Tunneled hemodialysis catheters: use of a silver-coated catheter for prevention of infection--a randomized study

Radiology. 1998 May;207(2):491-6. doi: 10.1148/radiology.207.2.9577500.

Abstract

Purpose: To determine whether silver-coated tunneled hemodialysis catheters reduce infection and to determine the frequency of central venous thrombosis and stenosis with percutaneous placement of right internal jugular vein dialysis catheters by interventional radiologists.

Materials and methods: Ninety-one patients were randomly assigned to a treatment (silver-coated catheter; n = 47) or control (identical catheter without silver coating; n = 44) arm. Baseline venography was performed. Catheter tips were cultured and venography was repeated at catheter removal.

Results: Mean duration of catheter placement was 92 days. Infection occurred in 11 patients (five in the treatment group, six in the control group). Tip cultures in 15 patients (eight treatment, seven control) were positive without clinical infection. Infection and colonization rates were slightly but not significantly higher in the treatment group than in the control group. Silver-coated catheters in two (4%) patients were removed due to reaction to the coating. Completion venograms (n = 72) showed new minor abnormalities in four (6%) patients and major abnormalities (stenosis, thrombosis) in three (4%) patients. Permanent venous abnormalities occurred in two (3%) patients.

Conclusion: Silver coating does not confer a benefit against clinical infection or colonization. Interventional radiologic placement of tunneled dialysis catheters yields a low frequency of permanent central venous thrombosis and stenosis.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteria / growth & development
  • Bacterial Infections / prevention & control*
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation*
  • Catheters, Indwelling* / adverse effects
  • Colony Count, Microbial
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / prevention & control
  • Equipment Contamination
  • Equipment Design
  • Exanthema / chemically induced
  • Female
  • Fluoroscopy
  • Humans
  • Hyperpigmentation / chemically induced
  • Incidence
  • Jugular Veins* / diagnostic imaging
  • Male
  • Middle Aged
  • Phlebography
  • Radiography, Interventional
  • Radiology, Interventional
  • Renal Dialysis / adverse effects
  • Renal Dialysis / instrumentation*
  • Silver* / adverse effects
  • Surface Properties
  • Thrombosis / etiology
  • Thrombosis / prevention & control
  • Time Factors
  • Ultrasonography, Interventional
  • Vascular Diseases / etiology
  • Vascular Diseases / prevention & control

Substances

  • Silver