The clinical applications of ultrasound dilution in patients with tunneled cuffed catheter hemodialysis

Objective To explore the clinical application value of ultrasound Dilution (UD) technology in maintenance of vascular access in patients with tunneled cuffed catheter (TCC) hemodialysis (HD). Methods Those HD patients, who used TCC as the vascular access to conducted regular maintenance hemodialysis for over 6 months in Hemodialysis Center of West China Hospital from January 2015 to February 2016, which was assessed by performing UD with HD02 Hemodialysis Monitoring System, were enrolled in this study. Access recirculation (AR) and actual blood flow in all the patients with TCC were recorded. The application of UD in analysis of risk factors for AR was assessed. Chi-square test was adopted to compare the study groups; at the same time, Logistic multivariate regression analysis was adopted to further explore the influencing factors for TCC patients based on HD02 monitoring. Results A total of 78 patients undergoing HD were finally included.Results from UD monitoring analysis among patients with TCCs:(1) Comparison between groups suggested, compared to reverse catheter connection, AR decreased for normal catheter connection, with difference of statistical significance0% (0%~4%) vs. 34% (14%~42%), P<0.01. (2)Multivariate logistic regression analysis indicated that, inverse catheter connection in patients with TCC had independent correlation with AROR=14.754, 95% CI (3.689~59.013), while HD years, TCC creation time and diabetic condition had some correlation with AR without difference of statistical significance (P>0.05). Conclusions Inverse catheter connection is a risk factor for AR in patients with TCC. Vascular access monitoring based on UD may help find vascular access failure, and so has value for clinical application to maintenance of vascular access in HD patients. A multi-center prospective cohort study based is on our schedule to further validate the findings from this study.