Access recirculation in jugular venous catheter in regular and reversed lines.

INTRODUCTION: The aim of this study was to determine access recirculation in functioning catheters in the regular and reversed positions.

MATERIALS AND METHODS: Access recirculation was measured in 2 sequential hemodialysis sessions in patients with functioning internal jugular catheters inserted not earlier than 2 weeks before the study. The arterial and venous lines were in their regular position during the first session and they were reversed during the second measurement. Changes in access recirculation were assessed. Also, type of the catheter and number of catheter insertions were evaluated in relation to access recirculation.

RESULTS: Twenty-five of the patients had a permanent catheter and 5 had a temporary catheter. During the first session, the mean of access recirculation was 6.9 +/- 6.7% in the patients with a permanent catheter and 7.8 +/- 8.4% in those with a temporary catheter (P = .45). The mean access recirculation was 7.1 +/- 6.9% (range, 0 to 20%) in the 30 patients on hemodialysis with the arterial and venous lines in their regular positions. When the lines were reversed, access recirculation increased significantly (P = .01) to a mean of 20.5 +/- 20.5% (range, 2.3% to 75%). There was no significant correlation between the type of catheter or the number of catheter insertions and access recirculation.

CONCLUSIONS: After reversing the arterial and venous lines, access recirculation in both temporary and permanent functioning catheters may increase; therefore, dialysis adequacy might be impaired by reversed lines. Replacing malfunctioning catheters with new ones seems to be better than reversing the lines.