Abstract

MOYA MEJIA, Carmen et al. Systematic monitoring of permanent catheter: a useful tool in studying the rate of infection and dysfunction in two types of tunnelled catheters used in haemodialysis. Rev Soc Esp Enferm Nefrol [online]. 2006, vol.9, n.3, pp.13-19. ISSN 1139-1375.

Patients in haemodialysis are more and more elderly, increasing the complications in their vascular access. Tunnelled permanent catheters (PC) are a good option, but present dysfunctions and/or infections, with a high rate of morbidity. Nursing plays a fundamental role in minimising this risk, so we believe that it could be useful to monitor it and establish protocols from the multidisciplinary viewpoint. Our objectives were: to evaluate the usefulness of systematic monitoring of TPC; to compare the rate of infection and dysfunction between two types of TPC; to identify variables associated with infection; and to evaluate the existence of a relationship between infection and dysfunction. We studied 52 PC: 28 Opti-Flow^® and 24 Schon-Cath^®, fitted in 14 women and 30 men with an average age of 72.3 among patients with Schon-Cath and 73.6 among those with Opti-Flow. The studied variables are: complications in fitting, problems in functioning and infection. Data were collected in a base placed in a network and implemented on line by nursing, nephrologists and radiologists. The results indicated: 1. An overall rate of 0.79 bacteraemia related to the catheter (BRC) / 1000 days of catheter, presenting a larger number of cases of infection with the Schon-Cath^®. 2. The Opti-Flow^® show a high rate of radiological interventions and/or changes and a greater possibility of spontaneous loss. 3. We note a relationship between handling and infection, closer in the Schon-Cath^®, and attributable to greater problems of artery flow and venous pressure. 4. The survival of the catheter increases with the administration of urokinase (UK) and radiological intervention.

Keywords : permanent catheter; haemodialysis; dysfunction; infection.

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