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Bleeding Complications in Uremic Patients After Ultrasound-Guided Central Venous Catheter Placement

INTRODUCTION: Bleeding associated with elevated blood urea nitrogen (BUN) is a known complication. Patients with uremia require a central venous catheter insertion by dialysis. The relation between BUN and bleeding complications during central venous catheter insertion is not yet clear. OBJECTIVE: W...

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Autores principales: Diaz, Carime, Quintero, Jaime A, Zarama, Virginia, Bustamante-Cristancho, Luis Alfonso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843503/
https://www.ncbi.nlm.nih.gov/pubmed/36660271
http://dx.doi.org/10.2147/OAEM.S384081
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author Diaz, Carime
Quintero, Jaime A
Zarama, Virginia
Bustamante-Cristancho, Luis Alfonso
author_facet Diaz, Carime
Quintero, Jaime A
Zarama, Virginia
Bustamante-Cristancho, Luis Alfonso
author_sort Diaz, Carime
collection PubMed
description INTRODUCTION: Bleeding associated with elevated blood urea nitrogen (BUN) is a known complication. Patients with uremia require a central venous catheter insertion by dialysis. The relation between BUN and bleeding complications during central venous catheter insertion is not yet clear. OBJECTIVE: We described the frequency of complications associated with central venous catheter implantation in uremic patients and evaluated the statistical relationship between bleeding complications and catheter type, number of punctures, and catheter insertion site. Also, we determined if any value of BUN is associated with bleeding complications. METHODS: We included patients with a serum value of BUN >70 mg/dl that required insertion of a central venous catheter. The quantitative variables were expressed through the measure of central tendency. A bivariate analysis and a ROC curve were performed. RESULTS: A total of 273 catheters were included in this study. Bleeding complications were detected in 69 cases (25.3%), and local bleeding was the most frequent complication in 51/69 cases. Statistically significant association was not established. We did not find a specific cut-off value directly related to BUN levels and the rate of complications. CONCLUSION: Bleeding complications associated with the insertion of central venous catheter and the suspected disorder of hemostasis given by BUN levels >70 mg/dl are common. It was not possible to determine a BUN cut-off value to predict complications. The association analysis was not conclusive. High BUN levels should not be considered a high-risk condition for central venous cannulation under ultrasound guidance performed by trained personnel.
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spelling pubmed-98435032023-01-18 Bleeding Complications in Uremic Patients After Ultrasound-Guided Central Venous Catheter Placement Diaz, Carime Quintero, Jaime A Zarama, Virginia Bustamante-Cristancho, Luis Alfonso Open Access Emerg Med Original Research INTRODUCTION: Bleeding associated with elevated blood urea nitrogen (BUN) is a known complication. Patients with uremia require a central venous catheter insertion by dialysis. The relation between BUN and bleeding complications during central venous catheter insertion is not yet clear. OBJECTIVE: We described the frequency of complications associated with central venous catheter implantation in uremic patients and evaluated the statistical relationship between bleeding complications and catheter type, number of punctures, and catheter insertion site. Also, we determined if any value of BUN is associated with bleeding complications. METHODS: We included patients with a serum value of BUN >70 mg/dl that required insertion of a central venous catheter. The quantitative variables were expressed through the measure of central tendency. A bivariate analysis and a ROC curve were performed. RESULTS: A total of 273 catheters were included in this study. Bleeding complications were detected in 69 cases (25.3%), and local bleeding was the most frequent complication in 51/69 cases. Statistically significant association was not established. We did not find a specific cut-off value directly related to BUN levels and the rate of complications. CONCLUSION: Bleeding complications associated with the insertion of central venous catheter and the suspected disorder of hemostasis given by BUN levels >70 mg/dl are common. It was not possible to determine a BUN cut-off value to predict complications. The association analysis was not conclusive. High BUN levels should not be considered a high-risk condition for central venous cannulation under ultrasound guidance performed by trained personnel. Dove 2023-01-12 /pmc/articles/PMC9843503/ /pubmed/36660271 http://dx.doi.org/10.2147/OAEM.S384081 Text en © 2023 Diaz et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Diaz, Carime
Quintero, Jaime A
Zarama, Virginia
Bustamante-Cristancho, Luis Alfonso
Bleeding Complications in Uremic Patients After Ultrasound-Guided Central Venous Catheter Placement
title Bleeding Complications in Uremic Patients After Ultrasound-Guided Central Venous Catheter Placement
title_full Bleeding Complications in Uremic Patients After Ultrasound-Guided Central Venous Catheter Placement
title_fullStr Bleeding Complications in Uremic Patients After Ultrasound-Guided Central Venous Catheter Placement
title_full_unstemmed Bleeding Complications in Uremic Patients After Ultrasound-Guided Central Venous Catheter Placement
title_short Bleeding Complications in Uremic Patients After Ultrasound-Guided Central Venous Catheter Placement
title_sort bleeding complications in uremic patients after ultrasound-guided central venous catheter placement
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843503/
https://www.ncbi.nlm.nih.gov/pubmed/36660271
http://dx.doi.org/10.2147/OAEM.S384081
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