Hemodiyaliz Hastalarında Ultrasonografi Eşliğinde Kalıcı Tünelli Kateter Uygulamalarımız

Objective: Vascular access is most important issue for patients on hemodialysis. Insertion of percutaneous hemodialysis catheters is an invasive procedure with a small but definite risk of morbidity and mortality. It has been suggested that the use of Doppler ultrasonography guidance reduces the immediate complications of haemodialysis catheter insertions such as pneumothorax or arterial puncture. In this study we aimed to show our experiences in permanent tunneled dialysis catheter placement under Doppler ultrasonography. Material and Methods: In our clinic, 98 cases in which permanent tunneled dialysis catheter had been applied were evaluated retrospectively from October 2010 to march 2012. The processes were attempted under local anesthesia and with Doppler ultrasonography. Results: 89 (91%) catheters were applied to the internal jugular vein (79 to the right, 10 to the left vein), 7 (7%) were applied to the subclavian veins and 2 (2%) catheters were implanted to the femoral veins. Puncture of the artery occurred in 2 patients (2%) during the procedure. 1 (1%) patent had catheter malposition. No patient had lung trauma and there was therefore no need for removal of the catheter or a surgical intervention for the complications. Conclusion: The most suitable application for the insertion of the catheters is the right internal jugular vein by using Doppler ultrasonography. With this method, complication and mortality and morbidity rates will be decreased.