Nursing management of catheter-related non-infectious complications of PD: Your questions answered.

A review from the last seven years (August 2016-July 2023) of questions posted to the International Society for Peritoneal Dialysis (ISPD) website "Questions about PD" by nurses and physicians from around the world revealed that 19 of the questions were associated with optimal approaches for preventing, assessing, and managing issues related to PD catheter non-infectious complications. Our review focused on responses to these questions whereby existing best practice recommendations were considered, if available, relevant literature was cited and differences in international practices discussed. We combined similar questions, revised both the original questions and responses for clarity, as well as updated the references to these questions. PD catheter non-infectious complications can often be prevented or, with early detection, the potential severity of the complication can be minimized. We suggest that the PD nurse is key to educating the patient on PD about PD catheter non-infectious complications, promptly recognize a specific complication and bring that complication to the attention of the Home Dialysis Team. The questions posted to the ISPD website highlight the need for more education and resources for PD nurses worldwide on the important topic of non-infectious complications related to PD catheters, thereby enabling us to prevent such complications as PD catheter malfunction, peri-catheter leakage and infusion or drain pain, as well as recognize and resolve these issues promptly when they do arise, thus allowing patients to extend their time on PD therapy and enhance their quality of life whilst on PD.

Evaluación radiológica de catéteres en UCI neonatal / Radiographic assessment of catheters in a neonatal intensive care unit (NICU)

Intravascular catheters are widely used in Neonatal Intensive Care Units. The major types of intravascular access in the newborn are peripheral catheters, venous or arterial umbilical catheters, central venous catheters and peripherally-inserted central venous catheters (PICC). Anomalous positioning of catheters, especially umbilical catheters, is quite frequent as their installation is without imaging guidance. The radiographic assessment of the catheter performed by pediatricians and/or radiologists, who must be able to recognize those poorly positioned as they can cause serious complications, is essential. This article contains a sample of correct and misplaced catheter x-ray often used in a NICU.

Los catéteres intravasculares son ampliamente utilizados en las Unidades de Cuidado Intensivo Neonatal. Dentro de los métodos de acceso intravascular en el RN se incluyen catéteres periféricos, catéteres umbilicales arteriales o venosos, catéteres venosos centrales y catéteres venosos centrales de instalación periférica (CCIP). Las posiciones anómalas de los catéteres, especialmente de los catéteres umbilicales son frecuentes ya que su instalación no es guiada por imágenes. Dado lo anterior es muy importante la evaluación radiológica de control de los catéteres que realizan los médicos pediatras y/o radiólogos, quienes deben ser capaces de reconocer aquellos mal posicionados ya que pueden causar complicaciones graves. Este artículo contiene una muestra pictográfica de radiografías de catéteres de uso frecuente en UCI Neonatal, bien y mal posicionados.