Research progress on tunnel-cuffed catheter placement and maintenance in maintenance hemodialysis patients_West China Medical Journal

Authors：

CHE Xu ¹ ,  QIAO Dongge ² , GUO Cunxia ³ , CAO Qizheng ⁴ , CUI Rongrong ⁴

1. Nursing Department, Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou, Henan 450002, P. R. China;
2. The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan 450001, P. R. China;
3. Blood Purification Center, Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou, Henan 450002, P. R. China;
4. School of Nursing, Henan University of Chinese Medicine, Zhengzhou, Henan 450046, P. R. China;

Corresponding author：

QIAO Dongge, Email: 906926832@qq.com

Keywords：

Hemodialysis; tunnel-cuffed catheter; research progress; review

DOI：

10.7507/1002-0179.202210194

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Tunnel-cuffed catheter catheters are one of the important means of vascular access for hemodialysis patients. Appropriate catheter placement methods and effective intervention measures can help improve the service life of tunnel catheters, reduce the incidence of complications, and ensure the quality of dialysis treatment. This article provides a review of the placement and maintenance of tunnel-cuffed catheters, with the aim of providing a reference for medical staff to perform tunnel-cuffed catheterization operations and reduce related complications. The placement of tunnel-cuffed catheters includes the type, location, and tip positioning of the catheter, the maintenance includes endovascular monitoring and use of disinfectants, dressings and ointments, use of sealing fluid, management of catheter complications, identification of individual differences and early assessment and screening.

Citation： CHE Xu, QIAO Dongge, GUO Cunxia, CAO Qizheng, CUI Rongrong. Research progress on tunnel-cuffed catheter placement and maintenance in maintenance hemodialysis patients. West China Medical Journal, 2023, 38(7): 1077-1081. doi: 10.7507/1002-0179.202210194 Copy

1.	中国医院协会血液净化中心分会血管通路工作组. 中国血液透析用血管通路专家共识(第 2 版). 中国血液净化, 2019, 18(6): 365-381.
2.	李玉伟, 王海蛟, 崔巍, 等. 保留后方韧带复合体的腰椎融合术远期疗效观察. 中国修复重建外科杂志, 2019, 33(1): 56-60.
3.	Agarwal AK, Haddad N, Boubes K. Avoiding problems in tunneled dialysis catheter placement. Semin Dial, 2019, 32(6): 535-540.
4.	王慧, 姚苗苗, 张佳馨, 等. 血液透析患者中心静脉置管护理的最佳证据总结. 中国血液净化, 2020, 19(8): 569-572.
5.	熊嫚, 贺锐, 赵晓珊, 等. 血液透析患者中心静脉置管后导管相关性血栓研究进展. 成都医学院学报, 2022, 17(3): 395-399.
6.	杨阳, 张凌, 刘晨, 等. 血液净化中心静脉导管结构优化的研究进展. 生物医学工程研究, 2022, 41(4): 411-416.
7.	刘云访, 喻姣花, 黄海燕, 等. ICU 中心静脉导管相关性血流感染预防的证据总结. 护士进修杂志, 2020, 35(4): 319-325, 333.
8.	张叶, 陈嘉, 徐宁, 等. 中心静脉导管相关血流感染的预防新进展. 中国老年保健医学, 2019, 17(5): 103-105.
9.	Clark E, Kappel J, MacRae J, et al. Practical aspects of nontunneled and tunneled hemodialysis catheters. Can J Kidney Health Dis, 2016, 3: 2054358116669128.
10.	Leiderman DBD, Souza KP, Binatti CET, et al. Arm mobilization provokes deformity of long-term indwelling ports implanted via the jugular vein. J Vasc Surg Venous Lymphat Disord, 2021, 9(4): 998-1006.
11.	Ling XC, Lu HP, Loh EW, et al. A systematic review and meta-analysis of the comparison of performance among step-tip, split-tip, and symmetrical-tip hemodialysis catheters. J Vasc Surg, 2019, 69(4): 1282-1292.
12.	Letachowicz K, Gołębiowski T, Miś M, et al. Partial breakage of a tunneled dialysis catheter: an uncommon finding. Hemodial Int, 2021, 25(2): E15-E17.
13.	Zhai S, Zhao Q, Feng Y, et al. Placement of tunneled cuffed vascular catheter through superior vena cava puncture. J Vasc Surg Venous Lymphat Disord, 2017, 5(4): 547-552.
14.	侯西彬, 杨涛, 詹申, 等. 四点定位法确定左侧颈内静脉隧道式 Cuff 导管皮下隧道长度. 临床肾脏病杂志, 2018, 18(9): 571-573.
15.	NKF-K/DOQI. III. NKF-K/DOQI clinical practice guidelines for vascular access: update 2000. Am J Kidney Dis, 2001, 37(Suppl 1): S137-S181.
16.	da Hora Passos R, Ribeiro M, Neves J, et al. Agitated saline bubble-enhanced ultrasound for assessing appropriate position of hemodialysis central venous catheter in critically ill patients. Kidney Int Rep, 2017, 2(5): 952-956.
17.	武煜, 王玲, 朱仁明, 等. 超声结合数字减影血管造影引导下颈内静脉置管的临床应用. 转化医学电子杂志, 2016, 3(12): 11-13.
18.	韩世盛, 徐艳秋, 王怡. 采用胸部 CT 定位颈部隧道式血液透析导管尖端位置. 中国血液净化, 2021, 20(9): 635-636.
19.	汪丽平, 鲁琦, 张海玲, 等. 生理盐水导引腔内心电图技术在新生儿脐静脉置管定位中的应用. 护理学杂志, 2021, 36(11): 1-3.
20.	Bream PR, Gu E. Use of an ECG-based confirmatory technique for bedside placement of reverse-tunneled cuffed dialysis catheters in three morbidly obese patients. Kidney Int, 2015, 88(3): 633-636.
21.	王雅雯, 仇晓霞. 腔内心电图定位技术辅助中心静脉通路导管尖端定位的研究进展. 护士进修杂志, 2022, 37(1): 52-56.
22.	Cho S, Lee YJ, Kim SR. The intracavitary ECG method for insertion of a tunneled dialysis catheter without using fluoroscopy. J Vasc Access, 2015, 16(4): 285-288.
23.	Ohara T, Sakurama K, Hiramatsu S, et al. New insertion support device assisted the accurate placement of tunneled cuffed catheter: first experience of 10 cases. J Vasc Access, 2018, 19(5): 501-505.
24.	Weber E, Liberek T, Wołyniec W, et al. Catheter tip malposition after percutaneous placement of tunneled hemodialysis catheters. Hemodial Int, 2015, 19(4): 509-513.
25.	Kang JS, Jang HR, Lee JE, et al. The bacterial colonization in tunneled cuffed dialysis catheter and its effects on residual renal function in incident hemodialysis patients. Clin Exp Nephrol, 2016, 20(2): 294-301.
26.	Brañas P, Morales E, Ríos F, et al. Usefulness of endoluminal catheter colonization surveillance cultures to reduce catheter-related bloodstream infections in hemodialysis. Am J Infect Control, 2014, 42(11): 1182-1187.
27.	Landry DL, Jaber RA, Hanumanthappa N, et al. Effects of prolonged ethanol lock exposure to carbothane- and silicone-based hemodialysis catheters: a 26-week study. J Vasc Access, 2015, 16(5): 367-371.
28.	刘宏, 孙晓萌, 张留平, 等. 70%乙醇封管在血液透析带隧道带涤纶套导管中的应用. 第二军医大学学报, 2017, 38(3): 329-334.
29.	秦钟媚, 吴春霞, 张丽宏. 改良皮肤管理对带 Cuff 血透导管置管者感染预防的效果. 上海护理, 2020, 20(3): 51-54.
30.	姜艳华, 邢唯杰, 周兴梅, 等. 连续性肾脏替代治疗患者中心静脉导管维护的最佳证据总结. 护士进修杂志, 2021, 36(6): 533-539.
31.	游畅, 廖宇捷, 杨红, 等. 敷料改良包扎法在血透 cuff 导管护理中的应用. 中国医药科学, 2018, 8(2): 93-96.
32.	谢素珍, 吴凌如, 周雅虹. 改良导管维护方式在血液透析患者 cuff 导管护理中的应用. 透析与人工器官, 2021, 32(3): 56-57, 59.
33.	吴春霞, 罗淑媛, 张丽宏, 等. 两种不同置管口护理方法对预防带 cuff 血透导管感染的影响. 实用临床护理学电子杂志, 2020, 5(4): 128.
34.	郑茜茜, 梅晓蓉, 黄若, 等. 血液透析隧道式深静脉导管出口自我护理效果探讨. 护士进修杂志, 2018, 33(11): 1048-1050.
35.	朱影, 陈林, 刁永书. 带 Cuff 的双腔中心静脉留置导管在血液透析中的护理. 西部医学, 2011, 23(11): 2261-2262.
36.	Ponce D, Mendes M, Silva T, et al. Occluded tunneled venous catheter in hemodialysis patients: risk factors and efficacy of alteplase. Artif Organs, 2015, 39(9): 741-747.
37.	Winnicki W, Herkner H, Lorenz M, et al. Taurolidine-based catheter lock regimen significantly reduces overall costs, infection, and dysfunction rates of tunneled hemodialysis catheters. Kidney Int, 2018, 93(3): 753-760.
38.	梁晓倩, 杨爽, 张放, 等. MHD 患者应用枸橼酸钠和肝素钠对 Cuff 导管维持开放的效果. 河北医药, 2019, 41(21): 3253-3256.
39.	Oguzhan N, Pala C, Sipahioglu MH, et al. Locking tunneled hemodialysis catheters with hypertonic saline (26% NaCl) and heparin to prevent catheter-related bloodstream infections and thrombosis: a randomized, prospective trial. Ren Fail, 2012, 34(2): 181-188.
40.	Zhao T, Liu H, Han J. Ethanol lock is effective on reducing the incidence of tunneled catheter-related bloodstream infections in hemodialysis patients: a systematic review and meta-analysis. Int Urol Nephrol, 2018, 50(9): 1643-1652.
41.	Schilcher G, Schlagenhauf A, Schneditz D, et al. Ethanol causes protein precipitation--new safety issues for catheter locking techniques. PLoS One, 2013, 8(12): e84869.
42.	Tasca Okamoto GF, Oliveira Portela FS, Alexandrino da Silva MF, et al. Intraoperative evaluation of tunneled dialysis catheter mobility and function with arm movement. J Vasc Surg Venous Lymphat Disord, 2022, 10(1): 146-151.
43.	吴健谊, 贾中尉, 杨林. 带 cuff 的中心静脉导管接头破损原因分析及护理对策. 护理学杂志, 2019, 34(15): 50-51.
44.	Parvulescu F, Oliver MJ, Reyna ME, et al. Factors affecting cuff extrusion of tunneled hemodialysis catheters. Can Assoc Radiol J, 2022, 73(2): 410-418.
45.	朱幼平, 袁慧中. 维持性血液透析患者带 Cuff 的中心静脉导管移位的原因及预防. 鄂州大学学报, 2016, 23(5): 110-112.
46.	鄢成静, 于洋, 周莉, 等. Caprini 静脉血栓风险评估模型在隧道式 cuff 透析导管功能不良伴中心静脉血栓患者中的有效性. 中华肾脏病杂志, 2017, 33(6): 429-434.

1. 中国医院协会血液净化中心分会血管通路工作组. 中国血液透析用血管通路专家共识(第 2 版). 中国血液净化, 2019, 18(6): 365-381.
2. 李玉伟, 王海蛟, 崔巍, 等. 保留后方韧带复合体的腰椎融合术远期疗效观察. 中国修复重建外科杂志, 2019, 33(1): 56-60.
3. Agarwal AK, Haddad N, Boubes K. Avoiding problems in tunneled dialysis catheter placement. Semin Dial, 2019, 32(6): 535-540.
4. 王慧, 姚苗苗, 张佳馨, 等. 血液透析患者中心静脉置管护理的最佳证据总结. 中国血液净化, 2020, 19(8): 569-572.
5. 熊嫚, 贺锐, 赵晓珊, 等. 血液透析患者中心静脉置管后导管相关性血栓研究进展. 成都医学院学报, 2022, 17(3): 395-399.
6. 杨阳, 张凌, 刘晨, 等. 血液净化中心静脉导管结构优化的研究进展. 生物医学工程研究, 2022, 41(4): 411-416.
7. 刘云访, 喻姣花, 黄海燕, 等. ICU 中心静脉导管相关性血流感染预防的证据总结. 护士进修杂志, 2020, 35(4): 319-325, 333.
8. 张叶, 陈嘉, 徐宁, 等. 中心静脉导管相关血流感染的预防新进展. 中国老年保健医学, 2019, 17(5): 103-105.
9. Clark E, Kappel J, MacRae J, et al. Practical aspects of nontunneled and tunneled hemodialysis catheters. Can J Kidney Health Dis, 2016, 3: 2054358116669128.
10. Leiderman DBD, Souza KP, Binatti CET, et al. Arm mobilization provokes deformity of long-term indwelling ports implanted via the jugular vein. J Vasc Surg Venous Lymphat Disord, 2021, 9(4): 998-1006.
11. Ling XC, Lu HP, Loh EW, et al. A systematic review and meta-analysis of the comparison of performance among step-tip, split-tip, and symmetrical-tip hemodialysis catheters. J Vasc Surg, 2019, 69(4): 1282-1292.
12. Letachowicz K, Gołębiowski T, Miś M, et al. Partial breakage of a tunneled dialysis catheter: an uncommon finding. Hemodial Int, 2021, 25(2): E15-E17.
13. Zhai S, Zhao Q, Feng Y, et al. Placement of tunneled cuffed vascular catheter through superior vena cava puncture. J Vasc Surg Venous Lymphat Disord, 2017, 5(4): 547-552.
14. 侯西彬, 杨涛, 詹申, 等. 四点定位法确定左侧颈内静脉隧道式 Cuff 导管皮下隧道长度. 临床肾脏病杂志, 2018, 18(9): 571-573.
15. NKF-K/DOQI. III. NKF-K/DOQI clinical practice guidelines for vascular access: update 2000. Am J Kidney Dis, 2001, 37(Suppl 1): S137-S181.
16. da Hora Passos R, Ribeiro M, Neves J, et al. Agitated saline bubble-enhanced ultrasound for assessing appropriate position of hemodialysis central venous catheter in critically ill patients. Kidney Int Rep, 2017, 2(5): 952-956.
17. 武煜, 王玲, 朱仁明, 等. 超声结合数字减影血管造影引导下颈内静脉置管的临床应用. 转化医学电子杂志, 2016, 3(12): 11-13.
18. 韩世盛, 徐艳秋, 王怡. 采用胸部 CT 定位颈部隧道式血液透析导管尖端位置. 中国血液净化, 2021, 20(9): 635-636.
19. 汪丽平, 鲁琦, 张海玲, 等. 生理盐水导引腔内心电图技术在新生儿脐静脉置管定位中的应用. 护理学杂志, 2021, 36(11): 1-3.
20. Bream PR, Gu E. Use of an ECG-based confirmatory technique for bedside placement of reverse-tunneled cuffed dialysis catheters in three morbidly obese patients. Kidney Int, 2015, 88(3): 633-636.
21. 王雅雯, 仇晓霞. 腔内心电图定位技术辅助中心静脉通路导管尖端定位的研究进展. 护士进修杂志, 2022, 37(1): 52-56.
22. Cho S, Lee YJ, Kim SR. The intracavitary ECG method for insertion of a tunneled dialysis catheter without using fluoroscopy. J Vasc Access, 2015, 16(4): 285-288.
23. Ohara T, Sakurama K, Hiramatsu S, et al. New insertion support device assisted the accurate placement of tunneled cuffed catheter: first experience of 10 cases. J Vasc Access, 2018, 19(5): 501-505.
24. Weber E, Liberek T, Wołyniec W, et al. Catheter tip malposition after percutaneous placement of tunneled hemodialysis catheters. Hemodial Int, 2015, 19(4): 509-513.
25. Kang JS, Jang HR, Lee JE, et al. The bacterial colonization in tunneled cuffed dialysis catheter and its effects on residual renal function in incident hemodialysis patients. Clin Exp Nephrol, 2016, 20(2): 294-301.
26. Brañas P, Morales E, Ríos F, et al. Usefulness of endoluminal catheter colonization surveillance cultures to reduce catheter-related bloodstream infections in hemodialysis. Am J Infect Control, 2014, 42(11): 1182-1187.
27. Landry DL, Jaber RA, Hanumanthappa N, et al. Effects of prolonged ethanol lock exposure to carbothane- and silicone-based hemodialysis catheters: a 26-week study. J Vasc Access, 2015, 16(5): 367-371.
28. 刘宏, 孙晓萌, 张留平, 等. 70%乙醇封管在血液透析带隧道带涤纶套导管中的应用. 第二军医大学学报, 2017, 38(3): 329-334.
29. 秦钟媚, 吴春霞, 张丽宏. 改良皮肤管理对带 Cuff 血透导管置管者感染预防的效果. 上海护理, 2020, 20(3): 51-54.
30. 姜艳华, 邢唯杰, 周兴梅, 等. 连续性肾脏替代治疗患者中心静脉导管维护的最佳证据总结. 护士进修杂志, 2021, 36(6): 533-539.
31. 游畅, 廖宇捷, 杨红, 等. 敷料改良包扎法在血透 cuff 导管护理中的应用. 中国医药科学, 2018, 8(2): 93-96.
32. 谢素珍, 吴凌如, 周雅虹. 改良导管维护方式在血液透析患者 cuff 导管护理中的应用. 透析与人工器官, 2021, 32(3): 56-57, 59.
33. 吴春霞, 罗淑媛, 张丽宏, 等. 两种不同置管口护理方法对预防带 cuff 血透导管感染的影响. 实用临床护理学电子杂志, 2020, 5(4): 128.
34. 郑茜茜, 梅晓蓉, 黄若, 等. 血液透析隧道式深静脉导管出口自我护理效果探讨. 护士进修杂志, 2018, 33(11): 1048-1050.
35. 朱影, 陈林, 刁永书. 带 Cuff 的双腔中心静脉留置导管在血液透析中的护理. 西部医学, 2011, 23(11): 2261-2262.
36. Ponce D, Mendes M, Silva T, et al. Occluded tunneled venous catheter in hemodialysis patients: risk factors and efficacy of alteplase. Artif Organs, 2015, 39(9): 741-747.
37. Winnicki W, Herkner H, Lorenz M, et al. Taurolidine-based catheter lock regimen significantly reduces overall costs, infection, and dysfunction rates of tunneled hemodialysis catheters. Kidney Int, 2018, 93(3): 753-760.
38. 梁晓倩, 杨爽, 张放, 等. MHD 患者应用枸橼酸钠和肝素钠对 Cuff 导管维持开放的效果. 河北医药, 2019, 41(21): 3253-3256.
39. Oguzhan N, Pala C, Sipahioglu MH, et al. Locking tunneled hemodialysis catheters with hypertonic saline (26% NaCl) and heparin to prevent catheter-related bloodstream infections and thrombosis: a randomized, prospective trial. Ren Fail, 2012, 34(2): 181-188.
40. Zhao T, Liu H, Han J. Ethanol lock is effective on reducing the incidence of tunneled catheter-related bloodstream infections in hemodialysis patients: a systematic review and meta-analysis. Int Urol Nephrol, 2018, 50(9): 1643-1652.
41. Schilcher G, Schlagenhauf A, Schneditz D, et al. Ethanol causes protein precipitation--new safety issues for catheter locking techniques. PLoS One, 2013, 8(12): e84869.
42. Tasca Okamoto GF, Oliveira Portela FS, Alexandrino da Silva MF, et al. Intraoperative evaluation of tunneled dialysis catheter mobility and function with arm movement. J Vasc Surg Venous Lymphat Disord, 2022, 10(1): 146-151.
43. 吴健谊, 贾中尉, 杨林. 带 cuff 的中心静脉导管接头破损原因分析及护理对策. 护理学杂志, 2019, 34(15): 50-51.
44. Parvulescu F, Oliver MJ, Reyna ME, et al. Factors affecting cuff extrusion of tunneled hemodialysis catheters. Can Assoc Radiol J, 2022, 73(2): 410-418.
45. 朱幼平, 袁慧中. 维持性血液透析患者带 Cuff 的中心静脉导管移位的原因及预防. 鄂州大学学报, 2016, 23(5): 110-112.
46. 鄢成静, 于洋, 周莉, 等. Caprini 静脉血栓风险评估模型在隧道式 cuff 透析导管功能不良伴中心静脉血栓患者中的有效性. 中华肾脏病杂志, 2017, 33(6): 429-434.

West China Medical Journal

Research progress on tunnel-cuffed catheter placement and maintenance in maintenance hemodialysis patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content