Randomized comparison of high-flow versus conventional hemodialysis catheters

Scott O. Trerotola, Himanshu Shah, Matthew Johnson, Jan Namyslowski, Kenneth Moresco, Nilesh Patel, Michael Kraus, Christine Gassensmith, Walter T. Ambrosius

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Abstract

PURPOSE: To evaluate short-term flow rates achieved with a new split-tip polyurethane hemodialysis catheter. PATIENTS AND METHODS: This was a prospective, randomized, nonblinded study. Patients referred for a tunneled- dialysis catheter received either a conventional silicone (Bard Hickman 13.5 F) if randomized to the control group, or a split-tip, high-flow polyurethane (MedComp AshSplit 14.5 F) catheter if randomized to the study group. Effective flow rates (QbEff) and recirculation were measured with use of ultrasonic dilution at pump settings (Qb) of 200, 300, 350 and 400 mL/min, as well as maximum Qb (QbMax, up to 500 mL/min) sustainable for at least 3 minutes. Measurements were repeated weekly for 6 weeks. Procedure times and initial and late complications were recorded. RESULTS: Twelve patients were enrolled in each group, 11 and eight completed the study in the test and control groups, respectively. Insertion complications, limited to the split- tip group, included asymptomatic air embolus (n = 1), prolonged tunnel bleeding (n = 2), and kinking (n = 2). Recirculation in both groups was low (mean < 6% at all flow rates). QbMax was 499 mL/min in the Ash group and 470 mL/min in the Hickman group. A repeated measures analysis of variance was used. Adjusted (for week) mean effective flow rates (Qbeff, mL/min) were as follows: at Qb = 200, Ash = 211, Bard = 211, P = .93; at Qb = 300, Ash = 301, Bard = 292, P = .28; at Qb = 350, Ash = 341, Bard = 314, P = .03; at Qb = 400, Ash = 375, Bard = 329, P = .01; at QbMax, Ash = 422, Bard = 359, P = .0005. CONCLUSION: Both catheters delivered flows within the acceptable range indicated by the Dialysis Outcomes Quality Initiative. The split-tip catheter is capable of higher flow rates (Qb and QbEff) compared with the conventional catheter, which may allow more efficient dialysis. Insertion complications appear to be higher with the new design.

Original languageEnglish (US)
Pages (from-to)1032-1038
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume10
Issue number8
DOIs
StatePublished - Jan 1 1999

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Keywords

  • Catheters and catheterization, technology
  • Dialysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Trerotola, S. O., Shah, H., Johnson, M., Namyslowski, J., Moresco, K., Patel, N., Kraus, M., Gassensmith, C., & Ambrosius, W. T. (1999). Randomized comparison of high-flow versus conventional hemodialysis catheters. Journal of Vascular and Interventional Radiology, 10(8), 1032-1038. https://doi.org/10.1016/S1051-0443(99)70188-0