Dr Andrea Huang1, Dr Jeffrey Wong1
1Department of Renal Medicine, Liverpool Hospital, SWSLHD, Sydney, Australia
Aim: To determine the common indications and safety of tunnelled haemodialysis catheter removals.
Background: Removal of tunnelled haemodialysis catheters are an essential skill important for patient safety done in both the inpatient and outpatient setting.
Methods: A retrospective analysis was done for 443 catheter removals done in Liverpool Hospital by renal physicians and trainees between 2016 and 2022. Date of insertion, removal indications, immediate post procedural complications, and functional time period of the catheters were analysed.
Results: A total of 443 catheters were removed during the follow up period. Renal trainees and consultants performed 76.98% and 23.02% of the procedures respectively. The majority of catheters removed were because of establishment of alternative dialysis access (60.7%, 269/443), and 21.2% of catheters were removed for infection of which 80.9% were done as an inpatient. Infected catheters had a mean lifespan of 344.1 days, whereas those removed due to a functioning fistula or PD catheter had a mean lifespan of 372.1 days and 158.2 days respectively with a significant difference (p<0.05). Those removed due to complete renal recovery in patients no longer requiring dialysis had a mean lifespan of 70.3 days. Of 341 removals done by trainees, 11 (3.2%) had complications, of which 8 were post procedural bleeds which did not require intervention. Out of these bleeds only one required hospitalisation overnight for monitoring without need for further intervention in the context of therapeutic anticoagulation.
Conclusion
Removal of tunnelled haemodialysis catheters is a procedure safely done by renal trainees with a low complication rate. Widespread training of such a skill could enable even earlier removal of catheters for patients.
Biography:
Andrea Huang is a first year renal advanced trainee currently at Liverpool Hospital. She graduated from University of Sydney in 2017 and trained at Nepean Hospital and Liverpool Hospital.