Place des cathéters tunnélisés dans la prise en charge de l'insuffisance rénale aiguë par épuration extrarénale

Vascular access (VA) is a basic and essential tool required for performing renal replacement therapy in acute renal failure (ARF). Central venous catheters have become the preferred VA in these settings. Despite significant design and material improvements, temporary dialysis catheters remain a leading cause of morbidity and mortality, especially infection, thrombosis, and catheter malfunction. The use of tunneled catheters may minimize these complications and would represent a new alternative option. Indeed, soft silicone twin-catheters with subcutaneous tunnelling improve catheter performances, decrease catheter-related infections and thrombosis, and may be used for a longer period (more than three weeks). In this review, we will describe tunneled cuffed catheters characteristics, evaluate their advantages and disadvantages and address current challenges and future directions for this VA in ICU ARF.