247 National Journal of Physiology, Pharmacy and Pharmacology 2017 | Vol 7 | Issue 3
RESEARCH ARTICLE
Intravenous catheter complications in hemodialysis
Shyamala Kumari Volabailu
1
, Venu Gopala Delanthabettu
2
1
Department of Physiology, Father Muller Medical College, Mangalore, Karnataka, India,
2
Department of Medicine, Kasturba Medical
College, Mangalore, Karnataka, India
Correspondence to: Shyamala Kumari Volabailu, E-mail: drshyamala@live.com
Received: September 02, 2016; Accepted: September 21, 2016
ABSTRACT
Background: Vascular access, still is a problem for hemodialysis. Venous catheters are commonly used for acute angioaccess
during maintenance hemodialysis in acute renal failure and end-stage renal failure patients. However, the catheters are often
complicated by mechanical or infectious complications which may result in morbidity and or premature removal of the
catheter. Even though, there are various studies on central venous catheters used in hemodialysis in western countries less is
documented in India. Aims and Objectives: Complications of intravenous catheter used during hemodialysis in our set up.
Materials and Methods: This prospective study was conducted on 110 patients selected by random sampling in dialysis units
of a government district hospital from October 2014 to September 2015. Patient age, sex, history, type of kidney disease, and
associated conditions were also noted according to the pro forma. Date of intravenous catheter insertion, site of insertion, and
insertion complications were noted. All patients were followed up until the day of catheter removal. Date of catheter removal,
reason for catheter removal, and duration of catheter days were noted. Data were collected and tabulated. Result: Only
47.8% of patients suspected with infections showed bacterial growth in catheter tip culture. However, blood culture showed
bacterial growth only in 19.6% of infection suspected patients. Blood culture reported 55.6% Staphylococcus aureus growth
followed by Pseudomonas (22.2%), Escherichia coli, and Acinetobacter (11.15%) growth in samples collected from infection
suspected dialysis patients. Conclusion: Fever due to infections is the most common cause for catheter removal.
KEY WORDS: Catheter Tip Culture; Blood Culture; Bacterial Growth; Hemodialysis; Staphylococcus Aureus
INTRODUCTION
Hemodialysis is a method of extracorporeal removal of
waste products from blood and maintaining a regulation of
the body fluids and chemical balances. Vascular access, still
is a problem for hemodialysis. Except for a small number of
patients who may have planned for End-stage renal diseases
care earlier, almost all end-stage renal diseases patients
require immediate/urgent dialysis, necessitating central
venous catheterization for emergency vascular access.
[1]
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DOI: 10.5455/njppp.2017.7.0927021092016
National Journal of Physiology, Pharmacy and Pharmacology Online 2016. © 2016 Shyamala Kumari Volabailu and Venu Gopala Delanthabettu. This is an Open Access article distributed
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It can be achieved by temporary venous access or a permanent
AV fistula. Hemodialysis access of <3 weeks duration should
be obtained using a noncuffed or a cuffed double-lumen
percutaneously inserted catheter.
[2]
Venous catheters are
commonly used for acute angioaccess during maintenance
hemodialysis in acute renal failure and end-stage renal failure
patients. Temporary access is established by the percutaneous
insertion of a catheter into a large vein.
[3]
Internal jugular,
femoral or less desirable, and subclavian
[4]
are the most
commonly selected ones.
It is recommended that temporary femoral catheters remain in
place for a maximum of 7 days and that internal jugular vein/
subclavian vein catheters remain in place for a maximum of
3 weeks.
[4]
However, the catheters are often complicated by mechanical
or infectious complications which may result in morbidity
National Journal of Physiology, Pharmacy and Pharmacology