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Hemodialysis Catheters in Infants: A Retrospective Single-Center Cohort Study.
Ma, Grace M Y; Ventura, Luís Marcelo; Amiribadi, Afsaneh; Gnannt, Ralph; Nemec, Rose; Noone, Damien; Licht, Christoph; Amaral, Joao; Temple, Michael; Muthasami, Prakash; Parra, Dimitri; Chamlati, Racha; Connolly, Bairbre.
Afiliação
  • Ma GMY; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada. Electronic address: gracemy.ma@gmail.com.
  • Ventura LM; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Amiribadi A; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Gnannt R; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada; Pediatric Interventional Radiology, Department of Diagnostic Imaging, Pediatric Interventional Radiology, University Children's Hospital Zurich
  • Nemec R; Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Noone D; Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Licht C; Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Amaral J; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Temple M; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Muthasami P; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Parra D; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Chamlati R; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
  • Connolly B; Image Guided Therapy, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
J Vasc Interv Radiol ; 31(5): 778-786, 2020 05.
Article em En | MEDLINE | ID: mdl-32305244
ABSTRACT

PURPOSE:

Evaluate technical aspects and outcomes of insertion/maintenance of hemodialysis (HD) central venous catheter (CVC) during infancy. MATERIALS AND

METHODS:

Single-center retrospective study of 29 infants who underwent 49 HD-CVC insertions between 2002 and 2016. Demographics, procedural, and post-procedural details, interventional radiology (IR) maintenance procedures, technical modifications, complications, and outcomes were evaluated. Technical adjustments during HD-CVC placement to adapt catheter length to patient size were labeled "modifications." CVCs requiring return visit to IR were called IR-maintenance procedures. Mean age and weight at HD-CVC insertion were 117 days and 4.9 kg.

RESULTS:

Of the 29 patients, 13 (45%) required renal-replacement-therapy (RRT) as neonates, 10 (34%) commenced RRT with peritoneal dialysis (PD), and 19 (66%) with HD. Fifteen nontunneled and 34 tunneled HD-CVCs were inserted while patients were ≤1 year. Technical modifications were required placing 25/49 (51%) HD-CVCs 5/15 (33%) nontunneled and 20/34 (59%) tunneled catheters (P = .08). Patients underwent ≤6 dialysis-cycles/patient during infancy (mean 2.3), and a mean of 4.1 and 49 HD-sessions/catheter for nontunneled and tunneled HD-CVCs, respectively. Mean primary and secondary device service, and total access site intervals for tunneled HD-CVCs were 75, 115, and 201 days, respectively. A total of 26 of 49 (53%) patients required IR-maintenance procedures. Nontunneled lines had greater catheter-related bloodstream infections per 1,000 catheter-days than tunneled HD-CVCs (9.25 vs. 0.85/1,000 catheter days; P = .02). Nineteen patients (65%) survived over 1 year. At final evaluation (December 2017) 8/19 survived transplantation, 5/19 remained on RRT, 2/19 completely recovered, 1/19 lost to follow-up, and 3 died at 1.3, 2, and 10 years.

CONCLUSIONS:

Placement/maintenance of HD-CVCs in infants pose specific challenges, requiring insertion modifications, and IR-maintenance procedures to maintain function.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cateterismo Venoso Central / Cateteres de Demora / Diálise Renal / Cateteres Venosos Centrais / Falência Renal Crônica Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Humans / Infant Idioma: En Ano de publicação: 2020 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cateterismo Venoso Central / Cateteres de Demora / Diálise Renal / Cateteres Venosos Centrais / Falência Renal Crônica Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Humans / Infant Idioma: En Ano de publicação: 2020 Tipo de documento: Article