Contribution of Ultrasound Guidance in the Placement of Hemodialysis Catheters

Abstract

Ultrasound has revolutionized the placement of hemodialysis catheters by offering a precise and secure method. Our prospective randomized study conducted at the nephrology department of CHU Bab el Oued between November 2016 and November 2018 compared the use of ultrasound guidance to anatomical landmarks for catheter placement. Among the 285 patients included, divided into two groups (anatomical and ultrasound-guided), ultrasound guidance showed significantly higher overall success rates and success rates at first puncture compared to anatomical landmarks (90.1% vs 52.4% and 53.52% vs 24.47% respectively, p < 0.0006). This trend persisted among experienced operators, with higher success rates for ultrasound guidance (94.7% vs 80.4%, p = 0.01). Furthermore, the use of ultrasound significantly reduced the incidence of complications related to catheter insertion. These results confirm the crucial importance of ultrasound guidance in the placement of hemodialysis catheters, regardless of the insertion site and the operator's level of experience, while emphasizing the need for an alternative in case of unavailability of the ultrasound machine or in extreme emergency situations.

Keywords: Hemodialysis catheter, Ultrasound, Renal failure, Venous access.