Dialysis Vascular access and Complications

Question 1

describe what a tunnelled central venous catheter(TCVC) is

Answer 1

a catheter inserted into a large vein, typically the internal jugular vein

Question 2

what is a pro and a con of a tunnelled central venous catheter(TCVC)

Answer 2

pro = easy to insert and can be used immediately
con = high risk of infection

Question 3

what infections are associated with a TCVC

Answer 3

staph aureus - endocarditis and discitis

Question 4

what treatment is used for TCVC infection

Answer 4

vancomycin + gentamycin and line removal/exchange

Question 5

what is the gold standard for vascular dialysis access

Answer 5

arteriovenous fistula(AVF)

Question 6

describe what an AVF is

Answer 6

when artery and vein are surgically connected, the venous part will develop to create an enlarged and thickened vessel which is the AVF

Question 7

what is a pro and con of the AVF

Answer 7

pro = good blood flow
con = requires surgery and usually 6-12 weeks before can be used

Question 8

what are some of the complications of dialysis

Answer 8

hypotension, haemorrhage, loss of vascular access, arrhythmia, cardiac arrest

Question 9

describe how hypotension can occur in dialysis

Answer 9

removal of large large volumes of H2O, potentially leads to under-filling of the intravascular space and low BP

Question 10

what are some of the medical reasons to withdraw from dialysis

Answer 10

haemodynamic instability, progressive dementia, cardio event