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Abstract: PO1353

The Catheter Tip Position as the Main Non-Infectious Cause of Catheter Replacement Survival

Session Information

  • Vascular Access
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Navarro gallardo, Joana Goretty, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Maggiani, Pablo, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Martinez murillo, Noe, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Font, Jorge Jaime, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Chavez, Jonathan, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Torres, Jose Antonio, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Flores, Christian Perez, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
Background

Identify the risk factors associated with catheter (Cath) replacement (CR). Novel anatomic variables analyzed

Methods

Our objectives: Identify risk factors associated with CR. The Cath were placed guided by ultrasound (US). We analyze age, gender, height, previous number of Cath and placement, lab tests, blood pressure, anatomic position, extrasystoles, # punctures, Jugular Vein (JV) collapsibility, Cath TUG, TIP and TOP, tunneled or not, Heparin, complications, Skin-JV Distance, Neck circumference, cath insertion to clavicula distance (CICD), JV and Carotid diameter and distance between JV and Carotid. Kaplan Meier survival analysis. Multivariable logistic regression model was performed. P < 0.05 which is significant

Results

From Feb-Dec 2019 with a 180 days follow-up, 147 vascular Cath placements were analyzed. The CR was presented in 21 patients (14.2%) with a survival of 85.5% (95% CI 0.80 to 0.91) (figure 1). The correct position of the Cath TIP decreases risk of CR (OR 0.81, 95% CI 0.73-0.90, p <0.001). Cath-related bloodstream infection (CRBI) increases the risk of CR (OR 2.52, 95% CI 2.13-2.98, P < 0.001). CICD >3.4 cm decrease risk of CR due to CRBI. (OR 0.89, 95% CI 0.81-0.97, P < 0.01)

Conclusion

Only the correct position of the Cath TIP protects vs CR while CRBI increases the risk. The shorter the CICD the less CR due to CRBI.

Multivariable logistic regression model to determine the variables associated with catheter replacement during the 180 days follow-up
VARIABLEOR 95% ICP Value
CATHETER INSERTION TO CLAVICULA DISTANCE (CM)0.990.961.010.57
BREASTBONE-CHIN DISTANCE (CM)1.010.991.030.10
TUNNELED CATHETER0.980.901.060.67
CATHETER-RELATED BLOODSTREAM INFECTION2.522.132.98<0.001
NECK CIRCUMFERENCE (CM)0.990.991.000.86
NORMAL TIP*0.810.730.90<0.001
ANATOMIC POSITION RJV0.970.871.070.57

Funding

  • Other NIH Support