Retrospective Study Of The Temporary Central Venous Catheter-Related Complications In The Hemodialysis Patients

Background:A variety of central venous catheters were more and more widely used in dialysis treatment over the past 20 years.The use of catheters as vascular access in acute and chronic renal failure has been increasingly accepted by doctors and patients.But the extensive use of central venous catheters will inevitably increase the risk of various complications,such as infection,catheter dysfunction,deep venous obstruction et al, which is not only a threat to the dialysis patient's quality of life and safety,but also a waste of enormous health care resources.Although there are many research on this field,the standard treatment have not developed in the nationwide.Objectives:To investigated the risk factors,prevalence and characteristics of catheter-related complications in hemodialisis patients with internal venous indwelling catheter, through a retrospective study.Materials and methods:A total of 261 cases on hemodialysis patients with indwelling short-term catheter from January in 2002 to July in 2008 were enrolled in this study about Guangzhou Red Cross Hospital.①We recorded the incidence rate of various complications,such as infections,catheters dysfunctions,center venous obstruction,et al,in the hemodialysis period about the hospitalized patients,then investigated the risk factors,prevalence and characteristics of catheter-related complications in hemodialisis patients with internal venous indwelling catheter.②Recorded and analyzed the diagnosis and treatment measure of complications.Results:1.Two hundred and sixty-one hemodialysis patients(median age:64.14±16.68 years) were included in this study.A total of 312 catheters were inserted,201 being subclavian(SCV) catheters,68 being femoral venous(FV) catheters, 43 being internal jugular venous(IJV) catheters.These average duration of use (SCV,FV,IJV) were(18.13±16.45),(15.68±19.81),(16.81±11.84), respectively.And the cases about hemodialysis catheter-related infections(HCRI), catheter dysfunction(CD),superior vena cava syndrome(SVCS) were 40 cases,49 cases and 13 cases,respectively.The prevalence of HCRI,CD,SVCS were 7.36/1000 catheter days,15.7%,5.3%.2.HCRI were related to the location,duration,age,diabetes of the hemodialysis patients with internal venous indwelling catheter.The prevalence of HCRI in which location of central venous catheterization were 4.94/1000 catheter days (SVC),14.07/1000 catheter days(FV),9.68/1000 catheter days(IJV), respectively.The prevalence of HCRI showed significant differences;The prevalence of HCRI in which duration of central venous catheterization less than 2 weeks was 7.5%,more than two weeks being 17.4%.The prevalence of HCRI showed significant differences between both of them.And the positive becteria of germiculture were methicillin-resistant staphylococcus aureus(60%), enterococcus faecom(20%),sphingomonas paucimobilis(20%).3.CD was related to the duration of central venous catheterization.The prevalence of CD in which duration of central venous catheterization less than 2 weeks was 11.2%,more than two weeks being 19.3%.The prevalence of CD showed significant differences between both of them.But CD wasn't related to the location of the catheter indwelled.4.For SVCS,the patient with subclavian(SCV) catheters,internal jugular venous(IJV) catheters is 11(5.5%),2(4.7%) respectively.The prevalence of SVCS showed no significant differences between both of them.Conclusions:1.The prevalence of HCRI was associated with significant risk factors,such as the site and duration of central venous catheterization,age,diabetes.It was low in subclavian catheters,whereas high in femoral venous catheters.What more it occurred with an increase in the risk of patients who have left catheters in place for more than two weeks.2.The duration of central venous catheterization was the risk factors of CD.The CD prevalence of patients who had been indwelled catheter for more than two weeks had an obvious growth.While the location of central venous catheterization wasn't associated with the CD prevalence.3.The location of central venous catheterization wasn't obviously related to the prevalence.4.The subclavian vena could be used to indwell the central venous catheters for hemodialysis.