PORT/CLAMP FRACTURE OF TUNNELLED DIALYSIS CATHETER BY DR VEERABHADRA GUPTHA, DR JIGAR SHRIMALI
As tunnelled dialysis catheters are used for long term, wear and tear is an issue, majorly affecting port or clamp as they are repeatedly manipulated. Due to this we see a fractured port or clamp as a common issue for tunnelled dialysis catheters after CRBSI (Catheter Related Blood Stream Infection).
Issues arise due to port/clamp fracture is
- Inability to double lock the port after dialysis
- Suction of air
- Increased risk of bleeding
- Higher risk of infection
One or both ports or clamps can be replaced using replacement kits for specific catheters without having to change the entire catheter.
FOR PORT FRACTURE
Reversed tunnel catheters are also available which comes in separate portions of catheter compared to single part in routine tunnelled dialysis catheter where we cannot replace different part directly. But if routine tunnelled dialysis catheter is used, in that case one example is shared where port from temporary dialysis catheter is removed and replaced.
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| Fractured port of tunnelled dialysis catheter | Port from temporary dialysis catheter is removed and replaced |
If there is a port fracture with air suction, there will be a higher risk of infection, and at the time of repair, prophylactic antibiotics should be given.
FOR CLAMP FRACTURE
Repair clamps are available in market which have grooves which allows repair clamps to be mounted easily. They have guide pin available in centre so that tube is pinched evenly.
For more information
https://cardiomed.com/catalog/dialysis/catheter-repair-clamp/
Article Courtesy –
DR Veerabhadra Guptha
About him:
Dr Veebhadra Gupta, MD DM Nephro (Gold Medallist) is working as a Senior Consultant Nephrology, at Aster RV Hospital at present. Dr Gupta has worked as an Assistant Professor, Nephrology, at the Institute of Kidney Diseases and Research Centre, Ahmedabad till 2007 and at the Institute of Nephro-Urology, Bangalore, after that, till 2009. During this time, he was actively involved in teaching and training students pursuing DM in Nephrology, MD in General Medicine and the Dialysis Therapy Course.
Dr Gupta has been the primary investigator for many national and international clinical trials. He has also received the Rotary Service Award and the Doctor’s Day Award from Lions Club, Bangalore. He later underwent higher training in Transplantation and Nephrology at the Asan Medical Centre, Seoul, South Korea, and Harvard University, Boston, respectively, and then attended the executive education programme for Nephrologists at IIM, Ahmedabad. Prior to joining Aster RV Hospital, Dr Veerbhadra Gupta worked as Head of the Department of Nephrology, Columbia Asia Hospital, Yeshwantpur, Bangalore.
Dr. Jigar Shrimali
About him:
Dr. Jigar Shrimali has completed his DM (Nephrology – Gold Medalist) from I.K.D.R.C. – ITS, BJ Medical College, Ahmedabad, Gujarat. He is currently working as a consultant Nephrologist and Transplant Physician in Renus kidney hospital, Ahmedabad, Nadiad, Gujarat. He is also keen on academic programs for which he has conducted several workshops for resident doctors, physicians and dialysis technicians covering 40+ topics on Dialysis Therapies alone. He is author of TEXTBOOK OF DIALYSIS THERAPY.
