title: Radiologically placed tunneled internal jugular catheters in the management of chronic hemodialysis and long-term infusion therapies in the pediatric population.
abstract: OBJECTIVE
  To evaluate the long-term outcomes of radiologically inserted dual-lumen hemodialysis and infusion catheters in pediatric patients.
  
  
  METHODS
  The authors retrospectively reviewed the outcomes of 114 tunneled internal jugular catheters in 71 consecutive pediatric patients between March 2003 and May 2006. Forty hemodialysis catheters were placed in 23 patients (11 girls, 12 boys), and 74 infusion catheters were placed in 48 patients (14 girls, 34 boys). The mean patient age was 11.2 years (range, 1-16 years) in the hemodialysis group and 7.86 years (range, 4 months to 16 years) in the infusion group.
  
  
  RESULTS
  The technical success rate was 100%. The mean duration of catheter use was 84 days (range, 5-730 days) in the hemodialysis group and 58 days (range, 3-206 days) in the infusion group. Nine hemodialysis (22%) and 29 infusion (39%) catheters were electively removed. The most common reasons for catheter removal were malfunction (22%) in the hemodialysis group and completion of therapy (39%) in the infusion group. Revisions were performed at a rate of 0.6 and 0.4 per 100 catheters days in the hemodialysis and infusion groups, respectively. Total infection rates were 0.15 and 0.38 episodes per 100 catheter days in hemodialysis and infusion catheters, respectively. Mean primary device service intervals were 86 and 60 days for hemodialysis and infusion catheters, respectively, with total access site service intervals of 140 and 71 days.
  
  
  CONCLUSIONS
  Radiologically placed tunneled internal jugular catheters appear to be safe and effective, with very low complication rates for both hemodialysis and long-term infusion therapies. Higher infection rates were seen in patients with cancer.
authors.affiliation: Department of Radiology, Hacettepe University, School of Medicine, Ankara, Turkey. borapeynir@gmail.com
authors.forename: Bora
authors.initials: B
authors.lastname: Peynircioglu
authors.forename: Fuat
authors.initials: F
authors.lastname: Ozkan
authors.forename: Murat
authors.initials: M
authors.lastname: Canyigit
authors.forename: Gulsun A
authors.initials: GA
authors.lastname: Pamuk
authors.forename: Serdar
authors.initials: S
authors.lastname: Geyik
authors.forename: Barbaros E
authors.initials: BE
authors.lastname: Cil
authors.forename: Ferhun
authors.initials: F
authors.lastname: Balkanci
mesh_terms: D000293:Adolescent; D002405:Catheterization, Central Venous; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007601:Jugular Veins / Q000000981:diagnostic imaging; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D015641:Radiography, Interventional; D006435:Renal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome