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THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: Vascular Access for Continuous Renal Replacement Therapy
Author(s) -
Vijayan Anitha
Publication year - 2009
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2008.00553.x
Subject(s) - medicine , hemodialysis catheter , renal replacement therapy , catheter , vascular access , hemodialysis , intensive care medicine , asepsis , surgery , lumen (anatomy) , internal jugular vein
A working vascular access is essential for performing continuous renal replacement therapy (CRRT) efficiently and without interruption. Dual‐lumen temporary hemodialysis catheters are the catheters of choice, although tunneled catheters can also be utilized if therapy is expected to be prolonged. Hemodialysis catheters have to be inserted under ultrasound guidance by trained personnel, using aseptic conditions. The right internal jugular vein is the preferred site. Catheter malfunction and catheter‐related infections can be reduced by adhering to preventive guidelines such as ultrasound guidance for placement, strict hand hygiene, gauze dressings, and sterile techniques during catheter handling. Antibiotic or antiseptic‐coated catheters and lock solutions may be beneficial in certain patients, but these are not widely used due to the concern for resistant organisms and allergic reactions.