Vascular Access in Hemodialysis: the 2006 KDOQI ... - Network 6

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CPG 7 Prevention and Treatment ofCatheter and Port Complications7.3 Methods that should be used to treat adysfunctional or nonfunctional catheter or portinclude:7.3.1 Repositioning of a malpositioned catheter; (B)7.3.2 Thrombolytics, using either an intraluminallytic, intradialytic lock protocol or anintracatheter thrombolytic infusion orinterdialytic lock (B)7.3.3 Catheter exchange with sheath disruption whenappropriate. (B)CPG7 Prevention and Treatment ofCatheter and Port Complications7.4 Treatment of an infected HD catheter or portshould be based on the type and extent ofinfection.7.4.1 All catheter-related infections, except forcatheter exit-site infections, should beaddressed by initiating parenteraltreatment with an antibiotic(s) appropriate for theorganism(s) suspected. (A)7.4.2 Definitive antibiotic therapy should be based onthe organism(s) isolated. (A)
CPG7 Prevention and Treatment ofCatheter and Port Complications7.4.3 Catheters should be exchanged as soon aspossible and within 72 hours of initiating antibiotictherapy in most instances, and such exchange doesnot require a negative blood culture prior to theexchange. (B+) Follow-up cultures are needed 1week after cessation of antibiotic therapy (standardpractice).7.4.4 Port pocket infections should be treated withsystemic antibiotics and irrigation, in conjunctionwith the manufacturers’ recommendations. (B)CPG 8 - Clinical Outcome Goals:8.1 Goals for Access Placement.8.1.1 Each center should establish a databaseand CQI process to track the types of accessescreated and the complication rates for theseaccesses (cannot accomplish without a VAT)8.1.2 The goals for incident hemodialysis accessplacement should include:fistula >65%, catheters
Page 1 and 2: Vascular Access in Hemodialysis:the
Page 3 and 4: Overview of the NKF-DOQI Guidelines
Page 5 and 6: Mission Given - Limited Revision:
Page 7 and 8: The evidence2892+112 +5 = 3009 arti
Page 9 and 10: Vascular Access - KDOQI 2006CPG 5.
Page 11 and 12: Major Focus Areas• Monitoring and
Page 13 and 14: Patient Preparation for Long-Term H
Page 15 and 16: CPG 1: Preparation & Evaluation1.3
Page 17 and 18: CPG 2. Selection of Access2.2Fistul
Page 19 and 20: Exercise shouldboth enlarge thevein
Page 21 and 22: CPG G 4. Detection of Access Dysfun
Page 23 and 24: CPG 4. Surveillance & Monitoring4.4
Page 25 and 26: CPG 5. Treatment of Fistula Complic
Page 27: CPG 7 Prevention and Treatment ofCa
Page 31 and 32: Clinical Practice Recommendations f
Page 33 and 34: It’s s always aboutthe Patient!Th
Page 35: Research:7. Catheters• With moder

Vascular Access in Hemodialysis: the 2006 KDOQI ... - Network 6

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