Catheter infections are a significant problem in pediatric hemodialysis. To reduce infection rates, the use of closed luer-lock access connectors, which create a mechanically and microbiogically closed system while allowing unobstructed blood flow, was implemented Infection rates fell from 7.8 infections per 1000 patient days to 3.65 infections per 1000 patient days after the switch to the clos...

Over 60% of patients initiating chronic hemodialysis in the United States have a chronic central venous catheter (CVC) as their first blood access device. Although it would be better if these patients started dialysis with fistulas, the CVC is used because it is a reliable and relatively safe method for obtaining blood access over a period of months. Drawing blood from a vein at 300-400 ml/minu...

PURPOSE We studied whether the risk of central venous catheter (CVC) -related thrombosis increased after an episode of CVC-related infection in patients undergoing intensive chemotherapy. Secondly, we determined whether thrombosis can be predicted or excluded by CVC lock fluid surveillance cultures. PATIENTS AND METHODS In a prospective setting, 105 consecutive patients were carefully examine...

Among currently available vascular access options for hemodialysis, central venous catheters show the poorest reliability, with frequent complications of thrombosis and stenosis impairing patency. The most serious problem, however, is catheter-related bloodstream infection (CRBI), which is typically a cause for removal of the catheter and protracted systemic antibiotic therapy. In our experienc...

epidural set with both horizontal and vertical flanges (in contrast to vertical flanges only or a smooth plunger) can avoid confusion between syringes (Figure). The feel and weight of the loss of resistance syringe with free and consistent movement of the plunger are well discernable to the experienced hand. One may preferably use such dedicated syringes for neuraxial drug administration. Furth...

BACKGROUND Thrombosis of the central venous haemodialysis catheter compromises dialysis adequacy and catheter survival. Heparin containing catheter-locking solution has been associated with bleeding, interferes with INR (prothrombin time/international normalized ratio) measurements and is costly. Sodium citrate has been used successfully as a catheter-locking solution, but long-term experience ...

BACKGROUND Tunnelled central venous dialysis catheter use is significantly limited by the occurrence of catheter-related infections. This randomised controlled trial assessed the efficacy of a 48 hour 70% ethanol lock vs heparin locks in prolonging the time to the first episode of catheter related blood stream infection (CRBSI). METHODS Patients undergoing haemodialysis (HD) via a tunnelled c...