Tunneled hemodialysis catheters: use of a silver-coated catheter for prevention of infection--a randomized study.

Abstract:

PURPOSE:To determine whether silver-coated tunneled hemodialysis catheters reduce infection and to determine the frequency of central venous thrombosis and stenosis with percutaneous placement of right internal jugular vein dialysis catheters by interventional radiologists. MATERIALS AND METHODS:Ninety-one patients were randomly assigned to a treatment (silver-coated catheter; n = 47) or control (identical catheter without silver coating; n = 44) arm. Baseline venography was performed. Catheter tips were cultured and venography was repeated at catheter removal. RESULTS:Mean duration of catheter placement was 92 days. Infection occurred in 11 patients (five in the treatment group, six in the control group). Tip cultures in 15 patients (eight treatment, seven control) were positive without clinical infection. Infection and colonization rates were slightly but not significantly higher in the treatment group than in the control group. Silver-coated catheters in two (4%) patients were removed due to reaction to the coating. Completion venograms (n = 72) showed new minor abnormalities in four (6%) patients and major abnormalities (stenosis, thrombosis) in three (4%) patients. Permanent venous abnormalities occurred in two (3%) patients. CONCLUSION:Silver coating does not confer a benefit against clinical infection or colonization. Interventional radiologic placement of tunneled dialysis catheters yields a low frequency of permanent central venous thrombosis and stenosis.

journal_name

Radiology

journal_title

Radiology

authors

Trerotola SO,Johnson MS,Shah H,Kraus MA,McKusky MA,Ambrosius WT,Harris VJ,Snidow JJ

doi

10.1148/radiology.207.2.9577500

subject

Has Abstract

pub_date

1998-05-01 00:00:00

pages

491-6

issue

2

eissn

0033-8419

issn

1527-1315

journal_volume

207

pub_type

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