Back
 IJCM  Vol.7 No.9 , September 2016
A New Type of Double-Lumen Catheter to Replace Current One in RCA
Abstract: Objective: To replace the peripheral venous puncture for blood sampling with taking blood samples extracorporally from arterial line before predilution during RCA-CRRT performed. Methods: A new type of double-lumen femoral catheter was used instead of the current tubes. The new type of double-lumen tube had a greater distance from the inner venous ports to the inner arterial ports than current tubes. The minimum distance from the venous port to the arterial port was greatly lengthened. Replacement solution contained citrate, zero Ca2+, zero bicarbonate, low Na+. Blood samples were synchronously collected from the arterial line before the infusion of citrate replacement fluid and from the peripheral vein. The iCa concentration data of two groups were analyzed to observe the difference between iCa concentration levels in the arterial line and in peripheral vein; the anticoagulant effect of RCA and possible complications were observed, such as bleeding, clottings and hypocalcaemia. Results: 28 times of RCA-CRRT were performed on17 AKI and CRF patients with active bleeding or at the high risk of bleeding; 336 blood samples were collected. Statistics showed that the difference of iCa concentration between arterial line group and the peripheral vein group was not significant (P = 0.9), there is a high degree of similarity between the iCa concentration of arterial line blood and the peripheral venous blood. None of the patients developed citrate toxicity or metabolic alkalosis. None induced bleeding, or bleeding aggravated. No obvious clotting occurred. Systemic calcium concentration was achieved in the ideal range. Conclusion: In clinical practice, the data of iCa concentration from arterial line can be used to replace that from peripheral vein when the new type of double-lumen femoral catheter is placed in femoral vein. RCA-CRRT therapy is safe and effective.
Cite this paper: Xue, Y. and Yu, Z. (2016) A New Type of Double-Lumen Catheter to Replace Current One in RCA. International Journal of Clinical Medicine, 7, 620-627. doi: 10.4236/ijcm.2016.79068.
References

[1]   Shum, H.-P., Chan, K.-C., Yan, W.-W., et al. (2012) Regional Citrate Anticoagulation in Predilution Continuous Venovenous Hemofiltration Using Prismocitrate 10/2 Solution. Therapeutic Apheresis and Dialysis, 169, 81-86.
http://www.ncbi.nlm.nih.gov/pubmed/22248200
http://dx.doi.org/10.1111/j.1744-9987.2011.01001.x


[2]   Evenepoel, P., Maes, B., anwalleghem, J.V., et al. (2002) Regional Citrate Anticoagulation for Hemodialysis Using a Conventional Calcium-Containing Dialysate. American Journal of Kidney Diseases, 39, 315-323.
http://www.ncbi.nlm.nih.gov/pubmed/11840372

[3]   Little, M.A., Conlon, P.J. and Walshe, J.J. (2000) Access Recirculation in Temporary Hemodialysis Catheters as Measured by the Saline Dilution Technique. American Journal of Kidney Diseases, 35, 477-481.
http://www.ncbi.nlm.nih.gov/pubmed/?term=Access+recirculation+in+temporary+
hemodialysis+catheters+as+measured+by+the+saline+dilution+technique


[4]   Palsson, R. and Niles, J.L. (1999) Regional Citrate Anticoagulation in Continuous Venovenous Hemofiltration in Critically Ill Patients with a High Risk of Bleeding. Kidney International, 55, 1991-1997.
http://www.ncbi.nlm.nih.gov/pubmed/10231464
http://dx.doi.org/10.1046/j.1523-1755.1999.00444.x


[5]   Zheng, Y. and Ding, F. (2015) Application of RCA in CRRT. Chinese Journal of Blood Purification, 1, 47-50.

 
 
Top