title: Practical Aspects of Nontunneled and Tunneled Hemodialysis Catheters.
abstract: Nontunneled hemodialysis catheters (NTHCs) are typically used when vascular access is required for urgent renal replacement therapy. The preferred site for NTHC insertion in acute kidney injury is the right internal jugular vein followed by the femoral vein. When aided by real-time ultrasound, mechanical complications related to NTHC insertion are significantly reduced. The preferred site for tunneled hemodialysis catheters placement is the right internal jugular vein followed by the left internal jugular vein. Ideally, the catheter should be inserted on the opposite side of a maturing or planned fistula/graft. Several dual-lumen, large-diameter catheters are available with multiple catheter tip designs, but no one catheter has shown significant superior performance.
authors.affiliation: Faculty of Medicine, University of Ottawa, Ontario, Canada.
authors.forename: Edward
authors.initials: E
authors.lastname: Clark
authors.affiliation: Faculty of Medicine, University of Saskatchewan, Saskatoon, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Kappel
authors.affiliation: Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: MacRae
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Dipchand
authors.affiliation: Faculty of Medicine, University of Ottawa, Ontario, Canada.
authors.forename: Swapnil
authors.initials: S
authors.lastname: Hiremath
authors.affiliation: Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors.forename: Mercedeh
authors.initials: M
authors.lastname: Kiaii
authors.affiliation: Faculty of Medicine, University Health Network, University of Toronto, Ontario, Canada.
authors.forename: Charmaine
authors.initials: C
authors.lastname: Lok
authors.affiliation: Department of Medicine, University of Western Ontario, London, Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: Moist
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Oliver
authors.affiliation: Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Miller
keywords: catheter insertion; catheter removal; exit-site care; nontunneled hemodialysis catheters; site selection; tunneled hemodialysis catheter