Prevalencias de complicaciones asociadas a la instalación de catéter venoso central para hemodiálisis

Resumen

Background: Placing central venous lines under ultrasonographic guidance reduces the complications of the procedure. Aim: To compare rates of complications of central venous line placements with or without ultrasonographic guidance. Material and methods: Review of medical records of two groups of patients subjected to a central venous line placement at a nephrology service for renal replacement therapy. In one group of 100 patients, the line was placed without ultrasonographic guidance between 2008 and 2012. Between 2015 and 2017 the line was placed in 138 patients using ultrasonographic guidance. The rates of complications with both types of procedures were recorded. Results: The frequency of complications of procedures with and without ultrasonographic guidance was 0.7 and 18% respectively (odds ratio 0.04, 95% confidence interval 0-0.3). Ninety five percent of recorded complications were arterial puncture, followed by hematomas in 10% and pneumothorax in 5%. The higher rate of complications was observed in emergency line placement without ultrasonographic guidance. There was a direct association between the number of line placement attempts in a single procedure and the rate of complications. Conclusions: Ultrasonographic guidance is associated with a reduction in the rate of central venous line complications.