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📌 Optimal site is R IJ since venous pathway to the RA is relatively short and straight
📌 Avoid SC Vein due to ⬆️ rate of insertion related complications
📌 L IJ is not optimal
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![](https://pbs.twimg.com/media/EBlLiBoX4AEyEJT.jpg)
📌 “Previously” thought to be high risk for infections
📌 CATHEDIA Study Group: Comparable rates of infection and time to catheter tip colonization (14 days) with Femoral vs IJ Catheters
👉🏼 cjasn.asnjournals.org/content/clinja…
#Nephpearls #DialysisDirector
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📌 Need to be at least 20 cm length so that tip is in IVC to allow better flow and minimize recirculation
📌 CATHEDIA Study Group: Delivered URR and Kt/V were similar with Femoral and IJ Catheters
👉🏼 cjasn.asnjournals.org/content/clinja…
#Nephpearls #DialysisDirector
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📌 ⬆️ risk of infection in obese patients (BMI > 28) 👉🏼 extent of this risk “probably” depends on distribution of body fat
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![](https://pbs.twimg.com/media/EBlRu-3WsAA99oJ.jpg)
📌 R IJ is preferred, followed by L IJ
📌 Use of Femoral vein is discouraged
📌 Use of SC vein is discouraged (due to frequent stenosis)
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👉🏼 academic.oup.com/ckj/article/3/…
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catheter exit site to decrease Staphylococcus colonization
⬇️ Catheter infection rate
⬆️ Catheter survival rate
⚠️ There is however, concern about the risk of long-term emergence of Mupirocin resistant organisms
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![](https://pbs.twimg.com/media/EBld3SqXkAA6jPX.jpg)
👉🏼 ncbi.nlm.nih.gov/m/pubmed/24150…
#Nephpearls #DialysisDirector
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