title: Adjacent central venous catheters can result in immediate aspiration of infused drugs during renal replacement therapy.
abstract: Dual-lumen haemodiafiltration catheters enable continuous renal replacement therapy in the critically ill and are often co-located with central venous catheters used to infuse drugs. The extent to which infusions are immediately aspirated by an adjacent haemodiafiltration catheter remains unknown. A bench model was constructed to evaluate this effect. A central venous catheter and a haemodiafiltration catheter were inserted into a simulated central vein and flow generated using centrifugal pumps within the simulated vein and haemodiafiltration circuit. Ink was used as a visual tracer and creatinine solution as a quantifiable tracer. Tracers were completely aspirated by the haemodiafiltration catheter unless the infusion was at least 1 cm downstream to the arterial port. No tracer was aspirated from catheters infusing at least 2 cm downstream. Orientation of side ports did not affect tracer elimination. Co-location of central venous and haemodiafiltration catheters may lead to complete aspiration of infusions into the haemodiafilter with resultant drug under-dosing.
authors: Magill Department of Anaesthesia, Intensive Care and Pain Management, Imperial College London, Chelsea and Westminster Hospital, London, UK. ronald.kam02@imperial.ac.uk
authors: K Y R
authors: KY
authors: Kam
authors: J M
authors: JM
authors: Mari
authors: T J
authors: TJ
authors: Wigmore
mesh_terms: D000465:Algorithms; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D057785:Catheters / Q000009:adverse effects*; D003404:Creatinine / Q000032:analysis; D017583:Hemodiafiltration; D006801:Humans; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D008962:Models, Theoretical; D017582:Renal Replacement Therapy; D053120:Respiratory Aspiration; D018616:Ultrasonography, Doppler, Duplex; D014682:Vena Cava, Inferior / Q000502:physiology; D014683:Vena Cava, Superior / Q000502:physiology
chemical_list: D003404:Creatinine