Abstract

RESTREPO, César A; CHACON, José Arnoby  and  VILLOTA, Duván Mauricio. Safety related to the implantation of jugular catheters for hemodyalisis and usefulness of PA chest Xrays post procedure. Acta Med Colomb [online]. 2008, vol.33, n.2, pp.68-74. ISSN 0120-2448.

Objective: to determine how safe the implantation of transient double lumen jugular catheters is for hemodialysis in patients with renal disease, and who require dialysis therapy and Posterior Anterior (PA) chest X-Ray post procedure. Design: observational descriptive study. Site: renal units at RTS Ltda. Sucursal Caldas (Hospital Santa Sofía y Hospital Infantil Rafael Henao Toro de la Cruz Roja). Patients: all patients with renal disease in whom it was necessary to do hemodyalitic therapy with implantation of a jugular catheter, with medical records of the events and complications that occurred during the procedure, with subsequent control AP chest XRay and that showed reports made by the radiologist or physician who carried out the procedure, about the findings in the chest XRay. Patients with renal disease, in whom jugular catheters had been inserted: Methods: variables such as age, gender, race, body mass index (BMI) etiology of the renal failure, time of evolution of the disease, indications for insertion, priority of catheter insertion, type of catheter inserted, amount of punctures, physician who carried out the procedure and patient’s co-morbidities were analyzed. The events considered as complicated were analyzed as well as if there was any relationship with co-morbidities and the analyzed variables. Findings in the PA chest X-Ray were recorded and their relationship with the difficulties encountered during the procedure. A bi-variance analysis was done. The dependent and independent variables were classified in the nominal measurement scale. Results: 774 clinical histories were reviewed. 562 were excluded due to lack of variables and impossibility to read the notes. Men older than de 55 (45,7%). 212 (97.1%) patients with diagnosis of chronic renal disease (CRD) and in whom 238 procedures were carried out. seven patients (2,85%) had acute renal failure (ARF). The first indication for central catheter insertion was in patients with chronic uremia syndrome as well as in patients with IRA uremia enchephalopathy. The internist nephrologists did most of the insertions (n=207, 84.5%). In 245 insertions 17 important events were described which corresponded to 6,9% of the procedures. Multiple punctures (more than 3) were reported in nine patients. The post implantation chest X-Ray made it possible to detect 4 complications, meaning 1,6% of the procedures, of which none of them was fatal. No association with the event/complications was found in the variables analyzed. No association between IMC and multiple punctures. Conclusions: the implantation of jugular catheters is an easy procedure with a low rate of events or complications. PA X-Ray provides little information when the procedure is free of complications.

Keywords : jugular catheter; complications; PA chest X-Ray.

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