The subclavian hemodialysis catheter offers fast and safe access for efficient hemodialysis and preserves peripheral vessels for permanent access.
We review 149 subclavian catheters placed in 120 patients requiring venous access for hemodialysis at Soonchunhyang University Hospital between March 1989 and June 1990.
@ES The following result were obtained:
@EN 1) The most frequent age group was in the 6th decade of life(26.7%) followed by the 5th decade(23.3%), and then the 4th decade(20.8). Male to female sex ratio was 1.4 : 1.
2) The main indications for subclavian catheter insertion were CRF while waiting permanent access, sudden loss of arteriovenous fistula peritoneal dialysis who require substitute hemodialysis and ARF.
3) The catheters were in place for an average of 47.9 days per catheter. A mean of 17.4 dialysis teatment for catheter and 1591 hemodialyses were performed.
4) The exit site infection developed in 21 cases(14.1%) of 149 catheters. The rist of exit site infection in this study increased linearly with time.
5) Over-all rate of complication was 52.4%. Complications during catheter placement were subclavian arterial puncture(3 cases), exit site bleeding(3 cases), but serious traumatic complications such as pneumothorax, or hemothorax, or
hemopericardium, or
air embolism did not occur. Complications during dialysis were exit site infection(21 cases), catheter thrombosis(6 cases) and catheter related septicemia(5 cases).
6) Organisms from exit site infection were Coagulase negative staphylococcus(14 cases), Staph, aureus(5 cases), E. coli(1 cases), Pseudomona aeruginosa(1 case). Staphylococci were the predominant organisms causing exit site infection. Organisms
causing
septicemia were E. coli(2 cases), Staph, aureus(2 cases) and Acinetotobacter calcoaceticus(1 case). There were no infection-related death.
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