None listed
Conditions
Brief summary
Non Tunneled Catheters (NTC) for hemodialysis are vital as vascular venous access. The accepted depth for the average insertion may guarantee the correct position of the tip of the CNT and does not prevent the indiscriminate use of resources used for its placement. The study hypothesis is the use of economic and human resources derived by NTC placement early complications in patients with urgent need of Hemodialysis is reduced when the NTC is placed in the second intercostal space compared to the fourth intercostal space. The study includes patients who need NTC placement to perform emergency hemodialysis. The selection criteria were: patients >18 years old who had accepted the placement of the CNT and needed emergency hemodialysis; patients who have signed the informed consent; and patients who can remain seated for anteroposterior chest radiography. The objective is to compare the use of economic and human resources used in two methods of CNT placement for Hemodialysis. The main outcome is the use of human and economic resources derived from the inadequate placement of the NTC when the tip of the NTC is placed in the second intercostal space (2ICS) or fourth intercostal space (4ICS). The length of the CNT tip placement depth was randomized by a true reported random number generator and split into two groups by measuring the distance between 2ICS or 4ICS, and the catheter entry point, measured in centimeters with a sterile tape measure prior to placement.
Interventions
The NTC will be inserted percutaneously by 2 trained nephrology specialists with dynamic ultrasound guidance and a modified Seldinger technique; duration of the procedure is 30- 45 minutes and will be realized on an sterile environment on a designated procedure room.
The placement of the NTC tip will be randomized to the classic method located in the fourth intercostal space (4ICS) and the intervention method located in the second intercostal space (2ICS).
The Intervention position group (IG
The NTC will be inserted percutaneously by 2 trained nephrology specialists with dynamic ultrasound guidance and a modified Seldinger technique; duration of the procedure is 30- 45 minutes and will be realized on an sterile environment on a designated procedure room. The placement of the NTC tip will be randomized to the classic method located in the fourth intercostal space (4ICS) and the intervention method located in the second intercostal space (2ICS). The Intervention position group (IG). In this group, the NTC tip will be inserted to be located on the second intercostal space (2ICS). The distance between 2ICS and the catheter entrance point (located at an imaginary traversal line that crosses the cricoid cartilage), will be measured in centimeters with a measure tape and defined as the length at which the NTC should be inserted. The adherence to the intervention will be assessed by a trained vascular nurse who will be function as an observer during the procedure and register the adherence to the established protocol.
Sponsors
Universidad Autonoma de Coahuila
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients over 18 years of age who have accepted the placement of the NTC for hemodialysis. Patients who have signed the informed consent. Patients who can remain seated for the chest X-ray in a protocolized manner.
Exclusion criteria
Patients who cannot collaborate in the performance of chest radiography or NTC placement. Patients who had an immediate complication during the placement, related to puncture such as pneumothorax, hemopneumothorax, catheter placement in the carotid artery, malpositioning of the NTC, hemomediastinum, air embolism. The use of other than the right internal jugular vein for vascular access to NTC placement.
Outcome results
None listed