Analysis of the functioning of temporary dialysis catheters in patients with COVID-19

Abstract

Background: Patients with acute renal failure requiring hemodialysis should be treated using temporary hemodialysis catheters due to the urgency and potential reversibility of the condition. To date, 3 studies in North America have suggested a higher risk of catheter-related issues in COVID-19 patients needing hemodialysis. Objectives: This study examines the functionality and complications of temporary hemodialysis access in COVID-19 patients at a Brazilian hospital during the coronavirus outbreak of 2020. Methods: A retrospective analysis was conducted at a COVID-19 referral center from May to July 2020. During this period, the Vascular Surgery team implanted temporary hemodialysis catheters in 107 patients. These patients were monitored, and their demographic and clinical characteristics were analyzed to identify any that correlated with catheter malfunction. Results: Of the 107 patients studied, 22 (20.6%) had catheter-related complications. Eighteen (16.8%) had catheter malfunctions, while 4 (3.7%) developed infections. Five patients had unfavorable clinical status and did not undergo catheter replacement. Catheter tip thrombosis was the cause of the malfunction in 13 of the patients with malfunctions. The analysis revealed that the only variables correlated with higher risk of malfunction were the need for orotracheal intubation (p = 0.009), deep vein thrombosis (p = 0.01), and a history of a previous catheter use (p = 0.002). Conclusions: The rate of temporary dysfunction of the high-flow catheter in patients with COVID-19 in this sample was similar to the rate described in the literature for patients without this disease.