Shanmugasundaram Srinidhi, Kubiak Aleksander, Dar Aleena, Shrinet Abhishek, Chauhan Nirav, Haque Humza, Kumar Abhishek, A Shukla Pratik
Division of Vascular and Interventional Radiology, Department of Radiology, Rutgers - New Jersey Medical School, Newark, NJ, USA.
J Vasc Access. 2022 Jan 10:11297298211067332. doi: 10.1177/11297298211067332.
To evaluate the incidence of large bore hemodialysis catheter malfunction in the setting of COVID-19.
A retrospective review was performed of all patients who underwent placement of a temporary hemodialysis catheter after developing kidney injury after COVID-19 infection at our institution. Data collected included demographic information, procedure related information, and incidence of replacement due to lumen thrombosis. Groups were compared using students -test for continuous variables and Fisher's exact test for nominal variables.
Sixty-four patients (43M, mean age 63.2 ± 13.3) underwent placement of temporary hemodialysis catheter placement for kidney injury related to COVID 19 infection. Thirty-one (48.4%) of catheters were placed via an internal jugular vein (IJV) access and 33 (52.6%) of catheters were placed via a common femoral vein (CFV) access. Overall, 15 (23.4%) catheters required replacement due to catheter dysfunction. There were no differences in demographics in patients who required replacement to those who did not ( > 0.05). Of the replacements, 5/31 (16%) were placed via an IJV access and 10/33 (30.3%) were placed via a CFV access ( = 0.18). The average time to malfunction/replacement was 7.8 ± 4.8 days for catheters placed via an IJ access versus 3.4 ± 3.3 days for catheters placed via a CFV access ( = 0.055).
A high incidence of temporary dialysis catheter lumen dysfunction was present in patients with COVID-19 infection. Catheters placed via a femoral vein access had more frequent dysfunction with shorter indwelling time.
评估2019冠状病毒病(COVID-19)背景下大口径血液透析导管故障的发生率。
对我院所有在COVID-19感染后发生肾损伤并接受临时血液透析导管置入术的患者进行回顾性研究。收集的数据包括人口统计学信息、手术相关信息以及因管腔血栓形成导致的导管更换发生率。连续变量采用学生t检验,分类变量采用Fisher精确检验对组间进行比较。
64例患者(43例男性,平均年龄63.2±13.3岁)因COVID-感染相关肾损伤接受了临时血液透析导管置入术。31根(48.4%)导管通过颈内静脉(IJV)入路置入,33根(52.6%)导管通过股总静脉(CFV)入路置入。总体而言,15根(23.4%)导管因功能障碍需要更换。需要更换导管的患者与未更换导管的患者在人口统计学方面无差异(P>0.05)。在更换的导管中,5/31(16%)通过IJV入路置入,10/33(30.3%)通过CFV入路置入(P=0.18)。通过IJV入路置入的导管发生故障/更换的平均时间为7.8±4.8天,而通过CFV入路置入的导管为3.4±3.3天(P=0.055)。
COVID-19感染患者中临时透析导管管腔功能障碍的发生率较高。通过股静脉入路置入的导管功能障碍更频繁,留置时间更短。