Extrusión del dacron en un catéter venoso central tunelizado para hemodiálisis

Abstract

The day-to-day work of nurses in haemodialysis units (HD) shows us the great incidence of the use of tunneled central venous catheters as vascular accesses to perform this technique. These catheters, as we all know, are not exempt from problems that we encounter more often than we would like (dysfunctions due to lack of flow, increased venous pressure, etc.) and which we fortunately manage to resolve before starting the session or during it on the vast majority of occasions. In addition to the more serious complications such as infections, thrombosis¹, etc. there is another, not very frequent but no less important, complication such as the extrusion of the dacron cuff into a tunneled central venous catheter. According to existing recommendations, it requires the replacement of the catheter², which is usually done in a systematic manner, with greater or lesser promptness, after the patient has been informed and consented to; information and consent regulated by "Law 41/2002, of 14 November, basic regulation of patient autonomy and rights and obligations in matters of clinical information and documentation" ("...the patient or user has the right to decide freely after receiving adequate information among the available clinical options")³. A case was presented at our Unit of extrusion of Dacron in a tunneled venous catheter for HD, the patient refusing to replace it, under the protection of the aforementioned law, as long as the catheter was working and did not give rise to any major problems.