Management of a non-cuffed catheter in continuous renal replacement therapy

Abstract

Vascular access (VA) is essential for blood purification therapy by means of an extracorporeal circulation technique. The non-cuffed type of vascular catheter is most useful in creating vascular access for acute blood purification therapy, associated with continuous renal replacement therapy (CRRT). The advantage of using a non-cuffed vascular catheter is that it may be inserted quickly, and blood purification therapy may be started immediately. A non-cuffed catheter may also be utilized as a central venous line for the administration of drugs and fluid. A non-cuffed catheter is required to have the following capacities as a medical device: operability during insertion, placement and fixation, safety during the attachment or detachment of the circuit, smooth blood transfer performance, minimal invasiveness to the vessel wall, and antibacterial attributes. However, even if a catheter has sufficient capacities, it is humans who handle it. In other words, when using a non-cuffed catheter, it is important to understand its characteristics and to know how to handle it appropriately. In this review, we summarized the evidence regarding effective and safe techniques for using a non-cuffed catheter for CRRT in the field of emergency and critical-care medicine. The qualities of the ideal device for blood purification therapy were also explored.