Prospective follow-up of a novel design haemodialysis catheter; lower infection rates and improved survival

Nephrol Dial Transplant. 2008 Mar;23(3):977-83. doi: 10.1093/ndt/gfm767. Epub 2007 Nov 5.

Abstract

Background: Untunnelled straight jugular catheters (USC) are uncomfortable for patients and cannot be well fixated. This could be a reason for the high incidence of catheter-related complications.

Methods: We prospectively analysed the outcome of a novel designed untunnelled precurved catheter (UPC) with better fixation properties and compared it with the outcome of USC. The outcome was also related to data on tunnelled cuffed catheters (TCC).

Results: The outcome of USC was documented over a 32-month period. Thereafter, we switched to an UPC. The same catheter care protocol was used and not changed over time. A total of 104 USC and 65 UPC were inserted. Compared to USC, less UPC had to be removed for a complication (53 versus 15%; P < 0.001) and less periods of catheter-related bacteraemia were observed in UPC compared to USC [0 versus 5.6 per 1000 catheter days (cd); P < 0.01]. Removal for flow problems was similar. Compared to 64 TCC, inserted in the same period, UPC had more flow problems. Other outcomes and complication rates were similar. Complication rates for TCC inserted before and after the switch from USC to UPC were similar.

Conclusions: UPC have better patency rates and a lower risk for bacteraemia and exit-site infection compared to USC.

MeSH terms

  • Adult
  • Aged
  • Bacteremia / etiology*
  • Bacteremia / mortality
  • Bacteremia / prevention & control
  • Catheterization / adverse effects*
  • Catheterization / instrumentation*
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Jugular Veins / microbiology
  • Kaplan-Meier Estimate
  • Kidney Diseases / therapy
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Renal Dialysis / instrumentation*
  • Staphylococcal Infections / etiology*
  • Staphylococcal Infections / mortality
  • Staphylococcal Infections / prevention & control