Mahurkar Catheter for Dialysis: Sizes, French, Placement, Removal, Triple Lumen & Insertion Guide

Content:

• What is Mahurkar Catheter for Dialysis?
• Sizes
• French
• Placement
• Removal
• Triple Lumen
• Insertion Guide

What is Mahurkar Catheter for Dialysis?

The Mahurkar catheter is a specialized medical device designed for hemodialysis, a process that filters a patient's blood when their kidneys can no longer function effectively. It is a type of central venous catheter, often made from biocompatible materials to minimize the risk of clotting or infection. This catheter is typically placed in a large vein, such as the internal jugular or femoral vein, allowing high blood flow rates that are necessary for efficient dialysis treatment. Its structure and design help healthcare professionals achieve rapid and reliable vascular access, which is critical for patients needing urgent or long-term dialysis.

Unlike regular intravenous lines, the Mahurkar catheter is designed with multiple lumens to allow simultaneous withdrawal and return of blood during dialysis. This feature ensures that the dialysis machine can work continuously and efficiently. The device is available in different configurations to meet individual patient needs, such as acute or chronic dialysis, and it often comes pre-sterilized with protective features to reduce complications. It plays a vital role in life-saving renal replacement therapy.

Sizes

Mahurkar catheters come in different sizes to accommodate varying patient requirements, treatment duration, and vein anatomy. Sizes are generally described in terms of length and French gauge (Fr), which refers to the outer diameter of the catheter. Common lengths range from 19 cm to 28 cm for adults, with shorter lengths for pediatric patients. The choice of size depends on factors such as the patient’s body habitus, site of insertion, and type of dialysis (acute or chronic). Larger sizes allow higher blood flow rates, which can improve dialysis efficiency, but they also require careful placement to avoid vessel damage.

Choosing the correct size is critical for maintaining optimal blood flow while minimizing complications such as kinking, clot formation, or patient discomfort. In acute settings, a slightly larger diameter may be used for high-flow access, while chronic patients may benefit from a size that balances comfort with performance. The availability of a range of sizes ensures that clinicians can tailor the device to each patient’s unique anatomical and clinical needs.

French

The French (Fr) scale is a standardized measurement used to indicate the outer diameter of catheters, including the Mahurkar catheter. One French unit equals 0.33 millimeters in diameter. For example, a 12 Fr catheter has an external diameter of approximately 4 millimeters. Mahurkar catheters are typically available in sizes like 12 Fr, 14 Fr, or even 16 Fr, depending on the required blood flow rate and the patient’s vein size. Larger French sizes generally allow faster blood withdrawal and return, which is important for efficient hemodialysis.

However, selecting the right French size also involves considering patient safety and comfort. Oversizing can lead to vein trauma, while undersizing may cause inadequate dialysis due to lower flow rates. The choice often depends on a combination of clinical judgment, patient anatomy, and the duration of treatment. Understanding the French measurement system is crucial for clinicians to ensure that the catheter provides optimal performance while minimizing risks.

Placement

Placement of a Mahurkar catheter is typically performed under sterile conditions in a hospital or dialysis center. The preferred insertion sites are the right internal jugular vein, left internal jugular vein, or femoral vein. The procedure is often guided by ultrasound to improve accuracy and reduce complications. The right internal jugular vein is generally favored because it provides a direct path to the superior vena cava, reducing the risk of kinking and improving flow efficiency.

Before placement, the patient is positioned to optimize vein exposure, and local anesthesia is administered. A guidewire technique is used to introduce the catheter into the vein, followed by secure fixation and sterile dressing application. Proper placement is crucial for ensuring consistent blood flow and reducing risks like thrombosis or catheter malfunction. X-ray confirmation is often performed after placement to verify the catheter’s position.

Removal

Removal of a Mahurkar catheter is usually a straightforward procedure but must be performed carefully to avoid complications such as bleeding or air embolism. The process begins by removing the dressing and securing sutures, followed by slowly withdrawing the catheter while the patient performs a Valsalva maneuver to prevent air entry. Direct pressure is applied to the insertion site after removal to control bleeding, and a sterile dressing is placed to promote healing.

In chronic dialysis patients, catheters may be removed after establishing a permanent vascular access, such as an arteriovenous fistula or graft. In acute cases, removal is often done once the patient no longer requires dialysis or when the catheter becomes infected or nonfunctional. Clinicians must follow strict aseptic protocols during removal to minimize infection risk and other complications.

Triple Lumen

Some Mahurkar catheters are designed with a triple lumen configuration, offering an additional port alongside the two main dialysis lumens. This extra lumen can be used for administering medications, fluids, or nutrition without interrupting dialysis. This design is especially beneficial in critically ill patients who require both renal replacement therapy and other intravenous treatments simultaneously.

Triple lumen catheters must be used with caution to prevent cross-contamination between dialysis and medication infusions. The added functionality makes them versatile in intensive care settings, where patients often require multiple concurrent therapies. However, careful management and regular flushing are essential to prevent blockage or infection in any of the lumens.

Insertion Guide

The insertion of a Mahurkar catheter follows a step-by-step sterile protocol. First, the patient’s insertion site is cleaned and draped. Local anesthesia is administered, and ultrasound is used to identify the vein. A needle is inserted into the vein, followed by a guidewire, over which the dilator and then the catheter are passed. Each step must be performed with precision to avoid vessel injury or malposition.

Once the catheter is in place, it is sutured securely to the skin, and a sterile dressing is applied. Blood flow rates are checked before connecting the catheter to the dialysis machine. Clinicians are trained to follow these guidelines strictly, as improper insertion can lead to serious complications such as bleeding, infection, or catheter malfunction. Post-insertion care includes monitoring for signs of infection, ensuring secure dressing changes, and regular flushing to maintain patency.