Smith Nancy Colobong
University of Washington Medical Center, Seattle, WA, USA.
Nephrol Nurs J. 2010 Sep-Oct;37(5):523-8; quiz 529.
An arteriovenous access is preferred for hemodialysis, but the use of tunneled, cuffed catheters may be necessary in the inpatient setting with acute kidney injury when immediate hemodialysis is required and fistula immaturity or access complications are present. Care of the dialysis central venous catheter is paramount in the prevention of central line-associated bloodstream infections in acutely ill individuals. One institution's approach to hemodialysis central venous catheter care and a quality improvement projectfor selecting tunneled catheters will highlight their changing practice.
血液透析首选动静脉通路，但在急性肾损伤的住院患者中，当需要立即进行血液透析且存在内瘘未成熟或通路并发症时，可能需要使用带隧道的带 cuff 导管。在预防急性病患者的中心静脉导管相关血流感染方面，透析中心静脉导管的护理至关重要。一家机构的血液透析中心静脉导管护理方法以及一项选择带隧道导管的质量改进项目将突出其不断变化的做法。
