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首页> 外文期刊>Artificial Organs >Bedside Tunneled Dialysis Catheter Removal-A Lesson Learned From Nephrology Trainees
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Bedside Tunneled Dialysis Catheter Removal-A Lesson Learned From Nephrology Trainees

机译：床边隧道透析导管删除 - 从肾脏学员那里吸取的课程

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摘要

Semi-permanent dual-lumen tunneled (or tunneled-cuffed) hemodialysis catheters (TDC) are increasingly utilized during renal replacement therapy, while awaiting permanent access maturation or renal recovery. Although there is a wealth of literature focused on placement, infection prevention, and maintenance of catheter patency, circumstances and indications for TDC removal are less well understood. Timely removal of these catheters is an important management decision, with the length of TDC duration representing the largest cumulative risk factor for catheter-associated blood stream infections. Waiting for assistance from surgical or radiological services-which may not be available in all hospitals-may result in delays in services and potential harm to the patients. Imparting and maintaining procedural skills to remove infected TDC may be very valuable for training programs in clinical nephrology. In this article the current literature on bedside TDC removal, including potential anticipated complications during removal, are reviewed. To date, the authors have documented successful implementation of bedside TDC removal in training programs from two different settings, including both in-and outpatients and with trainee involvement. In summary, training general nephrologists for bedside TDC removal will afford immediate removal of infected hardware in ill patients and avoid potential delays in outpatient setting.
机译：在肾替代疗法期间，半永久性双腔隧道（或隧道式袖扣）血液透析导管（TDC）越来越多地利用，同时等待永久性进入成熟或肾脏恢复。虽然有丰富的文学专注于放置，感染和维持导管通畅，但TDC去除的情况和适应症都不太了解。及时去除这些导管是一个重要的管理决策，TDC持续时间的长度表示导管相关血液流感染的最大累积危险因素。等待外科或放射服务的帮助 - 所有医院可能无法提供 - 可能导致服务延迟和对患者的潜在伤害。赋予和维护移除感染的TDC的程序技能可能对临床肾脏的培训计划非常有价值。在本文中，审查了当前关于床侧TDC的文献，包括在拆除期间拆除潜在的预期并发症。迄今为止，作者在培训方案中记录了从两个不同的环境中的培训计划中成功实施，包括内外观察员以及实习生参与。总之，培训床边TDC去除的一般肾病学家将立即去除生病患者中的受感染硬件，并避免门诊环境中的潜在延误。

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