Complications of Internal jugular catheters in haemodialysis patients at a kidney care center in Nigeria
Article Sidebar
Main Article Content
Abstract
Internal jugular vein catheters (IJC) is recommended as the central venous access of choice in haemodialysis patients. However it is associated with complications of variable severity.
Objectives: To study the complications associated with internal jugular vein catheters in haemodialysis patients in southern part of Nigeria.
Methodology: The clinical details of patients who had IJC insertion at the kidney house, Hilton clinics Port Harcourt from 1st October 2011 to 30th September 2016 were documented. Complications from the IJC developed by the patients during the study period were also documented. The data obtained was analyzed using SPSS version 22. P value less than 0.05 was considered significant.
Results: A total of 129 patients had 150 internal jugular catheter insertions. The mean age was 51.4±15.2 years with male to female ratio of 1.5:1. All the patients had chronic kidney disease; about 80% had tunneled IJC and 96.9% of the catheters were inserted in the right internal jugular vein. Immediate complications were recorded in 10% and late complications in 34.9% of the procedures. The immediate complications were kinking of guide wire (2%), arterial puncture (1.3%) and difficulty in locating the internal jugular vein (1.3%) or tunneling (1.3%). The late complications were infection (12.8%), poor blood flow (9.2%), bleeding (5.5%) and spontaneous removal of the catheter (5.5%). There was no statistical significant difference in both immediate and late complication with age and sex.
The ultrasound examination at discharge had a sensitivity of 31% and specificity of 87% to detect future symptomatic lymphoceles. The positive predictive value was only 10%. The second ultrasound test had the best test variables to detect symptomatic lymphoceles with a sensitivity of 93% and a specificity of 87% and a predictive value of 28%.
Conclusion: Internal jugular catheter is froth with immediate and late complications in haemodialysis patients.
Article Details
Copyright (c) 2019 Hughes OU, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
The Journal of Clinical Nephrology is committed in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. In order to use the Open Access paradigm to the maximum extent in true terms as free of charge online access along with usage right, we grant usage rights through the use of specific Creative Commons license.
License: Copyright © 2017 - 2025 | 
Open Access by Journal of Clinical Nephrology is licensed under a Creative Commons Attribution 4.0 International License. Based on a work at Heighten Science Publications Inc.
With this license, the authors are allowed that after publishing with the journal, they can share their research by posting a free draft copy of their article to any repository or website.
Compliance 'CC BY' license helps in:
| Permission to read and download | ✓ |
| Permission to display in a repository | ✓ |
| Permission to translate | ✓ |
| Commercial uses of manuscript | ✓ |
'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.
National Kidney Foundation. K/DOQI Clinical Practice Guidelines for vascular access. AJKD. 2000; 37: 137-180. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11229969
Weijmer MC, Vervloet MG, Ter Wee PM. Compared to tunnelled cuffed haemodialysis catheters, temporary untunnelled catheters are associated with more complications already within 2 weeks of use. NDT. 2004; 19: 670–677. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/14767025
Dhingra RK, Young EW, Hulbert- shearon TE, Leavey SF, Port FK. Type of vascular access and mortality in US haemodialysis patients. Kidney int. 2001; 60: 1443-1451.
Powe NR, Jaar B, Furth SL, Hermann J, Briggs W. Septicemia in dialysis patients incidence, risk factors, and prognosis. Kidney Int. 1999; 55: 1081-1090. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10027947
Saxena AK, Panhotra BR, Al-Mulhim AS. Vascular Access Related Infections in Hemodialysis Patients. SJKDT. 2005; 16: 46-71. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18209459
Napalkov P, Felici DM, Chu LK, Jacobs JR, Begelman SM. Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis. BMC Cardiovasc Disord. 2013; 13: 86. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24131509
Nakazawa N. Infectious and thrombotic complications of central venous catheters. Semin Oncol Nurs. 2010; 13: 121-131. PubMed:
Kusminsky RE. Complications of central venous catheterization. J Am Coll Surg. 2007; 204: 681-696. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17382229
Bhutta ST, Culp WC. Evaluation and management of central venous access complications. Tech Vasc Interv Radiol. 2011; 14: 217-224. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22099014
Leung J, Duffy M, Finckh A. Real-time ultrasonographically-guided internal jugular vein catheterization in the emergency department increases success rates and reduces complications: A randomized, prospective study. Ann Emerg Med. 2006; 48: 540-547. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17052555
Fragou M, Gravvanis A, Dimitriou V, Papalois A, Kouraklis G, et al.. Real-time ultrasound-guided sub clavian vein cannulation versus the landmark method in critical care patients: A prospective randomized study. Crit Care Med. 2011; 39: 1607-1612. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21494105
Istrate N, Mota E, Cana RD. Central vein catheter complications at haemodialysed patients. Curr health sci journal. 2014; 40.
Al-Wakeel JS, Milwalli AH, Malik GH, Huraib S, Al-Mohaya S, et al.. Dual lumen femoral vein catheterizarion as vascular access for hemodialysis a prospective study. Angiology. 1998; 49: 557-562. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9671855
Vats HS. Complications of catheters: Tunneled and nontunneled. Adv Chronic Kidney Dis. 2012; 19: 188-194. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22578679
Bowdle A. Vascular complications of central venous catheter placement: Evidence-based methods for prevention and treatment. J Cardiothorac Vasc Anesth. 2014; 28: 358-368. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24008166
Chung HY, Soo WK, Myong YN. Percutaneous Catheterization of the Internal Jugular Vein for Hemodialysis. The KJIM. 2001; 16: 242-246.
Kornbau C, Lee KC, Hughes GD, Firstenberg MS. Central line complications. Int J Crit illn Inj Sci. 2015; 5: 170-178. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26557487
Farida S, Ratzika F, Rima L. Haemodialysis catheter related infections: rate, risk factors and pathogens. Jour Inf Pub Health. 2017; 10: 403-408.
Kite P, Dobbins BM, Wilcox MH, McMahon MJ. Rapid diagnosis of central venous related blood stream infection without cathetr removal. Lancet. 1999; 354: 1504-1507.
Early TF, Gregory RT, Wheeler JR, Snyder SO Jr, Gayle RG. Increased infection rate in double-lumen versus single-lumen Hickman catheters in cancer patients. South Med J. 1990; 83: 34-36. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2300831
Ash SR. Advances in tunneled central venous catheters for dialysis: design and performance. Semin Dial. 2008; 21: 504-515. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19000125