Ultrasound-Guided Femoral Dialysis Access Placement
Open Access
- 1 February 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of the American Society of Nephrology
- Vol. 5 (2), 235-239
- https://doi.org/10.2215/cjn.04920709
Abstract
Background and objectives: Insertion of dialysis catheters (DCs) is a prerequisite for successful initiation of hemodialysis. We attempted to determine if ultrasonography-guided (USG) insertion was superior and safer than the anatomical landmark-guided technique (ALT) for the femoral vein (FV). Design, setting, participants, & measurements: This was a randomized prospective study on 110 patients requiring FV DCs in a tertiary care hospital. Patients were randomized into two groups: USG and ALT. Data were collected on demography, operator experience, and side of insertion. The USG group had their catheters inserted under USG guidance, whereas the ALT group had their DC inserted by ALT. Outcome measures included successful insertion of DC, number of attempts, and complications. Results: Both groups were comparable regarding age and gender of patients, operator experience, and the side of catheterization. The overall success rate was 89.1%, with 80% using ALT and 98.2% under USG guidance (P = 0.002). First attempt success rate was 54.5% in the ALT group as compared with 85.5% in the USG group (P = 0.000). The complication rate was 18.2% in the ALT group and 5.5% in the USG group (P = 0.039). The odds ratio (OR) for complications with two or more attempts was 10.73 with a relative risk (RR) of 3.2. The OR for successful insertion using USG was 13.5 (95% CI: 1.7 to 108.7). Conclusions: USG significantly improves success rate, reduces number of attempts, and decreases the incidence of complications related to FV DC insertion.Keywords
This publication has 15 references indexed in Scilit:
- Femoral vs Jugular Venous Catheterization and Risk of Nosocomial Events in Adults Requiring Acute Renal Replacement TherapyJAMA, 2008
- 2005 Annual Report: ESRD Clinical Performance Measures ProjectAmerican Journal of Kidney Diseases, 2006
- Ultrasonic locating devices for central venous cannulation: meta-analysisBMJ, 2003
- Safety and efficacy of femoral-based hemodialysis access graftsJournal of Vascular Surgery, 2002
- Cuffed-tunneled Femoral Catheter for Long-term HemodialysisThe International Journal of Artificial Organs, 2001
- Ultrasound-guided cannulation of the femoral vein for acute hemodialysis access with silicone catheters.The Journal of Vascular Access, 2001
- Ultrasound guidance for placement of central venous cathetersCritical Care Medicine, 1996
- Percutaneous translumbar inferior vena cava cannulation for hemodialysisAmerican Journal of Kidney Diseases, 1995
- Ultrasound-assisted cannulation of the internal jugular vein. A prospective comparison to the external landmark-guided technique.Circulation, 1993
- Comparison of Subdavian Vein With Femoral Vein Catheterization for HemodialysisAmerican Journal of Kidney Diseases, 1983