Objective To discuss the causes and nursing strategies for unplanned extubations of hemodialysis patients with central vascular catheter .Methods Using the retrospective method , we analyzed and reviewed 11 unplanned extubations hemodialysis patients with central vascular catheter in our hospital between January 2010 and December 2012, in order to proposed the effective preventive nursing strategies . Results Eleven unplanned extubations were related to personal ( patients and nurses ) factors and central vascular catheters ’ maintenance and management .According to above causes , nursing strategies were made and none unplanned extubations happened after January 2013 .Conclusions During the process of using central vascular catheters , many reasons may cause unplanned extubation .Through designing workflow and guidelines , improving nurse training , strictly following operation specification , early detection of potential factors and the communication with patients and their relations , the rate of unplanned extubations can be effectively reduced .