Experience using central venous access for long-term hemodialysis. A new concept.
Central venous access for acute renal failure has been used for a number of years. The femoral vein and, more recently, the subclavian vein have been the routes of access. This technique has many advantages, however, it also has some significant limitations. We have recently been using a catheter for long- as well as short-term hemodialysis. The catheter is placed by means of a short incision through an opening in the internal jugular vein, and maneuvered so that the tip lies in the superior portion of the right atrium. After dialysis, the catheter is filled with heparin. The catheter then requires no additional care between between hemodialysis sessions. We have reported an experience of 50 patients in whom this catheter has been used. The complications have been remarkably few, and none were serious or fatal. At present, the patient using the catheter for the longest period of time has had it in position for approximately 19 months. We believe this technique provides a significant new choice among the ways in which hemodialysis can be achieved for short- or long-term needs.
D058186:Acute Kidney Injury / Q000628:therapy; D006328:Cardiac Catheterization; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008134:Long-Term Care; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*