Survival and complications of cuffed catheters in children on chronic hemodialysis

• Published in: Pediatric nephrology (Berlin, West) West), 1999-04, Vol.13 (3), p.245-248
• Main Authors: SHARMA, A, ZILLERUELO, G, ABITBOL, C, MONTANE, B, STRAUSS, J
• Format: Article
• Language: English
• Subjects: Adolescent; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Bacterial Infections - epidemiology; Bacterial Infections - etiology; Biological and medical sciences; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - instrumentation; Emergency and intensive care: renal failure. Dialysis management; Evaluation Studies as Topic; Female; Humans; Incidence; Intensive care medicine; Male; Medical sciences; Prospective Studies; Renal Dialysis - instrumentation; Thrombosis - epidemiology; Thrombosis - etiology; Time; Treatment Outcome
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s004670050602

Central venous catheters are being increasingly used as hemodialysis vascular access. We evaluated catheter survival, outcome predictors, and complications in a total of 36 catheters used in 13 children and young adults undergoing chronic maintenance hemodialysis through catheter for a duration of 10.4+/-5.6 months. Reasons for catheter failure were: thrombosis 12 of 36 (33%), infection 6 of 36 (17%), and extrusion 2 of 36 (5.4%). Catheters were lost to infection and thrombosis at 1.1 and 2.2 episodes per 1,000 catheter days, respectively. Symptomatic infections, Gram-negative and polymicrobial sepsis increased the risk of catheter failure. Most of the thrombotic episodes occurred in patients with inherent thrombotic tendency. The survival of the 36 catheters was 62% at 1 year. The survival of 13 randomly chosen catheters, 1 from each patient, was 85% at 1 year. The time from insertion to first complication correlated significantly with the outcome (P