Abstract :
Recirculation is the phenomenon of the return of dialysis blood to the systemic circulation which is not in full equilibrium, the concentration of solutes in the blood in the arterial route is lower than in the systemic circulation. This indicates that the dialyzed blood is mixed with blood that has not been dialyzed. Determining the optimal position of the double lumen catheter (DLC) tip is complex and controversial. Blood flow in the Right Atrium (RA) is more static than in the Superior Vena Cava (SVC). The rate of rotation and vortex of RA blood flow is also higher. SVC blood flow is more laminar and RA blood flow is more rotational, so that when DLC tip in RA, already dialyzed from a hemodialysis machine (low urea level) which is flowed in through the proximal orifice via a venous cannula has a higher chance of being aspirated through the distal orifice than if the tip was placed in the SVC. This research is an analytic observational, cross-sectional data collection with a total sampling that meets the inclusion and exclusion criteria. Each sample was evaluated for the position of the DLC tip through a chest X-ray, then measured the distance from the carina. Then the peripheral blood urea level was checked and after undergoing hemodialysis for 30 minutes, Qb was lowered to zero, and simultaneously samples of blood flow between arteries and veins were taken respectively. Amount of urea measured and access recirculation value was calculated using Percent recirculation = ([P - A] [P - V]) × 100%. Based on Linear Regression test on the DLC tip position data and recirculation access data, there is a significant correlation p = 0,000 (p < 0,05). The deeper the tip position towards RA, the higher the recirculation value. This study concludes that there is a correlation between the position of the right subclavian vein temporary double lumen catheter tip and the incidence of hemodialysis access recirculation in patients with chronic kidney disease stage V.