Dialysis Catheter Care in ICU: Where Practice Varies

Posted on 1 December 2026

Study Overview

Nontunnelled dialysis catheters are essential for renal replacement therapy in critically ill patients, but they also have a relatively high risk of failure and complications.

This Australian cross-sectional survey explored how critical care nurses manage dialysis catheters after insertion, with a focus on site assessment, dressings, securement, catheter locking and troubleshooting. A total of 205 eligible responses were included in the analysis.

Key Findings

Most respondents worked in adult intensive care and had substantial critical care experience.
Around 85% reported having a local policy for postinsertion dialysis catheter care.
Common practices included inspecting the insertion site once per shift and using bordered chlorhexidine gluconate-impregnated dressings, usually changed every seven days or as required.
Despite this, the survey identified 97 different dressing and securement combinations, highlighting considerable variation between clinicians and services.
Heparin was the most commonly reported catheter locking solution.
When troubleshooting catheter dysfunction, nurses used a range of approaches, including repositioning the patient, swapping access and return lines, flushing, applying traction and rotating the catheter.

Implications

The study highlights substantial variation in how nontunnelled dialysis catheters are cared for after insertion in Australian intensive care units.

Some variation may reflect differences in local policies, products and patient needs, but it also points to areas where stronger evidence and more consistent guidance could support practice.

Further research is needed to identify the most effective approaches to dressing, securement, locking and catheter troubleshooting, with the aim of reducing complications and improving catheter performance.

Read more:https://doi.org/10.1016/j.aucc.2026.101653

Authors: Amanda Corley; Mari Takashima; Melissa J. Bloomer; Amanda J. Ullman; Samantha Keogh; Lucy Shinners; Stephanie Hall; Catherine O’Brien; Emily N. Larsen; Fiona Coyer; Nicole Marsh

Dialysis Catheter Care in ICU: Where Practice Varies

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