elevated phosphorus (p=0.03), and lower cholesterol (p=0.02) and albumin (p<0.0001) concentrations were independent predictors of elevated CRP in the multivariate analysis. Additionally, CRP levels were significantly associated with the presence of a catheter, when comparing the levels before and after catheter insertion (p=0.002) as well as before and after catheter removal (p=0.009). Our results indicate that the presence of a hemodialysis catheter is an independent determinant of an exaggerated inflammatory response in CHD patients representing a potentially modifiable risk factor. [source]

Inserting tunnelled hemodialysis catheters using elective guidewire exchange from nontunnelled catheters: Is there a greater risk of infection when compared with new-site replacement?

HEMODIALYSIS INTERNATIONAL, Issue 1 2008
Jonathan CASEY
Abstract The objective is to evaluate bacteremia outcomes and survival rates when using guidewire exchange to place tunnelled hemodialysis catheter (THDC) compared with a new-site replacement. Retrospectively, all patients were identified who received a THDC between January 1, 2000 and January 1, 2007. Any THDC having received antibiotic line locks or tunnel-to-tunnel exchange were excluded. This left 408 THDC placed in 329 patients: 46 guidewire exchange, 362 new-site replacement. Bacteremia rate from the new-site insertion group was 3.0 per 1000 catheter days, the guidewire exchange group demonstrated a rate of 2.8 per 1000 catheter days. Local infection rates did not differ between the groups at 1.2 per 1000 catheters days. The actuarial catheter survival rates using Kaplan-Meier survival analysis demonstrated no difference between the 2 groups. The placing of tunnelled cuffed hemodialysis catheters to replace temporary catheters using a guidewire exchange did not contribute to further episodes of sepsis and has the advantage of preserving venous access and minimizing invasive procedures for the patient. [source]

Antibiotic lock: In vitro stability of gentamicin and sodium citrate stored in dialysis catheters at 37 °C

HEMODIALYSIS INTERNATIONAL, Issue 3 2010
Marisa BATTISTELLA
Abstract Catheter-related bacteremia (CRB) is a major cause of morbidity and mortality especially among patients receiving hemodialysis. Antibiotic lock therapy represents a promising technique in the treatment of CRB. Several studies have evaluated antibiotics in combination with heparin as an interdialytic locking solution for prophylaxis of CRB. The objective of this study was to evaluate the stability of gentamicin and sodium citrate in hemodialysis catheters as an interdialytic lock. Solutions containing gentamicin 2.5 mg/mL and sodium citrate 40 mg/mL (4%) were prepared individually and in combination. The solutions were instilled into dialysis catheters and stored at 37 °C for 96 h. Samples were withdrawn randomly from catheter lumens at 24-hour intervals for 4 days and stored at ,20 °C until analysis. The samples were analyzed with validated, stability-indicating HPLC assays. The luminal concentration of gentamicin 2.5 mg/mL, sodium citrate 40 mg/mL (4%), and the combination was determined on study days 0, 1, 2, 3, and 4. When gentamicin was combined with sodium citrate and stored at 37 °C in dialysis catheters, the solution showed no decrease in either the gentamicin or the sodium citrate concentrations over the 96-hour study period. The percent of the original concentration at 96 h was 102.4±1.03 for gentamicin and 102.9±1.25 for citrate (P=0.5556). The combination of gentamicin 2.5 mg/mL and sodium citrate 40 mg/mL (4%) can be retained in hemodialysis catheters for at least 96 h at 37 °C with no evidence of degradation. [source]

Inserting tunnelled hemodialysis catheters using elective guidewire exchange from nontunnelled catheters: Is there a greater risk of infection when compared with new-site replacement?

Comparison of side hole versus non side hole high flow hemodialysis catheters

HEMODIALYSIS INTERNATIONAL, Issue 1 2006
Michael G. TAL
Abstract Current literature suggests that side holes may be detrimental to dialysis catheter performance. Today, these catheters are primarily available with side holes. The purpose of this study was to compare flow rates, infection rate, and survival of side hole vs. non side hole hemodialysis catheters. Over a 16-month period patients were arbitrarily assigned to either a 14.5 F MAHURKAR® MAXIDÔ cuffed dual lumen tunneled catheter with side holes or a 14.5 F MAHURKAR MAXID cuffed dual lumen tunneled catheter without side holes ("non side hole catheters"). We performed a retrospective analysis of catheter flow rates, patency, catheter survival, and catheter-related infections. Information was gathered for the life of the catheter or up to 28 weeks. A total of 54 patients were enrolled in the study. Thirty-seven of 54 (68%) patients received a catheter with side holes for a total of 3,930 catheter days and 17/54 (32%) received a similar catheter without side holes for a total of 2,188 catheter days. Catheter infection necessitating removal of the catheter occurred in 10/37 catheters with side holes and 1/17 without side holes. Infection rates per 1,000 catheter days were 2.545 with side holes and 0.254 without side holes (p<0.001). Slightly improved catheter survival (p<0.05) was recorded with the non side hole catheters. No insertion complication (e.g., air embolization, bleeding, or kinking) occurred with either catheter. One catheter without side holes had to be repositioned 5 days after insertion because of poor flows. No significant difference was recorded in mean blood flow rates between the catheters. Results indicate reduced catheter infection rate in hemodialysis patients with the use of non side hole dual lumen tunneled cuffed catheters. [source]

Extracorporeal photopheresis with permanent subcutaneous right atrial catheters

Percutaneous Permanent Pacemaker Implantation Via The Azygous Vein In A Patient With Superior Vena Cava Occlusion

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2008
M.R.C.P., RAVINDU HASMUKH KAMDAR B.Sc. (Hons)
Occlusion of the superior vena cava (SVCO) makes implantation of permanent pacemakers challenging and difficult. We describe an extended application of a Medtronic Attain (Medtronic Inc., Minneapolis, MN, USA) guide catheter (a tool designed for delivery of left ventricular pacing leads into the coronary sinus) for delivery of a right ventricular pacing lead via the azygous vein in a 72-year-old woman with SVCO secondary to long-term central venous hemodialysis catheters. This approach allowed the use of an endocardial pacing lead, implantation under local anesthesia, and conventional positioning of the pacemaker generator in the pectoral region in a patient with SVCO. [source]

Large Bore Catheters with Surface Treatments versus Untreated Catheters for Vascular Access in Hemodialysis

ARTIFICIAL ORGANS, Issue 7 2004
Rolf Bambauer
Abstract:, Infection, thrombosis, and stenosis are among the most frequent complications associated with blood-contacting catheters. Complications resulting from infection remain a major problem for hemodialysis catheters, with significant numbers of catheters being removed due to catheter-related sepsis. Numerous strategies have been employed to reduce the occurrence of infection and im-prove long-term outcomes, with varying degrees of success. The most important is the careful and sterile handling by the attending staff of the catheters during hemodialysis treatments to minimize or stop a microbial colonization of the skin and the catheter. Another approach is coating the external surface of the catheters with substances which are antibacterial like silver and/or substances with low thrombogenicity like silicone. This investigation reviews results of animal and clinical experiments conducted to assess the efficacy and biocompatibility of silver and silicone coated dialysis catheters. It is concluded that silver coatings can reduce bacterial colonization and occurrence of infection associated with these devices. The catheters employing ion implantation of silicone rubber showed low thrombogenicity. Results of the studies indicate that ion beam based processes can be used to improve thrombus and infection resistance of blood contacting catheters. A new development is the microdomain structured surface (PUR-SMA coated catheters). Preliminary results with these catheters are very encouraging. [source]