Study of access recirculation in reversed temporary indwelling catheters.

Abstract

At the Ottawa Civic Hospital hemodialysis unit, our prescribed blood flow rate for temporary indwelling catheters runs at 200 mls/min. We were concerned that, with the reversal of the ports of these catheters, our patients were not receiving the dialysis prescription ordered for them due to decreased efficiency of their treatment. Twenty-five of 108 patients in the program were included in a study related to the percentage of access recirculation when ports were reversed or not reversed. Of those 25 patients, approximately 42% had their ports reversed. The study took place over a two-week period and involved approximately six dialysis sessions per patient. Results indicated that the percentage recirculation increased from 2.3%-4.1% when ports were connected normally, to 12% when ports were reversed. As a result, a policy is now in place whereby our patients' treatment time is increased 20 minutes for reversed ports. In summary, recirculation rate increased with reversal of ports in temporary indwelling catheters. Extension of prescribed treatment times when ports are reversed will maintain the efficiency of dialysis.