title: Effect of reversal of catheter ports on recirculation: comparison of the PermCath with Tesio Twin Catheter.
abstract: To study the effect of the reversal of the blood ports on blood flow rate (QB), percentage recirculation, and blood urea nitrogen (BUN) clearance, we compared 12 well functioning chronic hemodialysis catheters (7 PermCaths and 5 Tesio Twin Catheters) in both standard and reversed blood flow setups. The reversal of PermCath ports caused no change in the QB (307+/-20 ml/min vs. 314+/-9 ml/min, standard vs. reversed hook-up, respectively), but a significant increase in percentage recirculation (2.5+/-1.8% vs. 12+/-4.6%, standard vs. reversed hook-up, respectively, p = 0.02). Reversal of the Tesio Twin Catheter ports caused a significant decline in QB (296+/-13 ml/min vs. 250+/-16 ml/min, standard vs. reversed hook-up, respectively, p = 0.02), but no significant change in percentage recirculation (2.8+/-1.4% vs. 3.8+/-2.5%, standard vs. reversed hook-up, respectively, p = not significant). Reversal of the ports caused no significant change in BUN clearance with the PermCath (264+/-18 ml/min vs. 257+/-17, standard vs. reversed hook-up, respectively, p = 0.8), but a significant decline in BUN clearance with the Tesio Twin Catheter (247+/-11 ml/min vs. 216+/-13.5 ml/min, standard vs. reversed hook-up, respectively, p = 0.015). In conclusion, our results suggest that reversed hook-up of a well functioning Tesio Twin Catheter is associated with a significant decline in QB and BUN clearance, but no change in percentage recirculation; however, inadvertent reversed hook-up of a well functioning PermCath can lead to a considerable increase in percentage recirculation but no change in QB or BUN clearance.
authors.affiliation: Department of Internal Medicine, Saint Louis University School of Medicine, MO 63110, USA.
authors.forename: Hatim A
authors.initials: HA
authors.lastname: Hassan
authors.forename: Debra L
authors.initials: DL
authors.lastname: Frenchie
authors.forename: Bahar
authors.initials: B
authors.lastname: Bastani
mesh_terms: D000328:Adult; D000368:Aged; D001775:Blood Circulation; D001806:Blood Urea Nitrogen; D002404:Catheterization; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*