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M J Kumwenda

Publications and source records attributed to M J Kumwenda.

7 recordsLinked to original sources
PubMed1999

The use of a channel-cleaning brush for malfunctioning Tenckhoff catheters.

BACKGROUND: Tenckhoff catheter malfunction causes morbidity in some patients on continuous ambulatory peritoneal dialysis (CAPD). Various methods of treatment of malfunction have been described; we report our experience of the use of a channel-cleaning brush for this problem. METHOD: Ten patients on CAPD who developed catheter malfunction were identified. The causes of malfunction were catheter migration in one patient, catheter obstruction due to fibrin and clots in six, probable omental wrapping in one, and pain on draining of PD fluid in two patients. A channel-cleaning brush was manipulated repeatedly in and out of the catheters using aseptic technique and fluoroscopy guidance in an attempt to restore patency or dislodge the catheter to another site. RESULTS: CAPD was successfully re-established after this procedure in eight patients (80%), two catheters were removed from those patients in whom the use of the brush was unsuccessful. CONCLUSION: In this study a channel-cleaning brush was effective and safe in the treatment of Tenckhoff catheter malfunction.

Adult↗
PubMed1997

Two different techniques and outcomes for insertion of long-term tunnelled haemodialysis catheters.

BACKGROUND: Renal Units employ different techniques for insertion of long-term haemodialysis catheters into jugular veins, and we decided to ascertain the success rate and peri-insertion complications of two percutaneous methods in a District General Hospital. METHODS: Results of venous cannulation from two studies using different techniques were obtained and compared. Both studies were prospective and the procedures were performed by the same Clinician in patients with end stage renal failure. Patients were divided into two groups. Group A had venous catheters inserted under ultrasonographic guidance using a Site Rite portable machine and Group B were inserted 'blind'. The aseptic percutaneous Seldinger technique was used for catheterizations in both groups. RESULTS: The first attempt/pass venous cannulation success rate was 88.6% in Group A compared to 61.4% in Group B. Complications rate was significantly lower in Group A (P = 0.0048) than in Group B. CONCLUSION: In this study the ultrasonographic guided technique was better than the blind technique in jugular venous cannulations.

Adult↗
PubMed1996

Survey of permanent central venous catheters for haemodialysis in the UK.

BACKGROUND: Venous catheter haemodialysis may be necessary in some patients without arterio venous fistulae on dialysis for end-stage renal failure. We conducted a survey to compare management of these catheters in different units in the UK. METHODS: Postal questionnaires were sent to nurses in charge of 81 renal units in the UK for a twelve month study period in 1994 to find out the type of catheter used, catheter after insertion care, the rate and management of exit site infections, and bacteraemia. RESULTS: (1) Total number of questionnaires returned 66 (81.5%). (2) 63.6% of renal units used double lumen Permcath catheters, 16.7% single lumen (Francis/Kimal, Gambro or Vascath), 10.6% use both double and single lumen catheters and 9.1% of renal units only use temporary polyurethane catheters. (3) Catheter exit site aseptic dressing technique was used in 84.8% of renal units, clean technique in 15.2%. 66.8% change dressings at each dialysis session, 22.7% weekly. The majority of renal units (63.6%) had one nurse to change the dressing, used Betadine as a cleaning agent and Mepore to cover the exit site. (4) 75.8% did not know the exact incidence of episodes of sepsis and/or exit site infections. Flucloxacillin was the antibiotic of choice for each catheter related sepsis episode. CONCLUSION: During this study period most renal units used Permcaths as first choice for long term catheter dialysis, the after insertion care of which varied. The number of episodes of sepsis was unknown. We suggest UK collection of data for all long term catheters and related problems for audit purposes.

Anti-Infective Agents, Local↗