Blood Pressure and Risk of Bleeding During Permcath Insertion

Background: The tunnelled double-lumen cuffed catheter (TDLCC) is commonest route of vascular access with risk of bleeding from its insertion site.Objective: To assess the effect of blood pressure on the risk of bleeding during tunnelled double-lumen catheter placement for haemodialysis.Methods: This study was carried out on patients who were ≥ 18 years old and required vascular access for haemodialysis. Patients having patent arteriovenous fistula, coagulopathy, and thrombocytopenia were excluded. All the patients were observed for haemodynamic instability and bleeding from the site of TDLCC insertion.Results: There were one hundred and forty (n=140) individuals, including 97 (69.29%) males, with a mean age of 56.21±14.86 years. The bleeding during TDLCC insertion was observed in 24 (17.14%) patients. The mean systolic blood pressure was 138.69±19.09 mmHg, while the mean diastolic BP was 85.89±12.31 mmHg. The receiver operating curve analysis of systolic blood pressure for the risk of bleeding showed the area under curve 0.792(95% confidence interval 0.697 - 0.886, p<0.001) and for diastolic blood pressure, the area under curve came out to be 0.767(95% confidence interval 0.662 - 0.871, p<0.001). The area under curve for serum creatinine was 0.654(95% confidence interval 0.536 – 0.772, p=0.017). The best cut-off values for systolic and diastolic blood pressure and serum creatinine for predicting bleeding risk were 142.50 mmHg, 92.50 mmHg, and 691.50 µmol/L, respectively.Conclusion: The blood pressure has a significant effect on the risk of bleeding during the insertion of a tunnelled double-lumen catheter in haemodialysis patients.