Definisi
The number of patients with end stage disease (ESRD) continues to increase over the years. In Malaysia the prevalence of patients undergoing dialysis has increased from 17,110 (2007) to 42,109 (2017) cases1. Out of the 42,109 cases, 89.8% were on HD and 10.2% were on PD1. This trend is also seen in our local setting. In Sabah, the prevalence of dialysis patients jumped from 1,534 (2013) to 2,203 (2017)1, 43% increment. Temporary CVC plays a major role as a vascular access in RRT, especially during the initiation of dialysis or while bridging till the permanent access is established. The number of temporary CVC insertions continue to increase and it has become a “common” procedure in the medical fraternity. Many factors have contributed to this situation such as crash landers, poor RRT preparation, poor vasculature for fistula creation in diabetic and elderly and long waiting time to establish permanent access. In 2007, 582 (4.5%) HD patients were on temporary CVC and by 2016 this number has increased to 2,613 (6.9%)1. This shift is also seen in developed countries such as the United States of America. In 2016, 80% of patients were using CVC at the initiation of HD and at the end of one year 64% were using arteriovenous fistula2. Temporary CVC insertion for hemodialysis is a lifesaving procedure. Cannulation success and complications vary according to the anatomic site, operator experience and the use of ultrasound guidance3. One should always remember that these large veins are life lines for ESRD patients. This guideline is meant as a quick reference to understand the indications and contraindications of the procedure as well as the steps and techniques of CVC insertion to reduce the complications related to this procedure.