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Inserting tunnelled hemodialysis catheters using elective guidewire exchange from nontunnelled catheters: Is there a greater risk of infection when compared with new‐site replacement?
Author(s) -
CASEY Jonathan,
DAVIES Jonathan,
BALSHAWGREER Amanda,
TAYLOR Nichola,
CROWE Alexander V.,
McCLELLAND Peter
Publication year - 2008
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2008.00240.x
Subject(s) - medicine , hemodialysis , catheter , surgery , bacteremia , hemodialysis catheter , sepsis , antibiotics , microbiology and biotechnology , biology
The objective is to evaluate bacteremia outcomes and survival rates when using guidewire exchange to place tunnelled hemodialysis catheter (THDC) compared with a new‐site replacement. Retrospectively, all patients were identified who received a THDC between January 1, 2000 and January 1, 2007. Any THDC having received antibiotic line locks or tunnel‐to‐tunnel exchange were excluded. This left 408 THDC placed in 329 patients: 46 guidewire exchange, 362 new‐site replacement. Bacteremia rate from the new‐site insertion group was 3.0 per 1000 catheter days, the guidewire exchange group demonstrated a rate of 2.8 per 1000 catheter days. Local infection rates did not differ between the groups at 1.2 per 1000 catheters days. The actuarial catheter survival rates using Kaplan‐Meier survival analysis demonstrated no difference between the 2 groups. The placing of tunnelled cuffed hemodialysis catheters to replace temporary catheters using a guidewire exchange did not contribute to further episodes of sepsis and has the advantage of preserving venous access and minimizing invasive procedures for the patient.