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Acta Medica Medianae |
CENTRAL VENOUS CATHETER AS A VASCULAR APPROACH TO HEMODIALVSTS
Miroslav RADIŠIĆ, Joksim JOVIČIĆ and Verica ĐORĐEVIĆ
Service for Nephroloev and Hemodialysis of the General Hospital "Stef ari visoki" in Smederevska Palanka
The application of the central venous catheter (CVC) as a temporary or permanent vascular approach to hemodialysis has been practiced in our Center since 1994. So far 30 (12,6%) patients have been thus treated. The primary application has been done in 25 patients, namely: the first making of the AV fistula has been done in 16, the ABT in 6, while the vascular approach correction in 3 patients. The secondary application has been done in 5 patients. The infection episode incidence concerning the CVC appolication is 20 infections per 1.000 patients. This is the upper limit according to the data given in the literature (5, rang 3-20). The average duration of the catheter is 21 + - 13 days (rang 1-47). Two-volume catheters have been used for a jugular approach though less often for a femoral one. The unsuccessful placing due to the catheter thrombosis has occurred in 4 patients, the catheter drop-out and its replacing have been done in 2 patients, while no replacement has happened in one čaše. The treatment has been stopped in one patient. In four patients the cerebrovascular insult has happened after placing the CVC. The mortality rate is 26,6%, that is, 8 patients, namely: 4 due to cerebrovascular insult, one due to lung emboly, one due to heart weakness and one due to the sepsis from the V fistula. One patient died at home for unknown reason. A high infection episode incidence rate is related to inadequate patients' placing so that their location in the rooms for intensive care is a way of reducing it. It is necessary to provide for general aseptic procedure at work as well as for betterment of the accompanying procedures (hemoculture, antibiograms, sterilization) in order to maintain a safe catheter function.
Key words: central venous catheter, hemodialysis, results |