Catheter used in artificial kidney

Kidney failure is a very common endocrine-urinary system disease that makes it difficult for patients to remove waste products and toxic substances from the blood. The current common treatment for this disease is hemodialysis. The placement of a central venous catheter for dialysis can greatly facilitate hemodialysis.

The kidney is a very important organ in the human body, responsible for filtering urine and blood, preventing waste and toxic substances from entering the blood and urine. In addition, the kidneys can also regulate the amount of water and minerals in the body and produce a number of substances necessary for the body's metabolism. Therefore, if in a day the kidneys are damaged and cannot perform their functions, it will lead to toxic wastes that will accumulate in the blood, causing many different diseases, including: causing coma and eventually death.
Hemodialysis is a treatment for this condition that prevents waste products from accumulating in the blood in excessive amounts. In this method, the blood of patients with kidney failure will be taken out through a central venous catheter to remove waste products in the blood, after filtering, the blood will be returned to the body through a tube. other. Hemodialysis through a central venous catheter is usually applied about 3 times / week for a patient, each dialysis takes about 3 to 4 hours.

Central venous catheters for dialysis are specifically indicated in the following cases:
Patients with acute renal failure Patients with acute poisoning Patients with indications for plasma exchange Patients in stage 5 of the disease chronic kidney disease is starting hemodialysis Patient is on hemodialysis treatment cycle is broken or patient is contraindicated for surgery Fistula, Graft... Patients with indications for peritoneal dialysis Patient There is an indication for a kidney transplant, which may be pending transplant or rejection. Types of catheters commonly applied in clinical practice such as:
1 Catheter Catheter, 2 Catheter Catheter is made of polymer or silicone The length of the catheter varies depending on the location of the vein in which the catheter is placed, if it is in the femoral vein then the catheter length is ≥ 20cm, the right internal jugular vein, the catheter length = 15cm, in case the catheter is placed in the left internal jugular vein, the length = 20cm Catheter without cuff or catheter with cuff Technique for placing central venous catheter The center position, also known as the Seldinger technique, is performed as follows:
Prepare the patient's position to be moderately inclined, the patient's body should not be too tilted because it will collapse the vessel. Elevate the patient's shoulder Identify the sternocleidomastoid muscle and sternum to find the carotid triangle, capture the carotid artery Use a 22G probe to poke the outside of the carotid artery at an angle of 30° - 45°, towards the nipple of the patient, while performing vacuum aspiration. In case there is no blood coming out of the syringe, it is necessary to withdraw the needle and poke the needle in an outward direction, in the middle compared to the original position until blood appears, then mark the depth and direction of the needle Withdraw the needle exploratory Central venous catheterization should be placed on the patient's head in a slanted position, if placed in the thigh, flex the patient's thigh to an angle of 30°.

Some complications that can occur when central venous catheters are placed are:
Bleeding after insertion Cardiac arrhythmias Air embolism Subclavian vein damage, left internal jugular vein injury Misplaced catheter placement Location Pneumothorax, hemothorax Hemopericardium Pericardial hemothorax Catheterization causing perforation or narrowing of the central vein Thrombosis: may be exogenous thrombus including thrombus in the venous wall, central vein, atrium or Endogenous thrombosis includes thrombus in the catheter lumen or tip or in the peri-catheter fibrin sheath. Appearance of fibrin sheath around the catheter Infection after central venous catheter insertion: is a common complication, possibly an infection of the exit site, causing the patient to have clinical symptoms such as swelling, pain, redness in the catheter site. , and there may be inflammatory or purulent exudate at the catheter outlet, or there may be central longitudinal tunnel infection. Another type of infection that can be encountered after insertion of a central venous catheter for dialysis is catheter sepsis, in which case the patient should be removed immediately because of the serious infection, the bacteria that cause dialysis. The disease moves from the skin to the connector, the catheter lumen causes infection in the patient and can lead to death in the absence of timely treatment. Central venous catheterization Central venous catheterization in hemodialysis is an effective treatment for patients with renal failure, helping to maintain dialysis capacity as well as prolonging the patient's life. . However, this is an invasive technique and can leave some complications, so the placement of central venous catheters for dialysis needs to be done in reputable medical facilities, with adequate equipment and teams. experienced medical team.
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