Ultrasound-guided femoral dialysis access placement: A single-center randomized trial

Mayoor V. Prabhu, Deven Juneja, Palepu B. Gopal, Mohan Sathyanarayanan, Sreepada Subhramanyam, Sridhar Gandhe, K. Shivanand Nayak

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Abstract

Background and objectives: Insertion of dialysis catheters (DCs) is a prerequisite for successful initiation of hemodialysis. We attempted to determine if ultrasonography-guided (USG) insertion was superior and safer than the anatomical landmarkguided technique (ALT) for the femoral vein (FV). Design, setting, participants, & measurements: This was a randomized prospective study on 110 patients requiring FV DCs in a tertiary care hospital. Patients were randomized into two groups: USG and ALT. Data were collected on demography, operator experience, and side of insertion. The USG group had their catheters inserted under USG guidance, whereas the ALT group had their DC inserted by ALT. Outcome measures included successful insertion of DC, number of attempts, and complications. Results: Both groups were comparable regarding age and gender of patients, operator experience, and the side of catheterization. The overall success rate was 89.1%, with 80% using ALT and 98.2% under USG guidance (P = 0.002). First attempt success rate was 54.5% in the ALT group as compared with 85.5% in the USG group (P = 0.000). The complication rate was 18.2% in the ALT group and 5.5% in the USG group (P = 0.039). The odds ratio (OR) for complications with two or more attempts was 10.73 with a relative risk (RR) of 3.2. The OR for successful insertion using USG was 13.5 (95% CI: 1.7 to 108.7). Conclusions: USG significantly improves success rate, reduces number of attempts, and decreases the incidence of complications related to FV DC insertion.

Original languageEnglish
Pages (from-to)235-239
Number of pages5
JournalClinical Journal of the American Society of Nephrology
Volume5
Issue number2
DOIs
Publication statusPublished - 15-03-2010

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All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Prabhu, M. V., Juneja, D., Gopal, P. B., Sathyanarayanan, M., Subhramanyam, S., Gandhe, S., & Shivanand Nayak, K. (2010). Ultrasound-guided femoral dialysis access placement: A single-center randomized trial. Clinical Journal of the American Society of Nephrology, 5(2), 235-239. https://doi.org/10.2215/CJN.04920709