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Abstract: SA-PO1089

Where Should the Non-Tunneled Catheter Tip Be Placed for Hemodialysis? Fourth vs. Second Intercostal Space

Session Information

  • Vascular Access - II
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Ibarra-Sifuentes, Héctor Raúl, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • Vera, Raymundo, Hospital Universitario, Monterrey, Mexico
  • Guerrero Gonzalez, Elisa Maria, Hospital Universitario UANL, San Nicolas de los Garza, Mexico
  • Morcos sandino, Michelle, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • Sanchez Martinez, Concepcion, Hospital Universitario, Monterrey, Mexico
Background

Non-tunneled catheters (NTC) for hemodialysis are an indispensable vascular access and very common in patients in need of hemodialysis, especially urgently. The insertion method used for the placement of NTC can reduce serious complications.

Methods

Randomized clinical trial with adult patients at the University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico, who required emergency hemodialysis by NTC. The NTC were inserted percutaneously with the ultrasound-guided modified Seldinger technique. Patients were randomized to NTC tip placement on the fourth intercostal space (4IS) and to the second intercostal space (2IS). The main outcome are to number of dysfunction, repositioning and relocation episodes due to NTC placement.

Results

The study included 115 patients who were placed on NTC for hemodialysis, with an average age of 51 years, 55% were female, the mean height was 163 cm, no difference between the groups. The incidence of catheter dysfunction and catheter relocation were not different. Catheter repositioning was presented in 50 and 16% for the 4IS insertion and 2IS groups, respectively (p 0.001).

Conclusion

The placement of the hemodialysis NTC tip on the 2IS decreases the incidence of repositioning, without affecting the incidence of dysfunction or repositioning when compared to 4IS. The search for new methods of catheter placement to reduce the potential complications of invasive treatments on renal replacement therapy is still pending.

Table 1. Primary outcome in classic and intervention group.
 Classic Group (4IS)Intervention Group (2IS)p
Disfunction, n(%)4 (8%)2 (4%)0.39
Repositioning, n (%)25 (50%)8 (16%)0.001
Relocation, n (%)0 (0%)1 (2%)0.13

4IS, fourth intercostal space; 2IS, second intercostal space.