A comparison of the Niagara™ and Dolphin® catheters for continuous renal replacement therapy

Purpose: The choice of vascular access catheter may affect filter life during continuous renal replacement therapy (CRRT); specifically, a new surface-modified catheter has been reported to possibly prevent thrombosis and catheter malfunction. Design and setting: A sequential, controlled study in a tertiary ICU. Aims: To compare circuit life when CRRT was performed with a Bard (R) Niagara (TM) catheter or the surface-modified GamCath (TM) Dolphin (R) Protect 1320 catheter. Patients and measurements: We studied 50 patients with acute kidney injury requiring CRRT, all delivered with catheters in the femoral position. We obtained information on age, gender, disease severity score (APACHE II and APACHE III), filter life, total heparin dose, hemoglobin concentration, platelet count, INR, and aPTT during CRRT. Results: We studied 341 circuits in 50 patients; 30 patients (140 circuits) used the Niagara and 20 patients (201 circuits) used the Dolphin catheter. Mean of circuit life in two groups was 14.9 hours and 13.1 hours, respectively (p=0.22). Patients using Niagara catheters had a more prolonged APTT (p<0.01) and lower platelet count (p=0.05), while heparin dose (p=0.22), and other anticoagulant treatment (p=0.73) were not significantly different. On Kaplan-Meier survival analysis, circuit life was not significant different between the two catheters (p=0.15). Conclusions: The Niagara and Dolphin catheters appear to be broadly equivalent in terms of their impact on circuit life.