Dialysis catheter in femoral vein - Journal of Intensive and
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Hemodialysis is important part of management in patients with severe metabolic acidosis and hyperkalemia. Central venous insertion of dialysis catheter in femoral vein and internal jugular vein is commonly performed. 58-year-old lady was admitted in intensive care unit with cardiogenic shock and severe metabolic acidosis. In view of anuria and progressive acidosis, it was decided to perform hemodialysis.

Under all aseptic precautions, left femoral vein was punctured and double lumen dialysis catheter was inserted. Back flow could be easily aspirated in one lumen but not in other; however saline was easily flushed in through both lumens without resistance. As the dialysis machine inflow and outflow tubes were connected to the two ports of catheter, blood could not be aspirated through outflow tube. Catheter was little pulled out and any mechanical kinking at insertion site was ruled out, however no free flow in aspiration was observed. Finally catheter was rotated by 180 degrees before considering other vein for catheter insertion. Blood could be easily aspirated through both lumens after rotating the catheter. Dialysis was started without any problem in inflow and outflow...

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