Use of a Dual-lumen Catheter with a Dacron Cuff as a Long-term Vascular Access for Hemodialysis in a Patient with Chronic Renal Failure: Influence on the Efficiency of Hemodialysis and Hemodynamics.
10.2185/jjrm.47.61
- VernacularTitle:Ｂｌｏｏｄ ａｃｃｅｓｓ作製困難な維持透析患者に対する長期留置用ｄｕａｌ‐ｌｕｍｅｎ ｃａｔｈｅｔｅｒの一使用経験例 その透析効率及び循環動態に及ぼす影響
- Author:
Gen KURAMOCHI
;
Shinji IGARASHI
;
Shin HASEGAWA
;
Isao KOBAYASHI
- Publication Type:Journal Article
- Keywords:
blood access trouble
- From:Journal of the Japanese Association of Rural Medicine
1998;47(1):61-66
- CountryJapan
- Language:Japanese
-
Abstract:
This report presents our experience in using a dual-lumen catheter with a Dacron cuff as longterm vascular access for homodialysis in an elderly patient. The female patient who at first treated with continuous ambulatory peritoneal dialysis for chronic renal failure, but the treatment could not be continued because she developed inveterate peritonitis. Thereafter, hemodialysis was performed. However, a lot of blood access troubles occurred and consequently peripheral access was exhausted. Therefore, we placed the catheter into a right internal jugular vein. This procedure made it possible to secure enough and stable blood flow during the hemodialysis session. Thus, the clearence ratios of blood urea nitrogen and serum creatinine and the value of KT/V increased. No complications have been observed since then. We further examined whether the placement of the catheter would affect hemodynamics in brain and upper extremities, using transcranial Doppler ultrasound and plethysmography. No remarkable difference in blood flow between right and left ophthalmic arteries and decrease in arterial blood flow of right finger tips were observed. Furthermore, venous dilatation, swelling in neck and right upper extremities, and facial edema were not found. The catheter, therefore, represents a significant advance, providing immediate, durable and relatively safe access for hemodialysis after repeated blood access troubles and exhausted peripheral access.
