Complications of central venous catheter insertion through 3 approaches in hemodialysis

Objective To summarize the clinical application of central venous catheters in hemodialysis and explore the better central venous catheter insertion site,catheterization time and the prevention and cure of catheter-related complications.Methods We retrospectively analyzed 2000 times of central venous catheterization in 1966 patients of acute or chronic renal failure treated in our department from January 2000 to June 2007.The catheter insertion site was femoral vein in 450 cases,subclavian vein in 86 cases,and internal jugular vein in 1464 cases.Results The catheterization time in femoral vein ranged 5-75 d(mean 20.5±13.1),that in subclavian vein 10-84 d(mean 41.8±20.1),and that in internal jugular vein 12-155 d(mean 53.8±28.5).Infections occurred in 211 patients and blood clogging in catheter in 183,both mainly in those undergoing internal jugular vein catheterization or femoral vein catheterization.Accidental withdrawal catheter happened in 15 patients,mainly in those undergoing femoral vein catheterization.Local hematoma occurred in 19,errhysis in 81,and arrhythmia in 2,all mainly in those undergoing internal jugular vein catheterization.Conclusion The advantages of central venous catheterization in hemodialysis are shortcut,convenience and safety.The catheterization time in internal jugular vein is longer than that in femoral vein and subclavian vein.The catheter-related complications occurred more often in femoral vein than in subclavian vein and internal jugular vein.The first choice of catheter insertion site is internal jugular vein in clinical operation.