The number of lumens and the size of the catheter have been described as risk factors for thrombus formation 21. Anticoagulation can be initiated, preventing further complications. Not all occlusions lead to upper extremity venous thrombosis (UEVT), and thrombotic occlusions can be treated with antithrombotic agents, while UEVT is treated symptomatically or with catheter removal. The literature describes occlusion rates in PICCs and links them to the number of lumens selected, reporting occlusion rates ranging from 7% to 34%, with fibrin sheath formation being a common cause of mechanical occlusion 20. Depending on the clinical situation, preference should be given to single-lumen devices as outlined in clinical practice guidelines 16-19. These findings have prompted a greater focus on ensuring appropriate use of the PICC in hospitalised patients, including recommendations on the “appropriate choice of vascular access type 16-17“.ĭouble and triple-lumen PICCs (Figure 2) are associated with an increase in occlusion. Ī recent study, for example, found considerable variation in the use of the PICC, indications for use and associated complications in a sample of 10 hospitals 15. It is recommended that double lumen subclavian vein catheterization should be part of post graduate training in large units where hemodialysis is available.However, the choice of device may in some cases be due to the limited information defining the appropriate indications for use of the single-lumen (Figure 1) versus the multi-lumen PICC 14. The procedure is a short term alternative to AV fistula formation for patients requiring long term hemodialysis. 02 (7.14%) cases had arrhythmias and death occurred in 02 (7.14%) cases.Ĭonclusions & Recommendations: Subclavian double lumen catheters proved to be reasonably safe, easy and a reliable way of obtaining vascular access for hemodialysis. Hemothorax and subclavian arterio-venous fistula developed in 02 (7.14%) each. Out of 28 patients who developed complications, in 08 (28.57%) cases complication was failure to cannulate, in 08 (28.57%) cases there was arterial puncture, in 04 (14.28%) cases catheters were mal-positioned/kincking. Out of 200 patients subjected to double lumen catheterizations 28 (14.0%) developed various complications related to insertion. 71% of the patients were female and 29% of the patients were male. Results: Mean Age of the patients was 54.55 ± 10.45. All patient underwent double lumen catheterization of subclavian vein after informed consent. Two hundred patients both male and female requiring hemodialysis were included in the study. Methodology: This cross-sectional descriptive study was conducted at DHQ Hospital Sargodha from April 2014 to April 2015. Objective: This study was designed to find out the frequency of complications during Central venous line insertion via sub clavian route. Inadvertent arterial puncture, ateriovenous fistula, thoracic duct injury, brachial plexus injury, laceration of the subclavian vein, and air embolism are the well described complications of the central line insertion. These devices are increasingly being used for administration of antibiotics and chemotherapeutic drugs, for total parentral nutrition and providing high flow access for hemodialysis and plasmapherisis. Introduction: The demand of long term central venous access devices has risen over the last few decades.
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