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Moossavi S
Vachharajani TJ, Jordan J, Russell
GB, Kaufman T, Moossavi S.
Wake Forest University Outpatient
Dialysis Centers, Wake Forset
University School of Medicine,
Winston-Salem, North Carolina,
USA.
Semin Dial.
2008 May-Jun;21(3):289-92.
Transonic Reference #
HD7669A |
| Catheter recirculation (CR)
occurs when blood returning
from the venous limb of the
catheter re-enters the arterial
limb of the catheter without
passage through the circulation.
Adequacy of dialysis is influenced
by the degree of access
recirculation. In this study we
evaluate factors influencing the
degree of dialysis central venous
catheter (CVC) recirculation in
prevalent hemodialysis patients.
This is a retrospective study of all
patients undergoing
hemodialysis via a catheter at the
Wake Forest University Outpatient
Dialysis Facilities from September
1, 2006 to May 15, 2007. CR was
correlated to catheter type,
catheter brand, site of placement,
catheter length, time on dialysis,
time on the current catheter, and
was measured via ultrasound
dilution technique. A total of 165
catheters were identified.
Seventy-one catheters were in
the right internal jugular
position, 43 in the left internal
jugular position, 13 in the right
subclavian, one in the left
subclavian, eight in the right
femoral, two in the left femoral,
and four in the trans-lumber
position. CR was 6.3 +/- 7.5% in
symmetric tip catheters (n = 14),
6.0 +/- 8.3% in split-tip
catheters (n = 102), 8.4 +/-
11.7% in step-tip catheters (n =
10), and 23.0 +/- 8.2% in
temporary catheters (n = 3),
respectively. These results are
borderline significant if
temporary catheters are included
(p = 0.052); however, the overall
p-value is only 0.80 for tunneled
dialysis catheters. There was no
correlation between CR and time
on dialysis (p = 0.66) or time on
the current catheter (p = 0.48).
The current study suggests that
the CVC recirculation is
independent of catheter brand,
type, time on dialysis, or time on
current catheter.
Key Words : Human, AV Access, |
