title: Use of a silicone catheter with a Dacron cuff for dialysis short-term vascular access.
abstract: Polyurethane and Teflon subclavian vein catheters have been widely used for temporary vascular access for hemodialysis, but their use has been associated with a significant complication rate. A silicone dual-lumen catheter with a Dacron cuff placed in the internal jugular or subclavian vein was evaluated as a means of obtaining short-term vascular access. Sixty-two catheters in 54 patients provided a cumulative experience of 206 patient-months. Blood flow rates greater than or equal to 200 mL/min were achieved, with a mean recirculation of 2.1%. Catheter function was better with placement on the right side. Exit-site infections developed in nine patients, for a rate of 5.3 episodes per 100 patient-months; all resolved with antibiotics. Catheter-related bacteremia occurred in one patient, for a rate of 0.49 episodes per 100 patient-months, a rate much lower than rates reported for polyurethane and Teflon catheters. Clotting occurred in 24.5% of catheters, and thrombolytic therapy was always successful in restoring function. Because of the lower rate of complications, the silicone dual-lumen catheter with a Dacron cuff provides a safer alternative for short-term hemodialysis vascular access than the Teflon and polyurethane catheters.
authors.affiliation: West Virginia University Medical Center, Department of Medicine, Morgantown 26506.
authors.forename: A H
authors.initials: AH
authors.lastname: Moss
authors.forename: M M
authors.initials: MM
authors.lastname: McLaughlin
authors.forename: K D
authors.initials: KD
authors.lastname: Lempert
authors.forename: J L
authors.initials: JL
authors.lastname: Holley
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000295:instrumentation*; D001424:Bacterial Infections / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors