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Accidental removal of dialysis central venous catheter inserted for blood purification therapy: a single-center study

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Abstract

Background

Dialysis central venous catheters (DCs) are used for various blood purification therapies. Accidental removal of a DC is a potentially life-threatening event. However, the risk factors associated with accidental removal have rarely been discussed in the literature.

Methods

We performed a 5 year retrospective, single-center, cohort study of patients who were admitted to the ward other than intensive care units and were inserted DCs. We compared patient characteristics between patients who used DCs with and without a history of accidental removal.

Results

There were 17 cases of accidental removal (3.5%) out of 489 DC insertions during the observation period. There was no significant difference between patients with and without accidental removal in terms of age, sex, reason for DC insertion, catheter type, or insertion site. The presence of dementia was 35 and 11% (p = 0.006), and that of delirium was 88 and 13% (p < 0.0001) in those with and without accidental removal, respectively. The median days from insertion to accidental removal were 5 (range 0–21) days, and removal occurred mainly at night (71%). One patient with accidental removal developed hemorrhagic shock, but there no deaths occurred due to accidental removal.

Conclusions

The present findings suggest that to prevent accidental removal, sufficient attention should be paid to delirium that occurs after admission as well to pre-existing dementia at the time of admission. As accidental removal occurs most commonly early after insertion and at night, special attention should be paid during these periods.

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Acknowledgements

We gratefully acknowledge Mie Tagaya for creating and managing the database for this research.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Shigeki Kojima, Yugo Shibagaki & Tsutomu Sakurada

  2. Department of Urology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Yuhji Marui

Authors
  1. Shigeki Kojima
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  2. Yuhji Marui
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  3. Yugo Shibagaki
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  4. Tsutomu Sakurada
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Corresponding author

Correspondence to Shigeki Kojima.

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Conflict of interest

All the authors have declared no competing interests

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of St. Marianna University School of Medicine (IRB approval No. 5047) and with the 1964 Helsinki declaration and its later amendments. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study or their family members. Participants were informed that they had a right to not participate in the study and participants could refuse to answer the questionnaires during the process or withdraw from the study at any time.

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Kojima, S., Marui, Y., Shibagaki, Y. et al. Accidental removal of dialysis central venous catheter inserted for blood purification therapy: a single-center study. Clin Exp Nephrol 26, 1218–1222 (2022). https://doi.org/10.1007/s10157-022-02271-4

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  • DOI: https://doi.org/10.1007/s10157-022-02271-4

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