Randomized study of temporary hemodialysis catheters.
Temporary catheters are still essential for acute dialysis access but their performance has not been compared in randomized trials. We conducted a randomized trial of our standard catheter and a newly designed catheter. The primary outcome was maximized blood flow over the entire use of the catheter. Seventy-six patients provided maximum blood flows. The new catheter provided an average blood flow of 349 ml/min and the standard catheter provided flows of 320 ml/mm (p=0.09). Lumen reversal occurred in 56.8% of dialysis sessions with the standard catheter compared to 27.4% with the new catheter (p<0.001). Left-sided internal jugular catheters and catheters inserted in females provided 103 ml/min and 36 ml/min less blood flow, respectively, compared to right sided catheters and catheters placed in males. Approximately 20% of catheters were removed for poor blood flow. Left sided catheters and catheters in females were more likely to need removal for malfunction but catheter design did not influence removal rates.
Oliver
M J
MJ
Division of Nephrology, SunnyBrook & Women's College Health Sciences Centre, Toronto, ON Canada. matthew.oliver@swchsc.on.ca
Edwards
L J
LJ
Treleaven
D J
DJ
Lambert
K
K
Margetts
P J
PJ
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation*; D013997:Time Factors