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001-es BibID:BIBFORM061608
Első szerző:Fülöp Tibor (kardiológus)
Cím:The safety and efficacy of bedside removal of tunneled hemodialysis catheters by nephrology trainees / Fülöp Tibor, Tapolyai Mihály, Qureshi, Naseem A., Beemidi, Vikram R., Gharaibeh, Kamel A., Hamrahian, S. Mehrdad, Szarvas, Tibor, Kovesdy, Csaba P., Csongrádi, Éva
Dátum:2013
ISSN:0886-022X
Megjegyzések:BACKGROUND:Some nephrologists remove tunneled hemodialysis catheters (TDC) at the bedside, but this practice has never been formally studied. Our hypothesis was that bedside removal of TDC is a safe and effective procedure affording prompt removal, including in cases of suspected infection.METHODS:We reviewed our consecutive 3-year experience (2007-2009) with bedside TDC removal at the University of Mississippi Renal Fellowship Program. Data were collected on multiple patients and procedure-related variables, success and complication rates. Association between clinical characteristics and biomarkers of inflammation and myocardial damage was examined using correlation coefficients.RESULTS:Of 55 inpatient TDC removals (90.9% from internal jugular location), 50 (90.9%) were completed without hands-on assistance from faculty. Indications at the time of removal included bacteremia, fever or clinical sepsis with hemodynamic instability or respiratory failure. All procedures were successful, with no cuff retention noted; one patient experienced prolonged bleeding which was controlled with local pressure. Peak C-reactive protein (available in 63.6% of cohort) was 12.9???8.4?mg/dL (reference range: <0.49) and median troponin-I (34% available) was 0.534?ng/mL (IQR 0.03-0.9) (reference range: <0.034) and they did not correlate with each other. Abnormal troponin-I was associated with proven bacteremia (p?<?0.05) but not with systolic and diastolic BP or clinical sepsis.CONCLUSION:Our results suggest that bedside removal of TDC remains a safe and effective procedure regardless of site or indications. Accordingly, TDC removal should be an integral part of competent Nephrology training.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Renal Failure. - 35 : 9 (2013), p. 1264-1268, -
További szerzők:Tapolyai Mihály (1968-) (nefrológus) Qureshi, Naseem A. Beemidi, Vikram R. (orvos) Gharaibeh, Kamel A. (orvos) Hamrahian, S. Mehrdad (orvos) Szarvas Tibor (matematikus informatikus) Kovesdy Csaba P. (orvos) Csongrádi Éva (1969-) (szakorvos)
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