Upward-directed exit-site of the swan-neck catheter and “Easy-to-disinfect the backside area of exit-site” may prevent PD complications
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Le résumé fourni par la source
BACKGROUND: Upward-directed exit-site has been believed to be the worst for frequent ESI by an old retrospective study using straight catheters. No comparison study of 3 exit-site directions using swan-neck catheter has been performed regarding which direction is the best for our endpoints, Easy-to-see the backside area of exit-site: ESBE, Easy-to-disinfect the backside area of exit-site: EDBE, reduction of both exit-site infection (ESI), symptomatic catheter dislocation and peritonitis. METHODS: We assessed the relationship of exit-site direction with our endpoints in a quantitative cross-sectional, multicentered questionnaire survey. Patients who received either non-surgical catheter implantation or exit-site surgery were excluded. RESULTS: The numbers (percentage) of exit-site directions in included 291 patients were upward 79 (26.0), lateralward 108 (37.5) and downward 105 (36.5). Cochran-Armitage analysis showed a significant step-ladder increase in the prevalence of ESI as the direction changed from upward to lateralward to downward (0.15 ± 0.41, 0.25 ± 0.54, 0.38 ± 0.69 episodes/patient-year, p = 0.03). Multivariable regression analysis revealed the upward exit-site independently associates with both higher frequency of ESBE (OR 5.55, 95% CI 2.23-16.45, p < 0.01) and reduction of prevalence of ESI (OR 0.55, 95%CI 0.27-0.98, p = 0.04). Positive association between the prevalence of symptomatic catheter dislocation and ESI (OR 2.84, 95% CI 1.27-7.82, p = 0.01), and inverse association between EDBE and either prevalence of symptomatic catheter dislocation (OR 0.27, 95% CI 0.11-0.72) or peritonitis (OR 0.48, 95% CI 0.23-0.99) observed. CONCLUSION: Upward-directed swan-neck catheter exit-site may be the best for both ESBE and prevention of ESI. EDBE may reduce catheter dislocation and peritonitis. Symptomatic catheter dislocation may predict ESI.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Upward-directed exit-site of the swan-neck catheter and “Easy-to-disinfect the backside area of exit-site” may prevent PD complications
- Date Crossref
- 10/02/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Jikei University Kashiwa hospital Division of Nephrology and Hypertension pays non établi dans la noticeÉtablissement de santé
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Jikei University School of Medicine Division of Nephrology and Hypertension pays non établi dans la noticeUniversité ou école supérieure
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Katsushika Medical Center Division of Nephrology and Hypertension pays non établi dans la noticeÉtablissement de santé
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Teikyo University Chiba Medical Center Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
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St. Marianna University School of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Iwate Prefectural Central Hospital Department of Nephrology and Rheumatology pays non établi dans la noticeÉtablissement de santé
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Saiseikai Kumamoto Hospital Department of Nephrology pays non établi dans la noticeÉtablissement de santé
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Tokyo Women's Medical University Adachi Medical Center Department of Nephrology pays non établi dans la noticeÉtablissement de santé
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Nippon Medical School Department of Nephrology pays non établi dans la noticeUniversité ou école supérieure
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Shimada Municipal Hospital Department of Nephrology pays non établi dans la noticeÉtablissement de santé
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Hitachi General Hospital Department of Nephrology pays non établi dans la noticeÉtablissement de santé
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JA Toride Medical Center Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
Division of Nephrology and Hypertension — Jikei University Kashiwa hospital, Division of Nephrology and Hypertension — Jikei University School of Medicine et Division of Nephrology and Hypertension — Katsushika Medical Center, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.