[Permanent double-lumen central venous catheters--replacement for arteriovenous fistula].

INTRODUCTION The adequate vascular access in the patients on chronically hemodialysis treatment is very importance element in patient feel secure, and medical staff in hemodyalisis centre. The aim of this work is to examinee possibility of the use of permanent double lumen central venous catheter (PermCath) in patients with inadequate vascular access. PATIENTS AND METHOD PermCath has been placed with local anesthesia in chirurgical room. Eight catheters was application in vena subclavia (three of them in links vena subclavia and six in right vena subclavia) and 26 in vena jugularis internal (for of them in links vena jugularis and 22 in right vena jugularis. The catheters were long 19 cm (26 catheters) and 23 cm (nine catheters). The catheters has been placed in 35 patients on chronically hemodialysis program, eight mean and 27 women, average age 56.03 +/- 16.52 (19 to 77 years). The causal chronically kidney disease has been diabetes mellitus in 12 (34.29%) patients, chronically pyelonephritis in eight (22.86%) patients, polycystic kidney disease in five (14.29%) patients, chronically glomerulonephritis in three (8.57%) patients and seven (20%) patients with other diseases. RESULTS The catheters has been placed average 233.55 +/- 303.58 days (9 to 1256 days). For three catheters have not registered wail the patients was from another hemodialysis centre. In four of patients were registered catheter sepsis episodes. In two of them catheter was treated with adequate doses of antibiotics since we have performed adequate and systemically antibiotics in lumen of catheter. The isolated bacteria from microbiological examination were: Enterococcus species and Pseudomonas species. Van catheter was isolated, and in microbiological examination from blood were registered Acinobacter species and Enterobacter species. A van patient past away and microbiological examination shown Staphylococcus species. CONCLUSION PermCath is very security permanent vascular access in the patients with loss construction arteriovenous fistula. The catheter in the patients who has been not adequate arteriovenous fistula, and with adequate treatment he has exchange for arteriovenous fistula.