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Internal jugular hemodialysis catheterization

Antonio Treglia, Dario Musone, Francesco Amoroso
BACKGROUND: Prevalent hemodialysis patients with vascular access consisting of a central venous catheter (CVC) are continuously increasing over the years. Improvement in evolution and CVC placement procedures represents therefore an essential tool to enhance performance and reduce intraoperative and long-term CVC complications. Internal jugular vein (IJV) catheterization techniques are different according to ultrasound probe position in relation to vein axis and to needle direction in relation to ultrasound beam...
January 18, 2017: Journal of Vascular Access
Manish Rathi, Venkata Siva Tez Pinnamaneni, Vinay Sakhuja
BACKGROUND: Absolute necessity in acute kidney injury (AKI) and ignorance in chronic kidney disease (CKD) make the use of un-cuffed, non-tunneled catheters an indispensable vascular access for hemodialysis. Although these catheters should be inserted under radiological guidance, it may not be feasible in certain circumstances. The aim of the present study was to evaluate safety and outcome of non-imaging assisted insertion of these catheters in internal jugular vein (IJV) for hemodialysis...
August 2016: Biomedical Journal
Anand Devraj, Venkata Siva Tez Pinnamaneni, Manisha Biswal, Raja Ramachandran, Vivekanand Jha
Introduction Staphylococcal infection of endogenous origin is an important cause of morbidity and mortality in patients who receive hemodialysis (HD). The risk of such infections in nasal carriers of the organism is well defined. Extranasal carriage of the organism at extranasal sites may pose similar risks. Methods A total of 70 patients about to undergo internal jugular vein catheterization for HD were enrolled in this prospective observational study. Swab cultures were obtained from anterior nares, posterior pharynx, axillae, toe web spaces, and vascular access sites at baseline and 1 week later...
June 29, 2016: Hemodialysis International
Hassan Barzegari, Arash Forouzan, Mohammad Ali Fahimi, Behzad Zohrevandi, Mandana Ghanavati
INTRODUCTION: Determining the proper angle for inserting central venous catheter (CV line) is of great importance for decreasing the complications and increasing success rate. The present study was designed to determine the proper angle of needle insertion for internal jugular vein catheterization. METHODS: In the present case series study, candidate patients for catheterization of the right internal jugular vein under guidance of ultrasonography were studied. At the time of proper placing of the catheter, photograph was taken and Auto Cad 2014 software was used to measure the angles of the needle in the sagittal and axial planes, as well as patient's head rotation...
2016: Emergency (Tehran, Iran)
Kevin Wong, Barry A Marks, Anwer Qureshi, Joseph J Stemm
Central venous catheterization is widely used in patients on hemodialysis. A rare complication associated with the clinical use of central venous catheters is perforation of the heart or major vessels. We report a case of inadvertent perforation of the left atrium and thrombosis after the placement of a hemodialysis catheter in the right internal jugular vein. In such cases, surgical removal of the central venous catheter from perforation sites in the heart and vessel walls poses anesthetic challenges because of the high risk of pneumothorax, hemorrhage, arrhythmias, thrombosis, and death...
July 1, 2016: A & A Case Reports
Qiao Zhou, Shashi Murthy, Alex Pattison, Gabriel Werder
A persistent left superior vena cava (PLSVC) is a rare, under-recognized congenital anomaly. The PLSVC is incidentally discovered during central venous access procedures when access is obtained from the left internal jugular vein. The vast majority of PLSVCs drain into the right atrium; however, it is critical to recognize a PLSVC that drains into the left atrium as it can predispose to systemic dispersion of emboli through bypassing the lungs. Additionally, PLSVC catheterization has also been previously reported to be associated with cardiac dysrhythmias, venous stenosis, coronary sinus thrombosis, cardiac tamponade, and cardiac arrest...
September 21, 2016: Journal of Vascular Access
Ewa Weber, Tomasz Liberek, Wojciech Wołyniec, Bolesław Rutkowski
The percutaneous catheterization of central veins is increasingly used in nephrological practice as a temporary or permanent vascular access. The aim of our study was to present and to analyze episodes of catheter tip malposition during percutaneous tunneled hemodialysis catheter insertion in the large, unselected group of patients. All patients who underwent the procedure of catheter insertion in our department during year 2012 were analyzed retrospectively. One hundred four tunneled hemodialysis catheters were inserted in 101 patients...
October 2015: Hemodialysis International
Dan Song, Sangchul Yun, Sungwoo Cho
A recent widespread concept is that ultrasound-guided central venous catheter insertion is a mandatory method. Some techniques have been introduced for ultrasound-guided central venous catheterization. Among them, short-axis lateral in-plane technique is considered to be the most useful technique for internal jugular vein access. Therefore, we used this technique for the insertion of a large-bore cuffed tunneled dual-lumen catheter for hemodialysis. Additionally, a lesser number of catheter angulations may lead to good flow rates and catheter function; we recommend that skin puncture site in the neck at the posterior triangle is better than the Sedillot's triangle...
February 2015: Annals of Surgical Treatment and Research
Kohei Hamamoto, Mitsunori Nakano, Kiyoka Omoto, Masahiko Tsubuku, Emiko Chiba, Tomohisa Okochi, Katsuhiko Matsuura, Osamu Tanaka
Pseudoaneurysms (PsA) and arteriovenous fistulae (AVF) of the thyrocervical trunk and its branches are rare complications of traumatic or iatrogenic arterial injuries. Most such injuries are iatrogenic and are associated with central venous catheterization. Historically, thyrocervical trunk PsA and AVF have been managed with open surgical repair; however, multiple treatment modalities are now available, including ultrasound-guided compression repair, ultrasound-guided thrombin injection, and endovascular repair with covered stent placement...
2014: Case Reports in Vascular Medicine
Hisashi Nagai, Hideyuki Maeda, Ryohei Kuroda, Masatomo Komori, Makoto Nakajima, Akina Nara, Takako Ito-Tsujimura, Kaori Shintani-Ishida, Naoki Yahagi, Ken-ichi Yoshida
Pulmonary air embolisms due to the removal of a central venous catheter are rare, but catheter removal is known to be a high risk factor for air embolism. In particular, the removal of a large catheter, such as a double-lumen hemodialysis catheter, can allow a large amount of air to enter into the bloodstream, which often results in sudden death. So, during catheter removal, special care should be taken to prevent air from entering blood vessels, for example, to ensure that the patient's head is tilted downward, that they have inhaled and are holding their breath, and that a covering gauze and inert ointment have been applied to the exit site...
December 2014: American Journal of Forensic Medicine and Pathology
Morteza Kavanin Zadeh, Amir Shirvani
Chest radiographs are obtained routinely after central venous catheter (CVC) insertion in many institutions, although it consumes time and money. The purpose of this study was to evaluate the role of post-procedural chest X-ray in detecting complications of CVC insertion; we performed CVC insertion without using ultrasonography guidance. A total of 454 patients who required an emergency vascular access for hemodialysis between February 2008 and March 2010 were included in this study. In cases where three to five unsuccessful attempts were encountered to place the CVC or pierce the artery, we used another site for CVC placement or we placed the CVC under ultrasonographic guidance...
September 2014: Saudi Journal of Kidney Diseases and Transplantation
P P Zachariah, V N Unni, G Kurian, R R Nair, A Mathew
Arteriovenous fistula (AVF) is an anomalous communication between an artery and a vein, caused by an iatrogenic or traumatic etiology. Surgically created upper limb AVF remains the preferred vascular access for patients on maintenance hemodialysis. Nonetheless central vein cannulation for hemodialysis is a common procedure done in patients who need hemodialysis. We incidentally detected a thyrocervical artery - jugular fistula in a patient on maintenance hemodialysis. He underwent a successful intra arterial coil embolization of the feeding vessel...
May 2014: Indian Journal of Nephrology
Julio C Chirinos, Javier A Neyra, Jiten Patel, Aylin R Rodan
BACKGROUND: Ultrasound-guided Central Venous Catheterization (CVC) for temporary vascular access, preferably using the right internal jugular vein, is widely accepted by nephrologists. However CVC is associated with numerous potential complications, including death. We describe the finding of a rare left-sided partial anomalous pulmonary vein connection during central venous catheterization for continuous renal replacement therapy (CRRT). CASE PRESENTATION: Ultrasound-guided cannulation of a large bore temporary dual-lumen Quinton-Mahurkar catheter into the left internal jugular vein was performed for CRRT initiation in a 66 year old African-American with sepsis-related oliguric acute kidney injury...
2014: BMC Nephrology
Po-Jen Hsiao, Ming-Hsien Tsai, Jyh-Gang Leu, Yu-Wei Fang
Iliopsoas abscess is a rare complication in hemodialysis patients that is mainly due to adjacent catheterization, local acupuncture, discitis, and bacteremia. Herein, we report a 47-year-old woman undergoing regular hemodialysis via a catheter in the internal jugular vein who presented with low back pain and dyspnea. A heart murmur suggested the presence of catheter-related endocarditis, and this was confirmed by an echocardiogram and a blood culture of methicillin-resistant Staphylococcus aureus. A computed tomography indicated a pulmonary embolism and an incidental finding of iliopsoas abscess...
April 2015: Hemodialysis International
Salvatore Mandolfo, Pasqualina Acconcia, Raffaella Bucci, Bruno Corradi, Marco Farina, Maria Antonietta Rizzo, Andrea Stucchi
BACKGROUND: Tunneled central venous catheters (tCVCs) are considered inferior to arteriovenous fistulas (AVFs) and grafts in all nephrology guidelines. However, they are being increasingly used as hemodialysis vascular access. The purpose of this study was to document the natural history of tCVCs and determine the rate and type of catheter replacement. METHODS: This was a prospective study of 141 patients who underwent hemodialysis with tCVCs between January 2008 and December 2012...
November 2014: Journal of Vascular Access
Edward G Clark, Jeffrey H Barsuk
The insertion of non-tunneled temporary hemodialysis catheters (NTHCs) is a core procedure of nephrology practice. While urgent dialysis may be life-saving, mechanical and infectious complications related to the insertion of NTHCs can be fatal. In recent years, various techniques that reduce mechanical and infectious complications related to NTHCs have been described. Evidence now suggests that ultrasound guidance should be used for internal jugular and femoral vein NTHC insertions. The implementation of evidence-based infection-control 'bundles' for central venous catheter insertions has significantly reduced the incidence of bloodstream infections in the intensive care unit setting with important implications for how nephrologists should insert NTHCs...
November 2014: Kidney International
Taner Ciftci, Hayrettin Daskaya, Mehmet B Yıldırım, Haluk Söylemez
The superficial cervical plexus block (SCPB) is utilized in pediatric patients to perform certain surgical procedures, but there is no evidence supporting its use in hemodialysis catheter placement. We evaluated the analgesic effectiveness, intraoperative complications, and patient satisfaction associated with SCPB for pediatric patients in renal failure undergoing emergent dialysis catheterization. A total of 52 patients ranging from 1 to 17 years old that required emergent dialysis catheter placement and received SCPB were included in this study...
July 2014: Hemodialysis International
Osama Gheith, Torki Al Otaibi, M R N Nampoory, Hosam Attia, Medhat Halim, Tarek Said, Prasad Nair, Mohamed Balaha, Waleed Awadein, Zakaria Zakariya, Hasanein Aboatteya, Nawas Moideenkutty
Chylothorax is the accumulation of chyle in the pleural cavity as a result of damage to the lymphatic ducts. We treated a young man who was a kidney transplant recipient who had a prior internal jugular vein permanent catheter for hemodialysis, who developed dyspnea and hypoxemia. Chest radiography showed bilateral pleural effusion. Analysis of the white, milky, cloudy, odorless effusion fluid showed cell count > 500/μL; lymphocytes, 60%; total protein, 3.6 mg/dL; urea nitrogen, 45 mg/dL; creatinine, 90 μmol/L; triglycerides, above 2...
April 2014: Experimental and Clinical Transplantation
Fredrik Hammarskjöld, Sören Berg, Håkan Hanberger, Knut Taxbro, Bo-Eric Malmvall
BACKGROUND: There are limited data on the long-term effects of implementing a central venous catheter (CVC) program for prevention of CVC infections. The aims of this study were to evaluate the incidence of CVC colonization, catheter-related infections (CRI), catheter-related bloodstream infections (CRBSI), and their risk factors over a 6-year period in a hospital with an active CVC team. METHODS: We conducted a continuous prospective study aiming to include all CVCs used at our hospital during the years 2004 to 2009, evaluating colonization, CRI, CRBSI, and possible risk factors...
February 2014: American Journal of Infection Control
Fang Yuan, Yinghong Liu, Zheng Li, Jianling Zhu, Danming Cao, Yining Li
OBJECTIVE: To investigate the value of real-time ultrasound guided placement of permanent internal jugular vein (IJV) catheterization in maintenance hemodialysis patients, and analyze its technical success and complication rate. METHODS: We prospectively analyzed 63 patients (39 males, 24 females) who underwent permanent IJV cannulation with real-time ultrasound guidance from January to October in 2012. Under the real-time guidance of Logiq 5 color Doppler, we placed the tunneled cuffed catheters into the jugular vein by Seldinger technique...
January 2014: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
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