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Central line placement

Leonardo Pacheco Roquero, Sandra Camelo-Piragua, Carl Schmidt
Cerebral air embolism is a recognized life-threatening complication, sometimes iatrogenic. Its timely diagnosis is essential because it can result in neurologic deficits or death. We report a case of a 58-year-old man who died from cerebral air embolism diagnosed by nonenhanced computed tomography scan of the head after a cardiac bypass surgery with Biventricular Assist Device and multiple vascular line placements. Autopsy revealed extensive subcutaneous emphysema, intravascular and perivascular air bubbles in the central nervous system and associated cerebral and cerebellar hemorrhagic infarction...
October 19, 2016: American Journal of Forensic Medicine and Pathology
Yuta Shimura, Yuji Sato, Noboru Kitagawa, Miyuki Omori
BACKGROUND: Proper implant placement is very important for long-term implant stability. Recently, numerous biomechanical studies have been conducted to clarify the relationship between implant placement and peri-implant stress. The placement of multiple implants in the edentulous posterior mandible has been studied by geometric analysis, three-dimensional finite element analysis (FEA), model experimentation, etc. Offset placement is a technique that reduces peri-implant load. However, few studies have used multiple analyses to clarify the value of the offset placement under identical conditions...
December 2016: Int J Implant Dent
Jay N Nathwani, Rebekah M Fiers, Rebecca D Ray, Anna K Witt, Katherine E Law, ShannonM DiMarco, Carla M Pugh
OBJECTIVE: The purpose of this study is to coevaluate resident technical errors and decision-making capabilities during placement of a subclavian central venous catheter (CVC). We hypothesize that there would be significant correlations between scenario-based decision-making skills and technical proficiency in central line insertion. We also predict residents would face problems in anticipating common difficulties and generating solutions associated with line placement. DESIGN: Participants were asked to insert a subclavian central line on a simulator...
September 23, 2016: Journal of Surgical Education
Francisco Matias, Edgar Semedo, Cláudia Carreira, Paula Pereira
BACKGROUND AND OBJECTIVES: Central venous catheterization of the internal jugular vein is a commonly performed invasive procedure associated with a significant morbidity and even mortality. Ultrasound-guided methods have shown to improve significantly the success of the technique and are recommended by various scientific societies, including the American Society of Anesthesiologists. The aim of this report is to describe an innovative ultrasound-guided central line placement of the internal jugular vein...
September 17, 2016: Revista Brasileira de Anestesiologia
Hossein Mohamadipanah, Chembian Parthiban, Jay Nathwani, Drew Rutherford, Shannon DiMarco, Carla Pugh
BACKGROUND: Due to the increased use of peripherally inserted central catheter lines, central lines are not performed as frequently. The aim of this study is to evaluate whether a virtual reality (VR)-based assessment of fine motor skills can be used as a valid and objective assessment of central line skills. METHODS: Surgical residents (N = 43) from 7 general surgery programs performed a subclavian central line in a simulated setting. Then, they participated in a force discrimination task in a VR environment...
October 2016: American Journal of Surgery
Gauri Bhutani, Mireille El Ters, Walter K Kremers, Joe L Klunder, Sandra J Taler, Amy W Williams, Andrew H Stockland, Marie C Hogan
Introduction Peripherally inserted central venous catheters (PICCs) may adversely impact future successful arteriovenous fistulae (AVF). As part of a quality improvement project, the performance of tunneled small bore tunneled central venous catheters (TSB-CVCs), as alternatives to PICCs, was evaluated. Methods A retrospective observational study, involving individuals ≥18 years of age who underwent TSB-CVC placement by Interventional Radiology at Mayo Clinic, Rochester, MN between 1/1/2010 and 8/30/2013...
September 20, 2016: Hemodialysis International
Hidenori Tanabe, Ryoko Murayama, Koichi Yabunaka, Makoto Oe, Toshiaki Takahashi, Chieko Komiyama, Hiromi Sanada
INTRODUCTION: Peripheral intravenous catheters (PIVCs) are frequently removed due to phlebitis. We hypothesized that catheters made of polyurethane, which is more flexible than Teflon, would decrease phlebitis, and that flexibility could be estimated by measuring the catheter-tip angle. Ultrasonography in two groups of patients with different catheter types was then used to compare catheter-tip angles and phlebitis. METHODS: Observational studies were carried out at a medical ward in a university hospital...
September 20, 2016: Journal of Vascular Access
Marie Aouad-Maroun, Christian K Raphael, Samia K Sayyid, Fadi Farah, Elie A Akl
BACKGROUND: Arterial line cannulation in paediatric patients is traditionally performed by palpation or with Doppler auditory assistance in locating the artery before catheterization. It is not clear whether ultrasound guidance offers benefits over these methods. OBJECTIVES: To assess first attempt success rates and complication rates when ultrasound guidance is used for arterial line placement in the paediatric population, as compared with traditional techniques (palpation, Doppler auditory assistance), at all potential sites for arterial cannulation (left or right radial, ulnar, brachial, femoral or dorsalis pedis artery)...
September 14, 2016: Cochrane Database of Systematic Reviews
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
Kevin N Johnson, Tina Thomas, Jason Grove, Marcus D Jarboe
BACKGROUND: Neonates commonly require central access, and in those with very low or extremely low birthweight this can be challenging. Described here is a technique that uses ultrasound guidance in the placement of peripherally inserted central catheters (PICC) in neonates and an analysis of outcomes. METHODS: A retrospective chart review was conducted of all patients below 1500 g that underwent placement of a peripherally inserted central catheter under ultrasound guidance between January 1, 2012, and December 31, 2014 at a single center...
November 2016: Pediatric Surgery International
Stefano Avanzini, Leila Mameli, Nicola Disma, Clelia Zanaboni, Andrea Dato, Giovanni Montobbio, Luigi Montagnini, Michela Bevilacqua, Filomena Pierri, Massimo Conte, Loredana Amoroso, Giovanna Pala, Sara Pestarino, Elio Castagnola, Angelo Claudio Molinari, Concetta Micalizzi, Giuseppe Morreale, Girolamo Mattioli, A Pini Prato
BACKGROUND: Ultrasound-guided (USG) cannulation of the brachiocephalic vein (BCV) is gaining worldwide consensus for central venous access in children. This study reports a 20-month experience with this approach in children. METHODS: All patients who underwent percutaneous USG central venous catheter (CVC) positioning in the BCV between August 2013 and March 2015 have been included. Devices inserted during this period were open-ended, either single or double-lumen tunneled CVC...
August 31, 2016: Pediatric Blood & Cancer
Fawzia E Al-Otaibi, Elham E Bukhari, Mona Badr, Abdulkarim A Alrabiaa
OBJECTIVES: To evaluate the epidemiology, risk factors, and antibiotic resistance of Gram negative bacteria (GNB) in patients with hematologic or solid organ malignancies.   METHODS: This is a retrospective study of 61 episodes of GNB bacteremia occurring in 56 patients with malignancy admitted to the Oncology Units in King Khalid University Hospital, Riyadh. Kingdom of Saudi Arabia during the period from January 2013 to October 2015. Data were retrieved from the computerized database of the microbiology laboratory and the patient's medical records...
September 2016: Saudi Medical Journal
Chris R Giordano, Kevin R Murtagh, Jaime Mills, Lori A Deitte, Mark J Rice, Patrick J Tighe
STUDY OBJECTIVE: Historically, the placement of internal jugular central venous lines has been accomplished by using external landmarks to help identify target-rich locations in order to steer clear of dangerous structures. This paradigm is largely being displaced, as ultrasound has become routine practice, raising new considerations regarding target locations and risk mitigation. Most human anatomy texts depict the internal jugular vein as a straight columnar structure that exits the cranial vault the same size that it enters the thoracic cavity...
September 2016: Journal of Clinical Anesthesia
R W Atmawidjaja, M Azri, I H Ismail
Pericardial effusion with cardiac tamponade is a rare and life-threatening complication of peripherally inserted central catheter (PICC) in a neonate. We report a 33-week preterm neonate who had sudden clinical deterioration at day seven of total parenteral nutrition regime via PICC. Recognition of pericardial effusion with cardiac tamponade in neonates with a PICC requires a high index of suspicion and steps in prevention include proper catheter tip placement and continuous monitoring of line position and function...
June 2016: Medical Journal of Malaysia
Robert P Richter, Mark A Law, Santiago Borasino, Jessica A Surd, Jeffrey A Alten
OBJECTIVE: To describe a novel real-time ultrasound (US)-guided distal superficial femoral vein (DSFV) cannulation technique for insertion of peripherally inserted central catheters (PICC) in critically ill infants with congenital heart disease. DESIGN: Descriptive retrospective cohort study SETTING: Pediatric cardiac intensive care unit in a pediatric tertiary hospital PATIENTS: First 28 critically ill infants that received DSFV PICCs via this new technique. RESULTS: Thirty-seven US-guided DSFV PICCs were attempted on 31 infants from September 2012 to November 2014; 34 PICCs were placed in 28 patients (success rate 92%)...
July 20, 2016: Congenital Heart Disease
Justin Robison, Nicholas B Slamon
OBJECTIVES: Critical care physicians' standard for arrival to a rapid response team activation is 10 minutes or less at this institution. This study proposes that a FaceTime (Apple, Cupertino, CA) video call between the staff at the bedside and the critical care physician will allow the implementation of potentially life-saving therapies earlier than the current average response (4.5 min). DESIGN: Prospective cohort study. SETTING: Freestanding, tertiary-care children's hospital...
September 2016: Pediatric Critical Care Medicine
James Morrison, John Kaufman
Vascular access is invaluable in the treatment of hospitalized patients. Central venous catheters provide a durable and long-term solution while saving patients from repeated needle sticks for peripheral IVs and blood draws. The initial catheter placement procedure and long-term catheter usage place patients at risk for infection. The goal of this project was to develop a system to track and evaluate central line-associated blood stream infections related to interventional radiology placement of central venous catheters...
July 6, 2016: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
Christopher P Filson, Hung-Jui Tan, Karim Chamie, Aaron A Laviana, Jim C Hu
OBJECTIVE: To examine factors associated with radical cystectomy operative time among Medicare beneficiaries. MATERIAL AND METHODS: Using linked Surveillance, Epidemiology, and End Results-Medicare data, we identified 4,975 patients who underwent a radical cystectomy during 1991 to 2007. Using a validated method of using anesthesia administrative data to quantify operative time, we used generalized estimating equations to examine the association of patient, provider, and hospital factors on radical cystectomy operative time...
October 2016: Urologic Oncology
Elinore J Kaufman, Douglas J Wiebe, Niels D Martin, Jose L Pascual, Patrick M Reilly, Daniel N Holena
BACKGROUND: Although trauma patients are frequently cared for in the intensive care unit (ICU), admission triage criteria are unclear and may vary among providers and institutions. The benefits of close monitoring must be weighed against the economic and opportunity costs of an ICU admission. MATERIALS AND METHODS: We conducted a retrospective cohort study of patients treated for blunt splenic injuries from 2011-2014 at 30 level I and II Pennsylvania trauma centers...
June 15, 2016: Journal of Surgical Research
Nicholas Hartman, Mary Wittler, Kim Askew, Brian Hiestand, David Manthey
PURPOSE OF THE STUDY: Tools created to measure procedural competency must be tested in their intended environment against an established standard in order to be validated. We previously created a checklist for ultrasound-guided internal jugular central venous catheter (US IJ CVC) insertion using the modified Delphi method. We sought to further validate the checklist tool for use in an educational environment. STUDY DESIGN: This is a cohort study involving 15 emergency medicine interns being evaluated on their skill in US IJ CVC placement...
June 23, 2016: Postgraduate Medical Journal
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