Q: Three-lumen dialysis catheter, popularly known as trialysis, is more popular than two-lumen dialysis catheter for practical purposes with advantage of one extra port. But it is not an ideal catheter for continuous renal replacement therapy (CRRT). Give at least three reasons why three-lumen dialysis catheter is inferior to two-lumen dialysis catheter (trialysis catheter).
Answer:
1. Presence of extra port/lumen in catheter take toll on diameters of other two lumens and decreases the internal diameter of the two dialysis lumens. Consequently it may hamper the blood flows.
2. Infusion of critical medications like antibiotics, inotrope or pressors may get more rapidly cleared by dialysis.
3. Calcium infused via third lumen of dialysis catheter may get recirculated and cause unreliable effect and measurement of ionized calcium.
Although, infusion via third lumen of intravenous fluids, heparin or blood products seems safe so far.
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