COMPARISON BETWEEN INTERNAL JUGULAR VEIN AND SUBCLAVIAN VEIN DOUBLE LUMEN CATHETER CANNULATION, CATHETER RELATED INFECTIONS AND COMPLICATIONS IN HEMODIALYSIS PATIENTS

Main Article Content

Adnan Mushtaq
Hamza Shafiq
Uzzam Ali
Fatima Abdul Hameed
Amna Akbar
Farwa Kazmi
Sarosh Khan Jadoon
Raja Muhammad Ijaz Khan
Sabahat Tasneem

Keywords

Renal failure, double lumen internal jugular vein catheter, double lumen subclavian vein catheter, hemodialysis, complications

Abstract

Introduction: Hemodialysis (HD) is a technique chosen as a substitute for renal function to support the life of patients with low-grade morbidity and renal failure. Vascular access is a critical concern in patients undergoing long-term hemodialysis (HD). Limited data is available regarding the safety analysis of venous catheter-associated complications in local healthcare settings. Internal jugular vein double-lumen catheterization and subclavian vein double-lumen catheterization is be compared in terms of bacterial infection-related adverse effects in a randomized controlled study. This study aimed to identify the safest catheterization technique to decrease significant morbidity-related concerns in patients with renal disease.


Methodology: A comparative prospective study with a cohort of 218 patients (sample size determined by WHO sample size calculator) with renal failure requiring hemodialysis was selected from the Department of Nephrology, Pakistan Institute of Medical Sciences, SZABMU, Islamabad, and were divided into group A (double-lumen internal jugular vein catheter) and group B (double-lumen subclavian vein catheter) after fulfilling the selection criteria. The collected data were analyzed using SPSS version 23.


Results: In groups A and B, complications included procedure failure (18.3% vs. 8.3%), bleeding and hematoma formation (11.0% vs. 3.7%), arterial puncture (10.1% vs. 2.8%), and infection (14.7% vs. 4.6%). In group A, 32.1% of patients had positive culture reports, while in group B, 14.7% of patients had a positive culture report with p value (p=0.002).


Conclusion: Double-lumen subclavian vein catheterization had better outcomes than double-lumen internal jugular vein catheterization in terms of accessibility, infection, and complications.

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