What are the causes of bleeding from a permanent catheter (permacath)?

From the Guidelines

If you have a bleeding permacath, apply direct pressure to the exit site with sterile gauze for at least 10-15 minutes, as this is the most effective way to control bleeding and prevent further complications 1.

Immediate Action

To manage bleeding from a permacath, it is crucial to act quickly and follow proper protocols to minimize the risk of infection and other complications.

• Apply direct pressure to the exit site with sterile gauze for at least 10-15 minutes.
• If bleeding persists after pressure, contact your healthcare provider or go to the emergency room immediately.

Preventive Measures

Preventive measures are key to reducing the risk of bleeding and other complications associated with permacaths.

• Avoid pulling or tugging on the catheter, as this can cause damage to the vein or the catheter itself.
• Keep the site clean and dry, and follow proper dressing change protocols to prevent infection.
• If you're on blood thinners like warfarin or heparin, inform your healthcare provider about the bleeding as dosage adjustments may be necessary 1.

Potential Causes and Complications

Bleeding can occur due to various reasons, including recent placement, anticoagulant medications, or disruption of the exit site.

• Recurrent bleeding may indicate infection or catheter complications that require professional evaluation.
• Always maintain sterile technique when handling the catheter to prevent infection, which can be life-threatening in dialysis patients.

Importance of Sterile Technique

Maintaining sterile technique is crucial when handling a permacath to prevent infection and other complications.

• Use chlorhexidine or alcohol swabs to clean the area after bleeding has stopped.
• Apply a new sterile dressing to protect the site and prevent infection.
• Never remove the catheter yourself, as this can lead to serious complications, including infection and bleeding 1.

From the Research

Bleeding Permacath

• Bleeding permacath is a complication that can occur in patients with permanent venous access for hemodialysis, such as those using a Permcath 2, 3.
• The use of tranexamic acid (TXA) has been studied in various clinical settings, including trauma, surgery, and obstetric complications, as a potential treatment for bleeding disorders 4, 5, 6.
• TXA is an antifibrinolytic agent that works by inhibiting plasminogen activation, thereby reducing conversion of plasminogen into plasmin and preventing fibrinolysis 4, 5.
• The literature suggests that TXA may be effective in reducing bleeding in various clinical settings, including traumatic hemorrhage, postpartum hemorrhage, and surgical bleeding 4, 5, 6.
• However, there is limited evidence specifically addressing the use of TXA in the management of bleeding permacath, and further research is needed to determine its efficacy and safety in this context.

Management of Bleeding Permacath

• The management of bleeding permacath typically involves addressing the underlying cause of the bleeding, such as infection, thrombosis, or catheter malfunction 2, 3.
• The use of TXA may be considered as an adjunctive therapy in the management of bleeding permacath, particularly in cases where bleeding is severe or refractory to other treatments 4, 5, 6.
• However, the decision to use TXA should be made on a case-by-case basis, taking into account the individual patient's clinical circumstances and the potential risks and benefits of treatment 4, 5, 6.