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Frequently Asked Questions
What are the KDOQI guidelines?
The KDOQI (Kidney Disease Outcomes Quality Initiative) is a program of the National Kidney Foundation that formulates clinical practice guidelines based on high-quality research to improve outcomes for patients with Chronic Kidney Disease (CKD).
What is Arrow’s recommended catheter site care protocol?
Arrow follows the Centers for Disease Control (CDC) guidelines for proper catheter site care. The CDC recommends that either sterile gauze or sterile, transparent, semi-permeable dressing be used to cover the catheter site. Tunneled CVC sites that are well-healed might not require dressings. If the patient is diaphoretic, or if the site is bleeding or oozing, gauze dressing is preferable to a transparent, semi-permeable dressing. If the catheter-site dressing becomes damp, loosened, or visibly soiled it should be replaced. The CDC guidelines specify that topical antibiotic ointment or creams are acceptable for use with dialysis catheters. To see additional site care instructions and recommendations on antiseptics used for catheter site care click here.
For more information on infection control measures, please reference 2006 KDOQI guidelines at: http://www.kidney.org/professionals/kdoqi/guideline_upHD_PD_VA/va_guide3.htm
What is the recommendation for catheter dressing change?
KDOQI guidelines recommend all hemodialysis catheters be examined prior to every dialysis treatment and a dressing change is necessary after every treatment.
What is the flush recommendation for the Cannon Catheter™?
Every 48 hours, but no longer than 72 hours.
What are the Cannon Catheter flow rates and pressures?
*In vitro test performed by an independent laboratory (Citech, Plymouth Meeting, PA)
What are the priming volumes for Arrow’s chronic catheters?
It is total volume per lumen including the extension lines. This information is printed on the catheter extension lines. The priming volumes are as follows:
How would I determine the accurate priming volume for the Cannon Catheter after the hub has been replaced or the catheter has been trimmed at some point other than the cut line?
If the catheter is cut at some point other than the cut line, the priming volume will need to be adjusted. For every centimeter cut away from the trim line, the priming volume changes by 0.13 cc. To determine the new priming volume for each 1 cm the catheter is trimmed proximally (towards the catheter hub) from the trim line, the arterial and venous priming volumes should be increased by 0.13 cc. For each 1 cm the catheter is trimmed distally (away from the catheter hub) from the trim line, the arterial and venous priming volumes should be decreased by 0.13 cc.
What is Arrow’s recommended protocol for catheter heparinization and recommended heparin concentration?
To maintain patency of the catheter between treatments, a heparin lock is usually instilled in each lumen of the catheter. The concentration of heparin, or alternative anticoagulant, should be determined by hospital protocol or physician order. Prior to flushing the catheter, first aspirate out existing lock solution, then flush catheter with saline or as per facility protocol.
What strength of heparin can be used on the Cannon Catheter?
10 units/cc to 1,000 units/cc has been found to be effective. However, it is best to check with the respective physician or hospital protocol. Dialysis catheters are typically instilled with 1,000 units/cc to 5,000 units/cc of heparin.
What is the recommended treatment for thrombotic occlusions within the Cannon Catheter?
The physician or hospital protocol will ultimately decide what agent to use for lysing clot in long-term catheters, however The Cathflo® Activase® has been proven to restore function to central venous access devices as assessed by the ability to withdraw blood.
Click on the following link for more Activase® details: http://www.cathflo.com.
How soon after catheter placement can a MRI procedure be done?
An MRI can be performed at any time following catheter placement.
What are the indications for use with the Cannon Catheter?
The Arrow Cannon catheter is indicated for attaining long-term vascular access for Hemodialysis and Apheresis. The Cannon Catheter is inserted percutaneously and is preferentially placed into the internal jugular (IJ) vein. Alternately, this catheter may be inserted into the subclavian vein, although the jugular vein is the preferred site. Catheters greater than 40 cm are intended for femoral vein insertion. The Cannon Catheter is intended for use in adult patients.
How soon after a catheter is placed can it be used?The Cannon Catheter can be used as soon as the inserting physician successfully aspirates for blood return and proper tip location is verified.
Can the Cannon Catheter be used in pediatric patients?
No. The Cannon Catheter is indicated for adult patients only.
What syringe size is recommended for use with the Cannon Catheter?
It is recommended that a 10cc or larger syringe be used to infuse or flush the catheter. Infusion pressures should never exceed 40 psi to prevent damage to blood vessels. A two-pound weight equivalent force on the barrel of a 3cc syringe generates pressure in excess of 40 psi. The same two-pound weight equivalent force on the barrel of a 10cc syringe generates less than 8 psi of pressure.
Do any of the Cannon Catheter sets contain latex?
No. The catheter and its components are latex-free.
Is the Cannon Catheter MRI safe?
Yes. The Cannon Catheter presents no additional risks to the patient or other individuals during use with shielded magnetic resonance (MR) systems up to 3.0-Tesla, but may produce some MR imaging artifact in the area of the device. As always, the clinician should follow hospital protocol when making decisions regarding compatibility. For a more detailed discussion on MRI safety the following websites are listed for your convenience:
What is a chronic hemodialysis catheter?
According to KDOQI, a chronic, long-term, or tunneled cuffed catheter (TCC) is a device intended for use longer than 1 week that is typically tunneled and has a cuff to promote fibrous in-growth to prevent catheter migration and accidental withdrawal. These catheters are designed to remain in place for an extended period of time, allowing vascular access for dialysis. Benefits of this catheter include the dialysis nurse’s ability to start dialysis through the catheter rather than using a graft or fistula in the patient’s arm. Also, a chronic hemodialysis catheter provides a vascular access in patients who cannot have or do not want fistulas or grafts due to their medical condition.
Where are hemodialysis catheters placed?
Typically they are placed into a large vein in the neck. The Cannon Catheter can also be placed into a vein in the upper chest or the groin.
Can a tanning salon or direct sunlight be harmful to my catheter?
Yes. The UVA rays can degrade the catheter’s material with extended exposure.
What should be done if the dialysis staff can’t get a blood return from my catheter?
The dialysis staff have a variety of methods to restore blood flow. If they are not successful, they will contact the physician for further instructions.
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