Vascular access recirculation in hemodialysis patients with two noncuffed, single-lumen, jugular catheters in the same jugular vein

Janko Kovac, Jadranka Buturović-Ponikvar, Rafael Ponikvar
Therapeutic Apheresis and Dialysis 2009, 13 (4): 350-3
Having achieved excellent results with single-lumen temporary hemodialysis catheters as a long-term vascular access in our center, in this study we examined the amount of vascular access recirculation in the case of using two single-lumen catheters in a single jugular vein. In 11 adult end-stage renal disease patients on chronic hemodialysis (HD), vascular access recirculation was studied using a thermodilution technique during dialysis at our center. The vascular access in all patients consisted of two pre-curved, 15 cm-long, 8-Fr catheters inserted in the right jugular vein. Recirculation measurements were performed with the blood flow set to 250 mL/min in all patients. In five patients, additional measurements were performed with the blood flow set to 200 mL/min. During 16 HD procedures, 55 recirculation measurements were taken. The rate of recirculation was <15% in 50 measurements, between 15% and 20% in four measurements, and >20% in one measurement. The average recirculation rate during a single procedure was <15% in 10 patients, and 16.2% in one patient. We did not find any significant differences in the recirculation rates measured either at higher or lower blood flow rates. The clinical importance of vascular access recirculation was noted in a single patient. Vascular access recirculation in hemodialysis patients with two single-lumen catheters in the same jugular vein is mostly acceptable. Some measures for preventing clinically important recirculation are also suggested.

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