COMPARISON AMONG INTERNAL JUGULAR VEIN, FEMORAL VEIN AND SUBCLAVIAN VEIN DOUBLE LUMEN CATHETER CANNULATION, CATHETER RELATED INFECTIONS AND COMPLICATIONS IN HEMODIALYSIS PATIENTS OF NEPHROLOGY DIVISION KHYBER TEACHING HOSPITAL PESHAWAR

Abstract

Background: Hemodialysis is a critical therapeutic intervention for patients with renal failure, and the choice of vascular access for catheterization plays a pivotal role in its success. This study focuses on comparing the outcomes of double lumen catheter cannulation in three major vascular access routes: internal jugular vein, femoral vein, and subclavian vein, within the context of the Nephrology Division at Khyber Teaching Hospital, Peshawar.

Aim: The primary aim of this study is to assess and compare the incidence of catheter-related infections and complications among hemodialysis patients utilizing different vascular access routes—specifically, internal jugular vein, femoral vein, and subclavian vein.

Methods: The study encompasses a duration from January 2023 to June 2023, involving a sample size of 300 hemodialysis patients. The patients were divided equally into three groups, with 100 individuals each undergoing catheterization through the internal jugular vein, femoral vein, and subclavian vein. Data collection included monitoring for complications such as central stenosis, collateral formations, catheter-related infections, and other associated complications.

Results: The findings indicate a substantial variation in complications among the three vascular access routes. The subclavian route demonstrated the highest incidence of complications, including central stenosis and collateral formations. Furthermore, the infectious rate associated with subclavian catheterization was notably elevated. Conversely, the femoral route exhibited fewer complications compared to the subclavian route. The internal jugular vein emerged as the most favorable route, demonstrating the lowest incidence of complications and catheter-related infections.

Conclusion: In conclusion, this study underscores the significance of selecting an appropriate vascular access route for hemodialysis catheterization. The internal jugular vein emerges as the safest and most favorable option, with the least complications and infection rates. The subclavian route, while widely used, poses a higher risk of complications, including central stenosis and collateral formations. The femoral route, though presenting fewer complications than the subclavian route, still falls short of the internal jugular vein in terms of safety.