Clinical application of internal jugular vein cuffed-tunneled catheters: Report of 240 cases

Objective To contrast the catheterization and application of internal jugular vein cuffed-tunneled catheters in hemodialysis (HD) patients at different ages, and to evaluate the safety and effectiveness of the application of internal jugular vein cuffed-tunneled catheters in elderly patients.Methods The internal jugular vein cuffed-tunneled catheters were inserted to 240 patients with end stage renal disease in navy general hospital to perform hemodialysis by using Seldinger technique. According to whether the age is more than 65 years old, the patients were divided into group A and B. The end position of the catheters, the incidence of the dysfunction of the catheter, the proportion of the normal use of the catheter, the reasons for the stopping use of the catheter and the common complications of the catheterization were observed, and the statistical treatment was performed.Results All catheters of group A and B can be used normally and the blood flow was 250~500 ml/min. The average survival of the internal jugular vein cuffed-tunneled catheters was 16.3 months, the longest was 41 months and the shortest was 4 months. There is a statistical difference between the two groups of intubation on the left and right internal jugular vein approach (P<0.05). The dysfunction rates between two groups were not different. The proportions of normal use and disuse between two groups were not different (P=0.265 and P=0.296). Patients of group A and B with bleeding, catheter blockage, infection and other complications were less, and the catheters can be used normally after treatment.Conclusions For some HD patients with difficulty in establishing the A-V fistula, the internal jugular vein cuffed-tunneled catheter can achieve dialysis adequacy and is a safe and effective choice for elderly patients.