Introduction:

Dysfunction and infections are the most frequent causes of removal of tunneled central venous hemodialysis catheters.

Objective:

To analyse whether the lateral or medial orientation of the catheter’s arterial line influences early dysfunction.

Material and Method:

Prospective observational study of 24 months’ duration. Adult hemodialysis patients undergoing first-time cannulation of a tunneled venous catheter of the Palindrome® or Bioflo Duramax® model were included. Variables: arterial line orientation, catheter model, socio-demographic and clinical characteristics, blood pump flows, arterial and venous pressures, conductance, complications and defining characteristics of early dysfunction.

Results:

A total of 178 patients were studied, mean age 64.4±15.1 years; 108 men; 105 with arterial line in lateral orientation and 73 with medial orientation. There was early dysfunction in 30 cases (16.9%): lateral orientation 63.3% (n=19) vs medial orientation 36.7% (n=11), (p=0.621). In all cases with early dysfunction, it was necessary to reverse the catheter line to the extracorporeal circuit connections, due to a pump flow <250 ml/min, being more frequent in Palindrome® catheters with arterial line in lateral orientation, 87.5% (n=7) vs medial orientation 12.5% (n=1), (p=0.063).

Conclusions:

In our sample, arterial line orientation did not influence early catheter dysfunction.