Use of a silicone catheter with a Dacron cuff for dialysis short-term vascular access

Am J Kidney Dis. 1988 Dec;12(6):492-8. doi: 10.1016/s0272-6386(88)80100-8.

Abstract

Polyurethane and Teflon subclavian vein catheters have been widely used for temporary vascular access for hemodialysis, but their use has been associated with a significant complication rate. A silicone dual-lumen catheter with a Dacron cuff placed in the internal jugular or subclavian vein was evaluated as a means of obtaining short-term vascular access. Sixty-two catheters in 54 patients provided a cumulative experience of 206 patient-months. Blood flow rates greater than or equal to 200 mL/min were achieved, with a mean recirculation of 2.1%. Catheter function was better with placement on the right side. Exit-site infections developed in nine patients, for a rate of 5.3 episodes per 100 patient-months; all resolved with antibiotics. Catheter-related bacteremia occurred in one patient, for a rate of 0.49 episodes per 100 patient-months, a rate much lower than rates reported for polyurethane and Teflon catheters. Clotting occurred in 24.5% of catheters, and thrombolytic therapy was always successful in restoring function. Because of the lower rate of complications, the silicone dual-lumen catheter with a Dacron cuff provides a safer alternative for short-term hemodialysis vascular access than the Teflon and polyurethane catheters.

MeSH terms

  • Adult
  • Aged
  • Arteriovenous Shunt, Surgical / instrumentation*
  • Bacterial Infections / etiology
  • Catheters, Indwelling* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis / instrumentation*
  • Thrombosis / etiology
  • Time Factors