Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFRN |
Texto Completo: | https://repositorio.ufrn.br/handle/123456789/52487 https://doi.org/10.1590/2175-8239-JBN-2019-0108 |
Resumo: | Introduction: Invasive procedures performed by trained nephrologists can reduce delays in making a definitive vascular access, complications, number of procedures on the same patient, and costs for the Public Health System. Objective: to demonstrate that a long-term tunneled central venous catheter (LTCVC) implanted by a nephrologist is safe, effective, and associated with excellent results. Methods: A retrospective study analyzed 149 consecutively performed temporary-to-long-term tunneled central venous catheter conversions in the operating room (OR) from a dialysis facility from March 2014 to September 2017. The data collected consisted of the total procedures performed, demographic characteristics of the study population, rates of success, aborted procedure, failure, complications, and catheter survival, and costs. Results: the main causes of end stage renal disease (ESRD) were systemic arterial hypertension and diabetes mellitus, 37.9% each. Patients had a high number of previous arteriovenous fistula (1.72 ± 0.84) and temporary catheter (2.87 ± 1.9) attempts until a definitive vascular access was achieved, while the preferred vascular site was right internal jugular vein (80%). Success, abortion, and failure rates were 93.3%, 2.7% and 4%, respectively, with only 5.36% of complications (minors). Overall LTCVC survival rates over 1, 3, 6, and 12 months were 93.38, 71.81, 54.36, and 30.2%, respectively, with a mean of 298 ± 280 days (median 198 days). The procedure cost was around 496 dollars. Catheter dysfunction was the main reason for catheter removal (34%). Conclusion: Our analysis shows that placement of LTCVC by a nephrologist in an OR of a dialysis center is effective, safe, and results in substantial cost savings. |
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Quintiliano, Artur Quintiliano Bezerra daPraxedes, Marcel Rodrigues Gurgel2023-05-19T15:32:36Z2023-05-19T15:32:36Z2020-01SILVA, Artur Quintiliano Bezerra da; PRAXEDES, Marcel Rodrigues Gurgel. Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista. Brazilian Journal Of Nephrology, [S.L.], v. 42, n. 1, p. 53-58, mar. 2020. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/2175-8239-jbn-2019-0108. Acesso em: 19 maio 2023.https://repositorio.ufrn.br/handle/123456789/52487https://doi.org/10.1590/2175-8239-JBN-2019-0108Brazilian Journal Of NephrologyAtribuição 3.0 Brasilhttp://creativecommons.org/licenses/by/3.0/br/info:eu-repo/semantics/openAccessvascular access devicesrenal replacement therapycost savingsEficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologistaEffectiveness, safety and cost reduction of long-term tunneled central venous catheter insertion in outpatients performed by an interventional nephrologistinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleIntroduction: Invasive procedures performed by trained nephrologists can reduce delays in making a definitive vascular access, complications, number of procedures on the same patient, and costs for the Public Health System. Objective: to demonstrate that a long-term tunneled central venous catheter (LTCVC) implanted by a nephrologist is safe, effective, and associated with excellent results. Methods: A retrospective study analyzed 149 consecutively performed temporary-to-long-term tunneled central venous catheter conversions in the operating room (OR) from a dialysis facility from March 2014 to September 2017. The data collected consisted of the total procedures performed, demographic characteristics of the study population, rates of success, aborted procedure, failure, complications, and catheter survival, and costs. Results: the main causes of end stage renal disease (ESRD) were systemic arterial hypertension and diabetes mellitus, 37.9% each. Patients had a high number of previous arteriovenous fistula (1.72 ± 0.84) and temporary catheter (2.87 ± 1.9) attempts until a definitive vascular access was achieved, while the preferred vascular site was right internal jugular vein (80%). Success, abortion, and failure rates were 93.3%, 2.7% and 4%, respectively, with only 5.36% of complications (minors). Overall LTCVC survival rates over 1, 3, 6, and 12 months were 93.38, 71.81, 54.36, and 30.2%, respectively, with a mean of 298 ± 280 days (median 198 days). The procedure cost was around 496 dollars. Catheter dysfunction was the main reason for catheter removal (34%). Conclusion: Our analysis shows that placement of LTCVC by a nephrologist in an OR of a dialysis center is effective, safe, and results in substantial cost savings.porreponame:Repositório Institucional da UFRNinstname:Universidade Federal do Rio Grande do Norte (UFRN)instacron:UFRNORIGINALEficaciaSegurançaReducao_Silva_Prazedes_2020.pdfEficaciaSegurançaReducao_Silva_Prazedes_2020.pdfapplication/pdf453967https://repositorio.ufrn.br/bitstream/123456789/52487/1/EficaciaSeguran%c3%a7aReducao_Silva_Prazedes_2020.pdf3a5561a3ebf16aed23c3b8d6430c8c5aMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8914https://repositorio.ufrn.br/bitstream/123456789/52487/2/license_rdf4d2950bda3d176f570a9f8b328dfbbefMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81484https://repositorio.ufrn.br/bitstream/123456789/52487/3/license.txte9597aa2854d128fd968be5edc8a28d9MD53123456789/524872023-05-19 12:34:03.55oai:https://repositorio.ufrn.br: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Repositório de PublicaçõesPUBhttp://repositorio.ufrn.br/oai/opendoar:2023-05-19T15:34:03Repositório Institucional da UFRN - Universidade Federal do Rio Grande do Norte (UFRN)false |
dc.title.pt_BR.fl_str_mv |
Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista |
dc.title.alternative.pt_BR.fl_str_mv |
Effectiveness, safety and cost reduction of long-term tunneled central venous catheter insertion in outpatients performed by an interventional nephrologist |
title |
Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista |
spellingShingle |
Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista Quintiliano, Artur Quintiliano Bezerra da vascular access devices renal replacement therapy cost savings |
title_short |
Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista |
title_full |
Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista |
title_fullStr |
Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista |
title_full_unstemmed |
Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista |
title_sort |
Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista |
author |
Quintiliano, Artur Quintiliano Bezerra da |
author_facet |
Quintiliano, Artur Quintiliano Bezerra da Praxedes, Marcel Rodrigues Gurgel |
author_role |
author |
author2 |
Praxedes, Marcel Rodrigues Gurgel |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Quintiliano, Artur Quintiliano Bezerra da Praxedes, Marcel Rodrigues Gurgel |
dc.subject.por.fl_str_mv |
vascular access devices renal replacement therapy cost savings |
topic |
vascular access devices renal replacement therapy cost savings |
description |
Introduction: Invasive procedures performed by trained nephrologists can reduce delays in making a definitive vascular access, complications, number of procedures on the same patient, and costs for the Public Health System. Objective: to demonstrate that a long-term tunneled central venous catheter (LTCVC) implanted by a nephrologist is safe, effective, and associated with excellent results. Methods: A retrospective study analyzed 149 consecutively performed temporary-to-long-term tunneled central venous catheter conversions in the operating room (OR) from a dialysis facility from March 2014 to September 2017. The data collected consisted of the total procedures performed, demographic characteristics of the study population, rates of success, aborted procedure, failure, complications, and catheter survival, and costs. Results: the main causes of end stage renal disease (ESRD) were systemic arterial hypertension and diabetes mellitus, 37.9% each. Patients had a high number of previous arteriovenous fistula (1.72 ± 0.84) and temporary catheter (2.87 ± 1.9) attempts until a definitive vascular access was achieved, while the preferred vascular site was right internal jugular vein (80%). Success, abortion, and failure rates were 93.3%, 2.7% and 4%, respectively, with only 5.36% of complications (minors). Overall LTCVC survival rates over 1, 3, 6, and 12 months were 93.38, 71.81, 54.36, and 30.2%, respectively, with a mean of 298 ± 280 days (median 198 days). The procedure cost was around 496 dollars. Catheter dysfunction was the main reason for catheter removal (34%). Conclusion: Our analysis shows that placement of LTCVC by a nephrologist in an OR of a dialysis center is effective, safe, and results in substantial cost savings. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-01 |
dc.date.accessioned.fl_str_mv |
2023-05-19T15:32:36Z |
dc.date.available.fl_str_mv |
2023-05-19T15:32:36Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
SILVA, Artur Quintiliano Bezerra da; PRAXEDES, Marcel Rodrigues Gurgel. Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista. Brazilian Journal Of Nephrology, [S.L.], v. 42, n. 1, p. 53-58, mar. 2020. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/2175-8239-jbn-2019-0108. Acesso em: 19 maio 2023. |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufrn.br/handle/123456789/52487 |
dc.identifier.doi.none.fl_str_mv |
https://doi.org/10.1590/2175-8239-JBN-2019-0108 |
identifier_str_mv |
SILVA, Artur Quintiliano Bezerra da; PRAXEDES, Marcel Rodrigues Gurgel. Eficácia, segurança e redução de custos no implante de cateter venoso central de longa permanência em pacientes dialíticos realizado por nefrologista. Brazilian Journal Of Nephrology, [S.L.], v. 42, n. 1, p. 53-58, mar. 2020. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/2175-8239-jbn-2019-0108. Acesso em: 19 maio 2023. |
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https://repositorio.ufrn.br/handle/123456789/52487 https://doi.org/10.1590/2175-8239-JBN-2019-0108 |
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Atribuição 3.0 Brasil http://creativecommons.org/licenses/by/3.0/br/ info:eu-repo/semantics/openAccess |
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Atribuição 3.0 Brasil http://creativecommons.org/licenses/by/3.0/br/ |
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Brazilian Journal Of Nephrology |
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Brazilian Journal Of Nephrology |
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