ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: SA-PO1090

Ultrasound-Guided Protocol Safely Eliminates Chest Radiography After Non-Tunneled Catheter Placement in Urgent Hemodialysis

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


  • Ibarra-Sifuentes, Héctor Raúl, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • Avila Velazquez, Jose Luis, University Hospital, Monterrey, Mexico
  • Vera, Raymundo, Hospital Universitario, Monterrey, NUEVO LEON, Mexico
  • Arteaga Muller, Giovanna Y., Hospital Universitario, Monterrey, NUEVO LEON, Mexico

Despite its morbidity and mortality, the Non-tunneled catheter (NTC) continues to be an indispensable vascular access when imminent need for Hemodialysis. The confirmation of the proper NTC placement and complications detection are a real concern to optimize patient safety.


Prospective, comparative study. Included patients aged >17 years with life-threatening complications (uremic syndrome, potasssium >6.5 mmol/L, acidosis pH <7.2 with high anion gap and HCO3 <15 mmol/L and pulmonary edema) all resistant to management and urgent Hemodialysis need. After NTC placement with ultrasound (US) guided Seldinger technique in the right internal jugular vein; investigators performed a saline flush test and performed thorax evaluation for pleural sliding and pleural point with US and chest x-ray (CXR). Objetive is to compare successful venous placement and immediate detection of complications derived from NTC placement with US and CXR.


113 patients were involved, 60% in the emergency room. Their mean age was 50 years, 62% were male. The main causes of NTHC placement were uremic syndrome (41%) and fluid overload (28%). The mean blood urea nitrogen was 111 mg/dL. The correct NTC placement was documented in all patients when the US and CXR were used. The agreement between US-guided protocol and CXR protocol is good (Kappa= 1). Only 1 pneumothorax developed, correctly detected in the US-guided protocol, with a high NPV (100%). The median evaluation time for US and CXR were 3 and 37 minutes, respectively; median difference of 34 minutes (p <0.0001).


The US is an effective tool for the assesemnt of adequate NTC placement and immediate complications detection in patients with urgent need of hemodialysis when compared to CXR.