Dialysis catheter

Dialysis catheters are large-lumen venous catheter with one or two lumens that allow in a temporary or permanent access to the vascular system for hemodialysis (dialysis). There are also triple-lumen catheter, the third lumen is relatively low and may be used for infusions.

Shaldon catheter

For acute dialysis, named after the Scottish nephrologists Stanley Shaldon Shaldon catheter is usually used. As a central venous catheter ( CVC ) shall be submitted to the Shaldon catheter usually via the right internal jugular vein or the subclavian vein into the superior vena cava. It does not come to lie in front of the right auricle due to the smaller length, so that the central venous pressure, in contrast to SPF can not be measured. More rarely, the groin is selected as the access path. This is problematic from a hygienic point, for the sake of mobilization of the patient and because of increased risk of thrombosis.

Atrial catheter by Demers and Siebold

Longer periods to plant a functioning dialysis shunts can be with a permanent central venous catheter, which was named after its inventor Demers catheter bridged. Also a permanent dialysis is over here possible.

Demers the catheter is a single lumen access, which is usually surgically implanted through the rare percutaneously right external jugular vein or via Seldinger technique through the right internal jugular vein and advanced into the right atrium. The outer part is usually to lie below the clavicle in the pit. Here, the catheter is guided through an inserted under the skin Dacron sleeve which will amalgamate in the connective tissue, thus ensuring a stable fit. Through this tunneling the risk of infection is greatly reduced.

In addition to the original Demers catheter, there are now more permanent central venous catheters from other manufacturers, sometimes in double lumen design.

Care and cleaning

If the dialysis catheter not used for hemodialysis, he becomes blocked with heparin or citrate. Because of the above-mentioned Problems, a high risk of infection and high blood loss, improper use, these catheters should be particularly monitored. They should not be used for blood sampling or infusions.

Literature and sources

• Catheter
• Nephrology