Experience of permacath placement in patients with end stage renal failure in a tertiary hospital

Abstract

Background & objective: Renal failure patients often need hemodialysis to optimize the deranged fluid and electrolyte balance in their blood. It involves drawing patients’ venous blood, route it through the hemodialysis (HD) machine and pump it back into the blood circulation. Frequent HD is conveniently performed through large bore, double lumen catheters and to prevent infection it is tunneled for a few centimeters. We conducted this retrograde study to determine the frequency of complications of tunneled permacath insertions in patients with end stage renal disease (ESRD) undergoing hemodialysis in our tertiary hospital
 Methodology: This retrograde descriptive study was conducted at Department of Anesthesiology, Fauji Foundation Hospital, Rawalpindi. from 1st Jan, 2019 – 1st Jan 2023. We searched and included data from the patient records of 804 patients in whom permacath was inserted for hemodialysis under ultrasound guidance and follow-up was done for 8 weeks. Data was retrieved and stored on a Performa and was analyzed on SPSS version 16.
 Results: Out of 812 permanent catheters passed in 804 patients, 19% had complications. The most common complication was catheter thrombosis (8%), followed by local site bleeding (5%), infection (3%), arterial prick (2%) and hematoma formation (1%).
 Conclusion: Tunneled permacath central venous catheter can be used in patients undergoing hemodialysis until maturation of arteriovenous fistula. It is quite a safe procedure under ultrasound guidance, but strict vigilance is required to prevent short-term and long-term complications.
 Key words: Central Venous Catheters; Renal Dialysis; Thrombosis; Hematoma; Kidney Failure, Chronic; Fluoroscopy; Ultrasonography.
 Citation: Ali L, Ali T, Mustafa SI, Qureshi AA. Experience of permacath placement in patients with end stage renal failure in a tertiary hospital. Anaesth. pain intensive care 2022;27(2):726−730; DOI: 10.35975/apic.v27i2.2357
 Received: June 24, 2023; Revised: September 26, 2023; Accepted: November 15, 2023