Jornal Vascular Brasileiro
http://www.jvb.periodikos.com.br/article/doi/10.1590/1677-5449.202500052
Jornal Vascular Brasileiro
Original Article

Analysis of the functioning of temporary dialysis catheters in patients with COVID-19

Análise do funcionamento de cateteres temporários para hemodiálise em pacientes com COVID-19

Bruno Jeronimo Ponte; Viviane Galli Dib; Arthur Souza Magnani; Felipe Soares Oliveira Portela; Marcela Juliano Silva Cunha; Lucas Lembrança Pinheiro; Nelson Wolosker

http://dx.doi.org/10.1590/1677-5449.202500052 J Vasc Bras, vol.24, e20250005, 2025
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Abstract

Background: Patients with acute renal failure requiring hemodialysis should be treated using temporary hemodialysis catheters due to the urgency and potential reversibility of the condition. To date, 3 studies in North America have suggested a higher risk of catheter-related issues in COVID-19 patients needing hemodialysis.

Objectives: This study examines the functionality and complications of temporary hemodialysis access in COVID-19 patients at a Brazilian hospital during the coronavirus outbreak of 2020.

Methods: A retrospective analysis was conducted at a COVID-19 referral center from May to July 2020. During this period, the Vascular Surgery team implanted temporary hemodialysis catheters in 107 patients. These patients were monitored, and their demographic and clinical characteristics were analyzed to identify any that correlated with catheter malfunction.

Results: Of the 107 patients studied, 22 (20.6%) had catheter-related complications. Eighteen (16.8%) had catheter malfunctions, while 4 (3.7%) developed infections. Five patients had unfavorable clinical status and did not undergo catheter replacement. Catheter tip thrombosis was the cause of the malfunction in 13 of the patients with malfunctions. The analysis revealed that the only variables correlated with higher risk of malfunction were the need for orotracheal intubation (p = 0.009), deep vein thrombosis (p = 0.01), and a history of a previous catheter use (p = 0.002).

Conclusions: The rate of temporary dysfunction of the high-flow catheter in patients with COVID-19 in this sample was similar to the rate described in the literature for patients without this disease.

Keywords

COVID-19; central venous catheter; hemodialysis; catheter obstruction

Resumo

Contexto: Em geral, pacientes com insuficiência renal aguda que necessitam de hemodiálise utilizam cateteres temporários devido à urgência e à possível reversibilidade da condição. Até o momento, três estudos realizados na América do Norte indicam um risco maior de problemas relacionados ao cateter em pacientes com COVID-19 que precisam de hemodiálise.

Objetivos: O presente estudo examina a funcionalidade e as complicações do acesso temporário para hemodiálise em pacientes com COVID-19 em um hospital brasileiro.

Métodos: Foi realizada uma análise retrospectiva em um centro de referência para COVID-19 entre maio e julho de 2020. Durante esse período, a equipe de Cirurgia Vascular implantou cateteres temporários para hemodiálise em 107 pacientes. Os pacientes foram acompanhados, e as características demográficas e clínicas que poderiam estar correlacionadas ao mau funcionamento do cateter foram analisadas.

Resultados: Dos 107 pacientes estudados, 22 (20,6%) apresentaram complicações relacionadas ao cateter. Dezoito (16,8%) apresentaram mau funcionamento, e quatro (3,7%) tiveram infecções. Cinco pacientes evoluíram com condições clínicas desfavoráveis e não foram submetidos à troca do cateter. Em 13 pacientes com mau funcionamento, a trombose da ponta do cateter foi identificada como a causa. Entre as variáveis analisadas, apenas a necessidade de intubação orotraqueal (p = 0,009), trombose venosa profunda (p = 0,01) e história de cateter anterior (p = 0,002) mostraram-se correlacionadas a um maior risco de mau funcionamento.

Conclusões: A taxa de disfunção de cateter temporário de alto fluxo em pacientes com COVID-19 nesta amostra foi semelhante à taxa descrita na literatura em pacientes sem essa doença.

Palavras-chave

COVID-19; cateter venoso central; hemodiálise; obstrução do cateter

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Submitted date:
01/13/2025

Accepted date:
05/07/2025

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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