Survey of permanent central venous catheters for haemodialysis in the UK

BACKGROUND: Venous catheter haemodialysis may be necessary in some patientswithout arterio venous fistulae on dialysis for end-stage renalfailure. We conducted a survey to compare management of thesecatheters in different units in the UK. METHODS: Postal questionnaires were sent to nurses in charge of 81 renalunits in the UK for a twelve month study period in 1994 to findout the type of catheter used, catheter after insertion care,the rate and management of exit site infections, and bacteraemia. RESULTS: (1) Total number of questionnaires returned 66 (81.5%). (2)63.6% of renal units used double lumen Permcath catheters, 16.7%single lumen (Francis/Kimal, Gambro or Vascath), 10.6% use bothdouble and single lumen catheters and 9.1% of renal units onlyuse temporary polyurethane catheters. (3) Catheter exit siteaseptic dressing technique was used in 84.8% of renal units,clean technique in 15.2%. 66.8% changed dressings at each dialysissession, 22.7% weekly. The majority of renal units (63.6%) hadone nurse to change the dressing, used Betadine as a cleaningagent and Mepore to cover the exit site. (4) 75.8% did not knowthe exact incidence of episodes of sepsis and/or exit site infections.Flucloxacillin was the antibiotic of choice for each catheterrelated sepsis episode. CONCLUSIONS: During this study period most renal units used Permcaths asfirst choice for long term catheter dialysis, the after insertioncare of which varied. The number of episodes of sepsis was unknown.We suggest UK collection of data for all long term cathetersand related problems for audit purposes.