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      Morbidity and Mortality of Central Venous Catheter Hemodialysis: A Review of 10 Years’ Experience

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          Abstract

          The morbidity and mortality of hemodialysis by internal central venous catheterization in the subclavian and internal jugular positions are reviewed. A follow-up study was performed in our unit over 10 years (786 catheterizations). The most frequent complications were inadequate flow (7.6%) inadvertent withdrawal (5.6%) and bacteremia (5.1%). The overall complication rate was 27.2%. Kinking (p < 0.001), bleeding (p < 0.0l) and bacteremia (p < 0.05) occurred more frequently in patients with chronic renal failure, compared to patients with acute renal failure. Inadvertent withdrawal was the only complication observed more frequently in the internal jugular than in the subclavian position (10.8 vs. 4.3%; p < 0.0l). Bacteremia occurred more frequently after prolonged periods of catheterization ( > 10 days). No fatal complications were observed. To obtain a more accurate idea about mortality, two supplementary large groups were studied: a review of 11 published series (1,542 catheterizations) and a questionnaire-based survey of 16 dialysis centers (approximately 4,000 catheterizations). Six fatalities were registered: 1 due to septicemia (in the literature review) and 3 due to traumatic perforation of the cardiac or the vessel wall, 1 to septicemia and 1 to air embolism (in the questionnaire-based survey). Based on the three different groups studied, the mortality of catheter dialysis could be estimated to be between 0 and 1.25/1,000 catheterizations.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1987
          1987
          05 December 2008
          : 47
          : 4
          : 274-279
          Affiliations
          aRenal Division, Department of Medicine, University Hospital, Gent, Belgium; bDepartment of Medicine, University of Newcastle upon Tyne, UK
          Article
          184523 Nephron 1987;47:274–279
          10.1159/000184523
          3696329
          © 1987 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 6
          Categories
          Original Paper

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