Survey of permanent central venous catheters for haemodialysis in the UK

Background. Venous catheter haemodialysis may be necessary in some patients without arterio venous fistulae on dialysis for end-stage renal failure. We conducted a survey to compare management of these catheters in different units in the UK. Methods. Postal questionnaires were sent to nurses in charge of 81 renal units in the UK for a twelve month study period in 1994 to find out the type of catheter used, catheter after insertion care, the rate and managementment of exit site infections, and bacteraemia. Results. (1) Total number of questionnaires returned 66 (81.5%). (2) 63.6% of renal units used double lumen Permcath catheters, 16.7% single lumen (Francis/Kimal, Gambro or Vascath), 10.6% use both double and single lumen catheters and 9.1% of renal units only use temporary polyurethane catheters. (3) Catheter exit site aseptic dressing technique was used in 84.8% of renal units, clean technique in 15.2%. 66.8% changed dressings at each dialysis session, 22.7% weekly. The majority of renal units (63.6%) had one nurse to change the dressing, used Betadine as a cleaning agent and Mepore to cover the exit site. (4) 75.8% did not know the exact incidence of episodes of sepsis and/or exit site infections. Flucloxacillin was the antibiotic of choice for each catheter related sepsis episode. Conclusion. During this study period most renal units used Permcaths as first choice for long term catheter dialysis, the after insertion care of which varied. The number of episodes of sepsis was unknown. We suggest UK collection of data for all long term catheters and related problems for audit purposes.