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  • Title: Applications and complications of subclavian vein catheterization for hemodialysis.
    Author: Kamran T, Zaheer K, Khan AA, Khalid M, Akhtar MS.
    Journal: J Coll Physicians Surg Pak; 2003 Jan; 13(1):40-3. PubMed ID: 12685975.
    Abstract:
    OBJECTIVE: To study the indications, complications and duration of 605 subclavian catheters inserted over a period of 4 years as venous access for the management of renal failure in local setup. DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Hemodialysis section, Department of Urology and Kidney Transplantation, Lahore General Hospital, Lahore. The study was conducted from October, 1998 to July, 2002. SUBJECTS AND METHODS: All patients coming for dialysis during the period of October 1998 to July 2002 were included information noted on specific form. RESULTS: Among the patients who underwent subclavian vein catheterization, 75.2% patients were suffering from chronic renal failure and 24.7% patients were admitted for acute renal failure. Among chronic renal failure patients, 21.9% catheters had to be replaced due to various complications e.g. thrombosis, infection or kinking of the catheter. The subclavian catheters remained in place for a mean duration of 4 weeks. Early complications encountered were arterial puncture, inability to cannulate the innominate vein, hemothorax, puncture of thoracic duct, hemomediastinum, arrhythmias and pulmonary hematoma in 10.7%, 16.5%, 0.5%, 0.2%, 0.6% and 0.2% of patients respectively. Mortality attributed to the procedure occurred in 0.1 % cases. Delayed complications included early infection in 15% catheterizations while delayed infection occurred in 39 % cases. CONCLUSION: Percutaneous subclavian catheterization is valuable, relatively easy to learn and safe method with acceptable rate of complications for patients necessitating hemodialysis and no established permanent vascular access.
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