Martins Marrocos Mauro Sergio, S Gentil Thais Marques, de C Lima Fernanda, R Laranja Sandra Maria
São Paulo State Public Server Hospital, São Paulo, Brazil.
J Vasc Access. 2018 Sep;19(5):467-472. doi: 10.1177/1129729818759259. Epub 2018 Mar 12.
Real-time ultrasound is indicated for hemodialysis catheters' insertion in internal jugular veins. We evaluated unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound between patients with and without previous short-term catheters.
Observational open-label study of unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound from July 2013 to August 2014.
A total of 185 procedures were compared in 122 individuals; 120 (64.86%) had previously used short-term catheters. There were 5 (8%) unsuccessful implantation among 62 catheterizations without previous short-term catheter and 41 (33.6%) among 122 with previous short-term catheter (p = 0.001 Pearson's chi-squared, odds ratio = 5.77, 95% confidence interval = 2.15-15.50, p = 0.001). Non-progressing guidewire occurred in 2 (3.2%) of 62 patients without previous short-term catheter and in 18 (14.8%) of 122 with previous short-term catheter (p = 0.018 Pearson's chi-squared, odds ratio = 5.19, 95% confidence interval = 1.16-23.15, p = 0.031). No difference was observed between size of the veins with or without non-progressing guidewire. All 11 cases of venous thrombosis occurred in patients who had previous short-term catheter removed due to infection.
Previous use of short-term catheter is pivotal in the occurrence of unsuccessful implantation of short-term catheter in internal jugular veins using real-time ultrasound.
实时超声适用于颈内静脉血液透析导管的插入。我们评估了在有或无先前短期导管的患者中使用实时超声进行颈内静脉短期血液透析导管植入失败的情况。
2013年7月至2014年8月对使用实时超声进行颈内静脉短期血液透析导管植入失败的观察性开放标签研究。
共对122例个体的185次操作进行了比较；120例（64.86%）曾使用过短期导管。在62例未使用过短期导管的插管中有5例（8%）植入失败，在122例曾使用过短期导管的插管中有41例（33.6%）植入失败（Pearson卡方检验p = 0.001，优势比 = 5.77，95%置信区间 = 2.15 - 15.50，p = 0.001）。在62例未使用过短期导管的患者中有2例（3.2%）导丝推进受阻，在122例曾使用过短期导管的患者中有18例（14.8%）导丝推进受阻（Pearson卡方检验p = 0.018，优势比 = 5.19，95%置信区间 = 1.16 - 23.15，p = 0.031）。导丝推进受阻的静脉大小与未受阻的静脉大小之间未观察到差异。所有11例静脉血栓形成均发生在因感染而拔除先前短期导管的患者中。
先前使用短期导管是使用实时超声进行颈内静脉短期导管植入失败发生的关键因素。
