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Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19

BACKGROUND: COVID-19, the syndrome caused by the novel SARS-CoV2, is associated with high rates of acute kidney injury requiring renal replacement therapy (RRT). It is well known that despite the ease of bedside insertion, the use of nontunneled dialysis catheters (NTDCs) is associated with increase...

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Autores principales: Williams, Austin D., Qaqish, Michael, Elnagar, Jaafar, Michos, Lia, Nantermet, Sebastian, Meisner, Robert, DiGiovanni, Vincent, Uribe, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825820/
https://www.ncbi.nlm.nih.gov/pubmed/33493592
http://dx.doi.org/10.1016/j.avsg.2021.01.059
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author Williams, Austin D.
Qaqish, Michael
Elnagar, Jaafar
Michos, Lia
Nantermet, Sebastian
Meisner, Robert
DiGiovanni, Vincent
Uribe, Alexander
author_facet Williams, Austin D.
Qaqish, Michael
Elnagar, Jaafar
Michos, Lia
Nantermet, Sebastian
Meisner, Robert
DiGiovanni, Vincent
Uribe, Alexander
author_sort Williams, Austin D.
collection PubMed
description BACKGROUND: COVID-19, the syndrome caused by the novel SARS-CoV2, is associated with high rates of acute kidney injury requiring renal replacement therapy (RRT). It is well known that despite the ease of bedside insertion, the use of nontunneled dialysis catheters (NTDCs) is associated with increased complications compared to tunneled dialysis catheters (TDCs). Our objective was to develop a strategy for TDC placement at the bedside to provide effective dialysis access, conserve resources and decrease personnel exposure at our medical center in an epicenter of the COVID-19 pandemic. METHODS: A technique for bedside TDC insertion with ultrasound and plain radiographs in the intensive care unit was developed. Test or clinically COVID-19-positive patients requiring RRT were evaluated for bedside emergent NTDC or nonemergent TDC placement. Patients who underwent NTDC placement were monitored for ongoing RRT needs and were converted to TDC at the bedside after 3–5 days. We prospectively collected patient data focusing on complications and mortality. RESULTS: Of the 36 consultations for dialysis access in COVID-positive patients from March 19 through June 5, 2020, a total of 24 bedside TDCs were placed. Only one patient developed a complication, which was pneumothorax and cardiac tamponade during line placement. In-hospital mortality in the cohort was 63.9%. CONCLUSIONS: Bedside TDC placement has served to conserve resources, prevent complications with transport to and from the operating room, and decrease personnel exposure during the COVID-19 pandemic. This strategy warrants further consideration and could be used in critically ill patients regardless of COVID status.
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spelling pubmed-78258202021-01-25 Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19 Williams, Austin D. Qaqish, Michael Elnagar, Jaafar Michos, Lia Nantermet, Sebastian Meisner, Robert DiGiovanni, Vincent Uribe, Alexander Ann Vasc Surg Article BACKGROUND: COVID-19, the syndrome caused by the novel SARS-CoV2, is associated with high rates of acute kidney injury requiring renal replacement therapy (RRT). It is well known that despite the ease of bedside insertion, the use of nontunneled dialysis catheters (NTDCs) is associated with increased complications compared to tunneled dialysis catheters (TDCs). Our objective was to develop a strategy for TDC placement at the bedside to provide effective dialysis access, conserve resources and decrease personnel exposure at our medical center in an epicenter of the COVID-19 pandemic. METHODS: A technique for bedside TDC insertion with ultrasound and plain radiographs in the intensive care unit was developed. Test or clinically COVID-19-positive patients requiring RRT were evaluated for bedside emergent NTDC or nonemergent TDC placement. Patients who underwent NTDC placement were monitored for ongoing RRT needs and were converted to TDC at the bedside after 3–5 days. We prospectively collected patient data focusing on complications and mortality. RESULTS: Of the 36 consultations for dialysis access in COVID-positive patients from March 19 through June 5, 2020, a total of 24 bedside TDCs were placed. Only one patient developed a complication, which was pneumothorax and cardiac tamponade during line placement. In-hospital mortality in the cohort was 63.9%. CONCLUSIONS: Bedside TDC placement has served to conserve resources, prevent complications with transport to and from the operating room, and decrease personnel exposure during the COVID-19 pandemic. This strategy warrants further consideration and could be used in critically ill patients regardless of COVID status. Elsevier Inc. 2021-05 2021-01-22 /pmc/articles/PMC7825820/ /pubmed/33493592 http://dx.doi.org/10.1016/j.avsg.2021.01.059 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Williams, Austin D.
Qaqish, Michael
Elnagar, Jaafar
Michos, Lia
Nantermet, Sebastian
Meisner, Robert
DiGiovanni, Vincent
Uribe, Alexander
Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19
title Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19
title_full Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19
title_fullStr Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19
title_full_unstemmed Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19
title_short Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19
title_sort bedside tunneled hemodialysis catheter placement in patients with covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825820/
https://www.ncbi.nlm.nih.gov/pubmed/33493592
http://dx.doi.org/10.1016/j.avsg.2021.01.059
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