The use of long- term indwelling central venous catheterization in maintenance hemodialysis patients

Objective To investigate the complications and their treatment in long-term indwelling central venous catheterization in maintenance hemodialysis(MHD) patients.. Method We retrospectively reviewed 339 MHD patients with long-term indwelling central venous catheterization in this hospital, and analyzed the complications due to the catheterization and their management. Results The operation for central venous catheterization was successful in all patients. Thirty- five patients died in the follow- up period, but they were unrelated to the catheterization. The average indwelling period of the catheters was 20.0 ± 15.9months in the rest of 304 patients. The major complications during catheterization operation included difficulties of the guide wire to enter blood vessels in 2 cases, errhysis in 3 cases, palpitation in 4 cases, injury of subclavian vein in one case, and angled torsion of the catheter in one case. Complications in the blood access for hemodialysis period included local infection in 11 cases, insufficient blood access in 24 cases, and cracks in the head of the catheter in one case, which caused termination of the catheterization in 25 cases. Conclusion In MHD patients unsuitable to establish arteriovenous fistulas, long-term indwelling central venous catheterization is an alternative and ideal route for blood access. However, complications due to the catheterization should be carefully monitored and treated.