Ⅰ. What is a CVC hemodialysis?
A dialysis central venous catheter is a synthetic double-lumen catheter with red and blue tips that represent the arterial and venous ends respectively. By puncturing the epidermis, it is inserted into the major veins of the thoracic and abdominal chambers, as well as the right atrium.
Blood is extracted from the red port, filtered, and then returned to the body through the blue port during dialysis. For CVC hemodialysis, the central venous catheter is primarily employed as a transitional or ultimate vascular access.
Ⅱ. What are the types of central venous catheters used in CVC hemodialysis?
There are two types of catheters: untunneled catheters without polyester sleeves (temporary dialysis catheters) and tunneled catheters with polyester sleeves (usually used as transitional vascular access) (i.e. long-term dialysis catheters, used for transitional vascular access or final long-term vascular access).
Ⅲ. Do you know how to install a central venous catheter for CVC hemodialysis?
Take, insertion into a jugular vessel, for example. The internal jugular vein is pierced once the skin has been thoroughly cleansed, and a local anesthetic has been injected. Then the internal jugular vein has been punctured. A guidewire is used to guide the insertion of the dialysis catheter into the target location after a successful puncture.
Because the jugular vessels are located at the top of the chest cavity, near the apex of the lung, and surrounded by arterioles, there is a risk of serious complications during the procedure, such as bleeding and haematoma caused locally by accidental artery penetration, and serious complications such as haemothorax and pneumothorax caused by lung apex penetration.
To avoid these risks, a technology that uses ultrasound to guide the puncture in real time and ultrasound with X-ray throughout the cannulation process can be used to assure accurate and safe catheter insertion.
IV. What are the respective indications for CVC hemodialysis temporary and long-term central venous catheters?
The central venous catheter can be utilized right away once it has been inserted. The following conditions are treated using temporary and long-term dialysis catheters, respectively.
1. Dialysis catheters for temporary use
(1) Patients with chronic renal disease who lack vascular access to dialysis but whose condition necessitates the initiation of CVC hemodialysis as soon as feasible.
(2) Patients on maintenance haemodialysis who require a temporary access transition due to permanent access deactivation, but with a transition duration of fewer than four weeks.
(3) Due to different complications, peritoneal dialysis requires a temporary switch to haemodialysis.
(4) Haemodialysis for short-term therapy of poisoning or autoimmune disorders.
2. Dialysis catheters for long-term use
(1) An internal fistula that has not matured for more than four weeks.
(2) Unable or unable to adopt alternate renal replacement treatment because they are unable or reluctant to construct an internal fistula due to acute heart failure or hypotension.
(3) Life expectancy is limited, particularly in individuals with advanced tumors and uremia.
(4) Patients who have had a kidney transplant within the last six months to a year.
(5) Acute renal failure, which necessitates a prolonged recovery period.
Notes:
The peculiarities of the patient's and vascular conditions must be considered while selecting an access method. Please follow medical guidance. Because the central venous catheter for CVC hemodialysis is made of synthetic material and is inserted into the human vasculature through a skin puncture, difficulties are unavoidable.
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