P1369ACUTE EXTRACORPOREAL DIALYSIS USING TWO-WAY PICC POWER INJECTABLE IN YOUNG CHILDREN

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2020-06, Vol.35 (Supplement_3)
• Main Authors: Annicchiarico Petruzzelli, Luigi, Serio, Vittorio, Luongo, Ilaria, Molino, Daniela, Minale, Bruno, Lepore, Lorenza, Ascione, Serena, Lubrano, Carmen, Malgieri, Gabriele, Pecoraro, Carmine
• Format: Article
• Language: English
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfaa142.P1369

Abstract Background and Aims Acute extracorporeal dialysis is a short treatment, performed by a central venous catheter of large size, ensuring high flow. These devices have limitations: high caliber, excessive length, impossibility of tunneling and exit-site location in the supraclavicular region, with a subsequent high risk of dislocation and contamination. The authors report a new approach to dialytic central venous catheters selection in children. Method From January 2013 to December 2017, 16 children weighing less than 15 kg needed acute extracorporeal dialysis. Patients received an ultrasound guided percutaneous implantation of a two-way PICC power injectable catheter, in the right internal jugular vein or in the anonymous right vein. The device size always respected the ratio of 1/3; the catheters were cut to be adapted to child height, and subclavear tunnelizations and stabilizations were ensured. The hemodialysis was performed with the Prismaflex Gambro system. The effectiveness of treatment was evaluated by recirculation test and by measuring the KT/Vat the third hour, expressing the dialysis adequacy. Results Two-way power injectable central venous catheter,sized from 5 to 7 Fr and long from 8 to 15 cm were used. The recorded blood flow ranged from 4.7ml/min/kg to 7ml/min/kg; a KT/V variable from 0.5 to 1 was detected; the recycling rate was between 32% and 40%. No catheter related complications were observed. Conclusion In children weighing less than 15 kg, PICC power injectable have lower blood flow and higher recirculation rate compared to traditional dialysis catheters. However, the dialytic adequacy was suitable for an acute hemodialysis treatment. In addition, these catheters are available in a wide range of calibers and result more adaptable to the venous system of younger children. Figure: