Keywords
Renal Replacement Therapy
SARS-CoV-2
Renal Dialysis
Critical Illness
Observational Study
How to Cite
Abstract
Background: Acute kidney injury that occurs in critical illness of patients infected with SARS-CoV-2 requires renal replacement therapy, as demonstrated by large studies in China and Italy where 12% required renal replacement therapy.
Purpose: To present the use of popliteal venous access for catheter placement in critically ill patients in the prone position, in whom renal replacement therapy will be started, and the supine position is impossible.
Case presentation: A young patient of 42 years of age, hospitalized for COVID-19 pneumonia, a few days later presents severe ARDS, requiring mechanical ventilation and a prone position strategy, on the third day he develops acute kidney injury, renal replacement therapy was started, due to his oxygenation disorder and hemodynamic instability, the supine position was impossible, so it was decided to place a temporary catheter for hemodialysis in the left popliteal vein guided by ultrasound.
Discussion and conclusion: Considering our case, the patient could not be placed supine due to severe hypoxemia, and first-line venous accesses such as jugular, femoral and subclavian were limited by position. Popliteal venous access is safe, offering advantages such as operator comfort when inserting the catheter under ultrasound guidance, being an easy access route, and secondly, it presents less risk of contamination, so we recommend this venous access as an alternative in this group of patients.
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