Presentation
NA
Patient Data
Right IJV double lumen dialysis catheter - tunneled in the anterior chest wall - with fluid overload status.
Left IJV double lumen dialysis catheter - tunneled. The lungs reveal fluid overload status.
Case Discussion
Jugular vein puncture is done under local anesthesia using ultrasound guidance. A guidewire is secured in the right atrium or the cavo-atrial junction under fluoroscopy over which a jugular sheath is placed. The dialysis catheter is inserted through a subcutaneous tunnel on the chest wall and is placed within the sheath - which is peel-away type of sheath. The sheath is peeled off keeping the catheter in position.
Right internal jugular vein is preferred for jugular dialysis catheters due to its straight access into the superior vena cava and the right atrium. These are placed through a tunnel in the subcutaneous plane with a dacron cuff positioned in the center of the tunnel around the catheter. The usual dialysis catheters are double lumen - one each for inflow and outflow. Triple lumen dialysis catheters may also be used - the third lumen used for intravenous fluid / drugs administration / central venous pressure assessment.
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