Haemodialysis catheter (Mahurkar) insertion guided with or without ultrasonography

Abstract

Background: Chronic kidney disease significantly contributes to the morbidity and the mortality of critically ill patients through metabolic derangements, fluid overloaded and harmful effects of these disturbances on other failing organs..Kidney failure does not happen overnight, in the early stages of kidney disease there are few, if any, symptoms..Kidney failure is the end result of atypically gradual loss of kidney function , and the most common causes of kidney failure are diabetes and high blood pressure ,kidney failure happens when: 85-90% of kidney function is gone, GFR falls below 15mg/dl, Kidney do not work well enough to keep you alive. Vascular access is be needed into the blood stream for placing needles needed for hemodialysis included fistula, graft and catheter. Patients and Methods: This Cross-sectional Comparative study was conducted on 100 patients of both sexes from outpatient clinic and inpatient wards of internal medicine department in Qena University hospital. Ultra-sonography through the position of IJV and femoral vein were determined using a 7, 5 MHZ linear ultrasound probe, after choosing the proper position the skin was infiltrated with 1% lidocaine and the IJV and femoral vein were located with an 18- gauge needle guided by the ultrasound probe. Results:The complications had occurred in patients using sonar to insert hemodialysis catheter (8%) less than patients with blind technique (22%). Conclusion: Real-time ultrasound guided catheter insertion is superior to the traditional anatomic-landmark techniques for the placement of dialysis catheters and is emerging as the new standard of care. Ultrasound-guidance improves the success, safety and speed of catheter insertion.

Keywords

• hemodialysis catheter; ultrasonography; blind technique