Prevention of hemodialysis catheter infections: Ointments, dressings, locks, and catheter hub devices

AbstractTunneled central venous catheters used for the provision of hemodialysis are associated with excess morbidity and mortality. Catheter related exit site and blood stream infections are major risks of their use. Although catheter ‐avoidance is the best strategy to reduce infections and mortality in the hemodialysis population, the use of catheters remains unacceptably high.In this review, the existing clinical practice guidelines for the prevention of hemodialysis catheter associated infections are outlined, and a comprehensive evidenced ‐based summary of interventions is provided. This includes details about the use of topical antimicrobial ointments and dressings, intranasal ointment application, prophylactic use of antibiotic and non‐antibiotic catheter lock solutions, and catheter hub devices for the prevention of catheter b lood stream infections.
Source: Hemodialysis International - Category: Hematology Authors: Tags: Review Article Source Type: research

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Introduction: There is no consensus regarding preferred site for central vein cannulation. [1] The jugular vein is the most “popular site” for central vein cannulation and is the “preferred site” for temporary hemodialysis. [2] The subclavian vein is less “infection-prone” but more likely to cause pneumothorax. [3] In case of chemo-port implantation, anatomical landmark puncture (ALP) of subclavian vein or ce phalic vein exploration (CVE) at delto-pectoral groove have been the more “convenient” and “preferred” methods to avoid unaesthetic two incisions and visible...
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction - central venous stenosis is one of the main causes of late arteriovenous fistula (AVF) failure. The endovascular techniques available for the treatment of central vein (CV) stenosis or obstruction (EVT) have been widely described in literature, however few studies have analyzed their efficacy in improving the AVF dialytic performance. Aim of our study is to evaluate the effectiveness of EVT in preserving AVF and improving its performance.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
ConclusionsThe IOA approach is a promising method to enable rapid access to the right jugular vein in the setting of pre-existing TCVO. Additional experience is needed to understand the generalizability of these observations.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Authors: Cho S, Yun S Abstract The primary site for a hemodialysis catheter insertion is the right internal jugular vein (IJV) followed by the left IJV and subclavian vein. In cases when veins of the upper extremities are exhausted, femoral veins are an alternative insertion location. Femoral catheter insertions should only be used for short periods because of the increased risk of infection. There is a percutaneous technique to recanalize occluded central veins for hemodialysis catheter insertion. We experienced success with a cut-down method for permcath through a completely occluded IJV. We, therefore, find surg...
Source: Annals of Surgical Treatment and Research - Category: Surgery Tags: Ann Surg Treat Res Source Type: research
A native arteriovenous fistula (AVF) is the vascular access of choice for hemodialysis (HD) treatment. Compared with other types of vascular access such as grafts and central venous catheters, it functions longer and is associated with a lower risk of complications. The aim of the study described here was to assess, in an HD population, the position of the fistula needles during an HD session and evaluate the role of ultrasound in the management of AVF puncture. Forty-five consecutive chronic HD patients with an AVF or an arteriovenous vascular graft were included in the study for ultrasound evaluation.
Source: Ultrasound in Medicine and Biology - Category: Radiology Authors: Tags: Technical Note Source Type: research
Conclusions: The incidence of catheter related bloodstream infections was comparable between the heparin and citrate 4.67% lock cohorts. The use of low concentration citrate as catheter lock was cost-effective when compared with heparin.
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
Publication date: Available online 6 November 2019Source: Journal of Vascular and Interventional RadiologyAuthor(s): Brendan C. Cline, Shawn M. Gage, James Ronald, Waleska M. Pabon-Ramos, Ellen D. Dillavou, Tony P. Smith, Jeffrey H. Lawson, Charles Y. KimAbstractPurposeTo compare outcomes after conversion of arteriovenous (AV) access to Hemodialysis Reliable Outflow (HeRO) graft vs stent deployment in patients with arm swelling owing to ipsilateral central vein stenosis.Materials and MethodsThis single-center retrospective study comprised 48 patients (19 men, mean age 58 y) with arm swelling ipsilateral to AV access and ce...
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
AbstractA 61-year-old man was hospitalized for creating vascular access for maintenance hemodialysis. Chronic interstitial nephritis was the cause of his end-stage kidney disease. An arteriovenous graft (AVG) was selected because superficial veins in his bilateral upper limbs were not suitable for arteriovenous fistula (AVF). Venography did not show any stenotic lesions in the drainage veins bilaterally. Soon after creation of the AVG, his left arm began to swell. Obstruction of the drainage vessels downstream of the AVG was highly suspected. Magnetic resonance imaging disclosed that the left brachiocephalic vein was compr...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
Primary arteriovenous fistula (AVF) remains the best vascular access for hemodialysis since it has the best long-term primary patency rate, requires less interventions/maintenance, and has the lowest incidence of morbidity and mortality. For this reason, the National Kidney Foundation began the “Fistula First Breakthrough Initiative”, which seeks to increase the amount of successful AVFs placed. Multiple factors play a role in primary AVFs creation; Vein diameter/quality, artery diameter/quality, central venous disease, hypercoagulable states and fistula location.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Source Type: research
CONCLUSION: The predictive value of intraoperative flow measurement is superior to intraoperative physical examination and could help reduce the fistula dysmaturation rate. Intraoperative transit time flow measurement is an easy method and can be used to predict successful fistula maturation in a high percentage rate. PMID: 31621478 [PubMed - as supplied by publisher]
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
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