Avoiding Trouble Down the Line: The Management and Prevention of Hemodialysis Catheter-Related Infections

摘要: Over the last 2 decades, hemodialysis catheter use has increased. Annually, approximately 30% of patients using a central venous (CVC) experience septic or bacteremic episode and are subsequently at risk its associated long-term complications mortality. Because serious clinical financial impact catheter-related bacteremias (HCRIs), standardized, validated definitions based on patient population necessary in order to better diagnose, monitor, report HCRI for quality assurance research purposes. The pathophysiology involves complex interaction between triad that consists host patient, infecting microorganism, vehicle catheter. Although microorganism contribution pathogenesis is likely most important, certain characteristics may be more amenable manipulation. key managing prophylaxis against initial adherence subsequent biofilm development. General specific prophylactic maneuvers directed both an intravascular extraluminal route entry discussed including antibiotic- silver-impregnated catheters dressings, subcutaneous access devices, topical exit site. In addition systemic antibiotic use, 3 methods HRCI treatment salvage, guidewire exchange, concurrent lock compared. outcome highlight importance careful, continual infection surveillance. multidisciplinary control team desirable, staffing education physician feedback have been shown improve guidelines reduce HCRI.