SUCCESSFUL USE OF SINGLE-LUMEN, UROKINASE IMMOBILIZED FEMORAL CATHETERS AS A TEMPORARY ACCESS FOR HEMODIALYSIS

Methods. Placement of a femoral vein catheter as a temporary vascular access for haemodialysis was conducted and the indications, catheter p atency rate, and incidence of catheter-related infections were examine d. An urokinase immobilized femoral vein catheter (UIFC) is a soft pol yurethane single-lumen catheter 2.7 mm in diameter and 22 cm in length which needs no heparin infusion (Japan Shawood Co., Ltd., Tokyo; Unit ica Co., Ltd., Hyogo, Japan). A soft silicon rubber was attached to th e tip of the catheter in order to avoid excessive bleeding during inse rtion. Aseptic adhesive wound dressing was employed at the exit-site w hich was cleansed with popidone-iodine and renewed at each dialysis se ssion. Results. Eighty-one UIFCs were used for haemodialysis in 64 pat ients (acute renal failure: 11; vascular access trouble: 53: initiatio n of chronic dialysis: 17). The average age of the patients was 58 +/- 13 years, ranging from 26 to 80 years. The mean duration of catheter indwelling was 22.4 +/- 13.1 days. An adequate blood flow of 180-200 m l/min was obtained through UIFC and returned to another peripheral vei n punctured at each dialysis session. Unexplained fever occurred in fo ur cases while the UIFC was in place (4.9%) but culture of either bloo d or the catheter tip was negative for bacteria. The catheter was remo ved immediately and fever subsided in all cases. The overall catheter survival rate was 84% at 34 days calculated using the Kaplan-Meier met hod. Catheter insertion was easy to perform and no serious complicatio ns such as pulmonary embolism or septicaemia occurred. Conclusion. Our modified type of UIFC is very useful as a temporary access for haemod ialysis with a very low incidence of catheter-related infections and n o need for heparinization. Excellent catheter patency was maintained w ith the plug system and careful dressing techniques without unnecessar y bleeding during catheter care.