DUAL-LUMEN FEMORAL VEIN CATHETERIZATION AS VASCULAR ACCESS FOR HEMODIALYSIS - A PROSPECTIVE-STUDY

Prospectively from January 1991 to January 1993, the efficacy and comp lications of 104 polyurethane, double-lumen femoral vein catheterizati ons (FVC) in 96 renal failure patients were studied. Ambulation was al lowed in the hospital as well as at home while the catheter was in. Th ere were 53 males and 43 females, with ages ranging from 13 to 87 (mea n, 48.3 +/- 19.7) years. Forty-eight patients had chronic renal failur e and 48 had acute renal failure. The catheters were used for 1 to 26 days (mean, 8 +/- 5 days). Fifty-two (50%) of the FVC were used for 2 weeks and 14 (13.5%) for 3 weeks or longer. The various complications encountered were infection (n=31), poor blood flow (n=8), displaced ca theter (n=6), thrombosis of the catheter (n=4), hematoma (n=4), bleedi ng (n=3), exit site infection (n=3), ileofemoral vein thrombosis (n=2) , and tear in the catheter wall (n=2). On removal, bacterial colonizat ion was present in 34 out of 93 catheter tips (36.5%); Staphylococcus epidermidis (n=12) was the commonest organism grown. There was no sign ificant difference of infection between diabetic and nondiabetic chron ic renal failure patients. The duration of catheterization was found t o have no relation with either thrombosis or infection. Femoral vein c atheters can be used for hemodialysis for 2 to 3 weeks and ambulation during cannulation may be allowed.