Retrospective analysis of cuffed-tunneled catheters in pediatric patients receiving maintenance hemodialysis
10.3760/cma.j.issn.0578-1310.2018.09.005
- VernacularTitle: 半永久双腔导管在维持性血液透析儿童中应用的回顾性分析
- Author:
Ping WANG
1
;
Wei RAO
;
Liwen SUN
;
Ying WU
;
Wenjian CHEN
;
Yulin KANG
;
Sheng HAO
;
Guanghua ZHU
;
Wenyan HUANG
Author Information
1. Department of Nephrology and Rheumatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Vascular access;
Central venous catheters;
Child
- From:
Chinese Journal of Pediatrics
2018;56(9):657-661
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the characteristics of cuffed-tunneled catheters insertion and investigate the values of cuffed-tunneled catheters in pediatric patients.
Methods:Between March 2015 and July 2017, all the pediatric patients who received maintenance hemodialysis at least 3 consecutive months in our center were included. Sixteen cuffed-tunneled hemodialysis catheters were inserted in patients for long-term hemodialysis access. The clinical manifestations and complications were retrospectively reviewed.
Results:Fifteen pediatric patients with end stage ranal disease (ESRD) were included in this study and they received 16 cuffed-tunneled catheters for long-term vascular access, including 10 males and 5 females; median age at start of catheter insertion was 11.5 (4.2-14.5) years. Body weight was (27.8±8.0)kg (16.0-39.4 kg) . The size and the length of the catheters were based on the height of patients as follows: 28 cm for (115.6±10.6) cm (102.0-130.0 cm) ,36 cm for (148.6±9.9)cm (140.0-167.0 cm) . Cuffed-tunneled catheters outcome: 10 cuffed-tunneled catheters were still functional at the end of the study; 5 catheters were removed after successful kidney transplantation. Catheter failure occurred in 1 out of 16 cuffed-tunneled catheters due to catheter-related infections. The median catheter survival time was 11.9 months (range 3.5-21.3 months). Complications of cuffed-tunneled catheters: Catheter placements operation was successful in 15 cases using ultrasound guidance. No serious complications were observed in any patients receiving catheter inserting operation. The overall rate of catheter-related infections and thrombosis/malposition was 6.3% and 18.7%, respectively.
Conclusions:Ultrasound guidance is suggested in pediatric patients during the catheters insertion. The size and the length of the catheters should be based on the height of patients. Cuffed-tunneled hemodialysis catheters could be effectively used for maintenance of hemodialysis vascular access for pediatric patients with ESRD.
