Abstract
This report centers on the management of hemodialysis for a child, dialyzed as of 3 months after birth, using a dual lumen catheter (Permcath®) for 4 years and 1 month.
The child is male born in June 1981, and he had a dialysis history of 9 years and 6 months as of March 1991.
The management of the catheter (Permcath®) consisted of the following: 1. unification of measures for prophylaxis against infection and blockage, 2. prevention of friction and movement of the catheter by (1) making a chest belt, (2) specially designing a schoolbag, and (3) applying stripped T gauze, 3. orientation for the patient and his parents, and 4. emphasizing close communication with his school. As a result of the above measures, the Permcath® could be used for 4 years and 1 month from the time when the patient was 5 years and 5 months old until he was 9 years and 9 months old, without clinical problems.
Prevention of catheter replacement is possible by replenishing heparin on non-dialysis days. When the insertion area was infected, it was treated by increasing the number of sterilizations, by administering antibiotics, and securing the Permcath®.
The catheter was cracked and had to be removed. The Permcath® ensured the initiation of dialysis for the child without pain caused by shunt piercing, decreased restrictions on body movement and allowed him to participate fully in study and play. The boy could spend the period from early childhood to the early years of elementary school in a very stable condition mentally. He was able to attend nursery school and go to a local elementary school, and the overall QOL of this child was enhanced.
