Greetings. We are considering switching from 2-lumen dialysis catheters to 3-lumen catheters (dual dialysis lumen plus central line port). Inherent advantages with three lumen in patients who are in shock with dialysis (as opposed to putting in two central lines). Local experience several years ago (which motivated switching from 3- to 2- lumens in the first place) was higher infection rate with 3-lumen dialysis catheters. I'm interested in your experience...either pro or con. Please advise. Many thanks.
Greetings Dr. Cobb,
In my practice, we stock both 2 and 3-lumen dialysis catheters. The 3-lumen is useful only when we have another indication for central access, which we typically do in hemodynamically unstable ICU patients. There certainly is a higher theoretical CLABSI risk with the extra lumen but it's likely significantly less than the risk of inserting a second central line exclusively for these medications. It's also useful to consider Nephrology's anticipated duration of dialysis on a case-by-case basis. In that, if you plan on keeping the HD line in for an extended period, a 2-lumen would have its advantages. Essentially, there are use cases for both but my practice favors the 3-lumen.
Hope that helps.
Lokesh Dayal, MD
Central Michigan University
Society of Critical Care Medicine500 Midway DriveMount Prospect, IL 60056 USAPhone: +1 847 827-6888Fax: +1 847 439-7226Email: email@example.com
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