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新型冠状病毒肺炎患者临时透析导管功能分析

Analysis of the functioning of temporary dialysis catheters in patients with COVID-19.

作者信息

Ponte Bruno Jeronimo, Dib Viviane Galli, Magnani Arthur Souza, Portela Felipe Soares Oliveira, Cunha Marcela Juliano Silva, Pinheiro Lucas Lembrança, Wolosker Nelson

机构信息

Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, Brasil.

Faculdade Israelita de Ciências da Saúde - FICSAE, São Paulo, SP, Brasil.

出版信息

J Vasc Bras. 2025 Jul 28;24:e20250005. doi: 10.1590/1677-5449.202500052. eCollection 2025.

Abstract

BACKGROUND

Patients with acute renal failure requiring hemodialysis should be treated using temporary hemodialysis catheters due to the urgency and potential reversibility of the condition. To date, 3 studies in North America have suggested a higher risk of catheter-related issues in COVID-19 patients needing hemodialysis.

OBJECTIVES

This study examines the functionality and complications of temporary hemodialysis access in COVID-19 patients at a Brazilian hospital during the coronavirus outbreak of 2020.

METHODS

A retrospective analysis was conducted at a COVID-19 referral center from May to July 2020. During this period, the Vascular Surgery team implanted temporary hemodialysis catheters in 107 patients. These patients were monitored, and their demographic and clinical characteristics were analyzed to identify any that correlated with catheter malfunction.

RESULTS

Of the 107 patients studied, 22 (20.6%) had catheter-related complications. Eighteen (16.8%) had catheter malfunctions, while 4 (3.7%) developed infections. Five patients had unfavorable clinical status and did not undergo catheter replacement. Catheter tip thrombosis was the cause of the malfunction in 13 of the patients with malfunctions. The analysis revealed that the only variables correlated with higher risk of malfunction were the need for orotracheal intubation (p = 0.009), deep vein thrombosis (p = 0.01), and a history of a previous catheter use (p = 0.002).

CONCLUSIONS

The rate of temporary dysfunction of the high-flow catheter in patients with COVID-19 in this sample was similar to the rate described in the literature for patients without this disease.

摘要

背景

由于急性肾衰竭患者病情紧急且具有潜在可逆性,需要进行血液透析的患者应使用临时血液透析导管进行治疗。迄今为止,北美的3项研究表明,需要血液透析的COVID-19患者发生导管相关问题的风险更高。

目的

本研究调查了2020年冠状病毒爆发期间,巴西一家医院中COVID-19患者临时血液透析通路的功能和并发症。

方法

于2020年5月至7月在一家COVID-19转诊中心进行回顾性分析。在此期间,血管外科团队为107例患者植入了临时血液透析导管。对这些患者进行监测,并分析他们的人口统计学和临床特征,以确定与导管故障相关的因素。

结果

在研究的107例患者中,22例(20.6%)出现导管相关并发症。18例(16.8%)发生导管故障,4例(3.7%)发生感染。5例患者临床状况不佳,未进行导管更换。导管尖端血栓形成是13例发生故障患者故障的原因。分析显示,与更高故障风险相关的唯一变量是需要进行气管插管(p = 0.009)、深静脉血栓形成(p = 0.01)和既往有导管使用史(p = 0.002)。

结论

该样本中COVID-19患者高流量导管的临时功能障碍发生率与文献中描述的非COVID-19患者的发生率相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e491/12419749/015b61205efa/jvb-24-e20250005-g01.jpg

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