I've been told by a new surgeon to my small town that dialysis can and should be done through tunnelled catheters i.e. Hickman's. Pt then has one access that is permanent and can be used for everything. No one in my town does this and I can just hear the nephrologists now. Would love to hear from anyone who has info on this. It came up because we have a 600 lb frequent flier (very frequent) who I finally persuaded the primary to order port a cath placement. along comes the surgeon, and doesn't want a port placed, says use the perma cath. OK but when the patient leaves and the perma cath is out, we're back to square one.
Traditional tunneled catheters have been used for hemodialysis in the past, however they are generally too small and do not consistently produce the high flow rates required for dialysis. The exit lumens are also not staggered as other dialysis catheters are. The idea of using one device for everything is not a good one. CDC guidelines state that dialysis catheters should only be used for other infusions in an emergency due to the high risk of loosing that dialysis catheter from infection, thrombosis, etc. Permacath is a long-term tunneled dialysis catheter that is larger than a regular tunneled catheter, has staggered exit lumens and is designed for dialysis.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861