VAS CATH PLACEMENT
The hemodialysis catheter is basically a tube, which is inserted in one of the neck veins, with the tip of the catheter advancing through the length of the vein, and opening up into a larger vein (either superior or inferior vena cava).
Vas cath is commonly inserted in internal jugular, sub-clavian and femoral veins. However, femoral veins are not preferred due to the risk of infection. Once placed, they are secured by sutures, attached to the dialysis machine and an X-ray is done to confirm its correct placement. Another way to confirm the venous origin of blood would be by taking a blood sample.
Vas caths have a life span of as many as 10 days, if they are placed in the internal jugular or sub clavian vein and a life span of 5 days if they have been placed in the femoral vein.
VAS CATH COMPLICATIONS AND THEIR PREVENTION
Like all the other central venous catheters, vas cath insertion also leads to an increased risk of complications. The major complications associated with these dialysis catheters are introduction of the infectious organisms and clotting of lumens.
Infections in these cases can be prevented by taking care of hygiene and following proper protocol. In addition to this an occlusive dressing always needs to be placed over the top of the insertion site to minimize the risk of infections.
There are higher chances of clotting, when the vas cath is not being used, since the blood is in the static state. In order to prevent this an anti-coagulant is flushed in to the lumen of the catheter such that the systemic coagulation status is not affected. Anti-coagulant preferred for this task is heparin and the procedure is heparin lock.
Other complications such as pneumothorax and arterial puncture can be very well ruled out with an x-ray.