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The use of dual lumen jugular venous catheters as definitive long term access for haemodialysis. 1990

P G Blake, and S Huraib, and G Wu, and P R Uldall
Renal Division, Toronto Western Hospital, Ontario, Canada.

We describe the long term use for haemodialysis of the PermCath (Quinton, Seattle, Washington) dual lumen, jugular venous catheter (DLJVC) in 21 patients who had no apparent alternative means of access. The nineteen patients maintained in this manner for periods of 30 to 600 days (mean 233.2) included 6 patients dialyzed for over 12 months. Blood flows exceeded 250 mls/min and recirculation rates averaged 5.9%. Infection and insufficiency due to thrombosis were the major problems. In 8 patients (38.1%) infection required DLJVC removal; in three the catheter was immediately replaced over a guidewire along the same track under antibiotic cover and infection has not recurred. Insufficiency occurred in 10 patients (47.6%) and was successfully managed with oral anticoagulants, local instillation of urokinase (4 cases), systemic streptokinase (2 cases) or by changing the DLJVC over a guidewire (2 cases). We believe that the DLJVC is the long term access method of choice for patients in whom conventional access cannot be constructed.

UI MeSH Term Description Entries
D007239 Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Infection,Infection and Infestation,Infections and Infestations,Infestation and Infection,Infestations and Infections
D007601 Jugular Veins Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins. Jugular Vein,Vein, Jugular,Veins, Jugular
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002405 Catheterization, Central Venous Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein. Central Venous Catheterization,Venous Catheterization, Central,Catheterization, Central,Central Catheterization,Catheterizations, Central,Catheterizations, Central Venous,Central Catheterizations,Central Venous Catheterizations,Venous Catheterizations, Central
D002408 Catheters, Indwelling Catheters designed to be left within an organ or passage for an extended period of time. Implantable Catheters,In-Dwelling Catheters,Catheter, In-Dwelling,Catheter, Indwelling,Catheters, In-Dwelling,In Dwelling Catheters,In-Dwelling Catheter,Indwelling Catheter,Indwelling Catheters
D005260 Female Females
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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