Does Tunneling the Temporary Vascular Access Extend Its Lifetime?

It is important that a reliable vascular access or dialysis catheter be available for doing replacementtherapy in cases with uremia syndrome. life time of a temporary access depends on its location; overall its life time is 2to 3 weeks for jugular vein. regarding short life time of these temporary accesses, it is necessary to find a clinical wayto increase the life time of such accesses. it seems that tunneling the temporary uncuffed access, prolongs its life timeand reduces its complications, as well as its cost.methods: this study was a prospective clinical trial, which has been done on 30 cases with uremia syndrome withoutusable vascular accesses who were divided into two groups, randomly. inclusion criteria were acute renal failure andend stage renal failure with different etiologies. all of them had got temporary vascular accesses because of their needto emergency hemodialysis. the type of used accesses, was used the same (arrow) in all cases. patients were followedup once a week for checking the fistula or returning of kidney function in cases who had acute renal failure. presence ofinflammation, redness, pus formation, bleeding, and sutures of the entrance site were checked weekly. life time ofcatheter was determined as the time of its insertion to the time of its extraction, in weeks. data analysis was done byspss (version 12) and expressed by mean and variance.results: one case out of 30 selected subjects was excluded because of poor cooperation with clinicians. thirteen femalesand 16 males (44.8% vs. 55.2%) were treated in two groups; the first group or tunneled group included 14 cases,and the second group, non-tunneled group, included 15 cases. mean of age and length of neck showed no significantdifferences between two groups. nine cases had fever before catheterization, however there wasn't any relationship betweenlife time of catheter and fever in both groups (p=o.49 and 0.24, respectively). in this research, the most commonreason for releasing the catheter in both groups was the fever due to catheter related infection, only (78.6% in tunneledgroup and 80.00% in non-tunneled group). mean life time of catheter in tunneled group was 6.71± 0.9 weeks and, incases of non-tunneled group it was 4.53± 0.8 weeks; this difference was statistically significant between two groups (pvalue=0.0017).conclusion: subcutaneous tunneling the temporary vascular access can extend the lifetime of catheter and reduce itssubsequent dangers and related costs due to repeated catheterization, with respect to routine method.