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Central line placement

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https://www.readbyqxmd.com/read/28881125/adjustable-ghajar-guide-technique-for-accurate-placement-of-ventricular-catheters-a-pilot-study
#1
Sang-Youl Yoon, Youngseok Kwak, Jaechan Park
OBJECTIVE: An adjustable Ghajar guide is presented to improve the accuracy of the original Ghajar guide technique. The accuracy of the adjustable Ghajar guide technique is also investigated. METHODS: The coronal adjustment angle from the orthogonal catheter trajectory at Kocher's point is determined based on coronal head images using an electronic picture archiving and communication system. For the adjustable Ghajar guide, a protractor is mounted on a C-shaped basal plate that is placed in contact with the margin of a burrhole, keeping the central 0° line of the protractor orthogonal to the calvarial surface...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28836268/sacral-anatomy-of-the-phytosaur-smilosuchus-adamanensis-with-implications-for-pelvic-girdle-evolution-among-archosauriformes
#2
Christopher T Griffin, Candice M Stefanic, William G Parker, Axel Hungerbühler, Michelle R Stocker
The sacrum - consisting of those vertebrae that articulate with the ilia - is the exclusive skeletal connection between the hindlimbs and axial skeleton in tetrapods. Therefore, the morphology of this portion of the vertebral column plays a major role in the evolution of terrestrial locomotion. Whereas most extant reptiles only possess the two plesiomorphic sacral vertebrae, additional vertebrae have been incorporated into the sacrum multiple times independently among early-diverging archosaurian (crocodylians + birds) clades...
August 23, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28822403/inpatient-peripherally-inserted-central-venous-catheter-complications-should-peripherally-inserted-central-catheter-lines-be-placed-in-the-intensive-care-unit-setting
#3
Michael Martyak, Ishraq Kabir, Rebecca Britt
Peripherally inserted central venous catheters (PICCs) are now commonly used for central access in the intensive care unit (ICU) setting; however, there is a paucity of data evaluating the complication rates associated with these lines. We performed a retrospective review of all PICCs placed in the inpatient setting at our institution during a 1-year period from January 2013 to December 2013. These were divided into two groups: those placed at the bedside in the ICU and those placed by interventional radiology in non-ICU patients...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28807074/a-model-to-predict-central-line-associated-bloodstream-infection-among-patients-with-peripherally-inserted-central-catheters-the-mpc-score
#4
Erica Herc, Payal Patel, Laraine L Washer, Anna Conlon, Scott A Flanders, Vineet Chopra
BACKGROUND Peripherally inserted central catheters (PICCs) are associated with central-line-associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. OBJECTIVE To operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual's risk of PICC-CLABSI prior to device placement. METHODS Using data from the Michigan Hospital Medicine Safety consortium, patients that experienced PICC-CLABSI between January 2013 and October 2016 were identified...
August 15, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28779785/symptomatic-superior-vena-cava-syndrome-in-hemodialysis-patients-mid-term-results-of-primary-stenting
#5
MULTICENTER STUDY
Mafalda Massara, Giovanni De Caridi, Antonino Alberti, Pietro Volpe, Francesco Spinelli
This clinical report details the results of endovascular treatment of symptomatic superior vena cava syndrome due to central vein stenosis or obstruction (CVSO) by stent angioplasty in patients with dialysis-dependent end-stage renal disease. A 3-year retrospective review of two institutional registries identified 25 chronic hemodialysis patients (17 men, 8 women) affected by CVSO who received endovascular treatment. The majority of the patients (n = 19) presented with symptomatic arm, breast, and facial swelling; and 6 patients presented with dialysis-access dysfunction and venous-line hypertension...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28772008/dual-wavelength-reflectance-spectroscopy-of-the-superior-vena-cava-a-method-for-placing-central-venous-catheters-at-the-cavoatrial-junction
#6
Bradley J Stringer, Spencer B Shumway, Matthew D Holbrook, Cameron G Copeland, Alexander A Gosch, Kai Kück
There are a limited number of methods to guide and confirm the placement of a peripherally-inserted central catheter (PICC) at the cavoatrial junction. The aim of this study was to design, test, and validate a dual wavelength, diode laser-based, single optical fiber instrument that would accurately confirm PICC tip location at the cavoatrial junction of an animal heart, in vivo. This was accomplished by inserting the optical fiber into a PICC and ratiometrically comparing simultaneous visible and near-infrared reflection intensities of venous and atrial tissues found near the cavoatrial junction...
August 3, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/28746169/traditional-long-term-central-venous-catheters-versus-transhepatic-venous-catheters-in-infants-and-young-children
#7
Amanda Marie Marshall, David A Danford, Christopher L Curzon, Venus Anderson, Jeffrey W Delaney
OBJECTIVES: Children with congenital heart disease may require long-term central venous access for intensive care management; however, central venous access must also be preserved for future surgical and catheterization procedures. Transhepatic venous catheters may be an useful alternative. The objective of this study was to compare transhepatic venous catheters with traditional central venous catheters regarding complication rate and duration of catheter service. DESIGN: Retrospective review of 12 congenital heart disease patients from September 2013 to July 2015 who underwent placement of one or more transhepatic venous catheters...
July 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28740394/a-case-of-iatrogenic-pneumothorax-in-which-chest-tube-placement-could-be-avoided-by-intraoperative-evaluation-with-transthoracic-ultrasonography
#8
Izumi Sato, Hirotsugu Kanda, Megumi Kanao-Kanda, Atsushi Kurosawa, Takayuki Kunisawa
We report a case of iatrogenic pneumothorax in which chest tube placement was avoided by continuous intraoperative evaluation with transthoracic ultrasonography. A 53-year-old man had undergone a subsegmentectomy. While attempting to place a central venous catheter in the right internal jugular vein after the induction of anesthesia, we identified gas absorption during the puncture and suspected a pneumothorax. Chest X-ray revealed an ~5-mm collapse of the right lung apex. Tension pneumothorax was a concern during surgery because of the long-term positive pressure ventilation, but we decided to start the operation without preventative chest tube placement...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28721474/single-stick-tunneled-central-venous-access-using-the-jugular-veins-in-infants-weighing-less-than-5%C3%A2-kg
#9
Will S Lindquester, C Matthew Hawkins, Eric J Monroe, Anne E Gill, Giridhar M Shivaram, F Glen Seidel, Matthew P Lungren
BACKGROUND: Despite the demonstrated feasibility of the single-stick technique in the femoral vein, its use in neonates and infants for placing central lines in internal and external jugular veins has not been reported. OBJECTIVE: Describe and assess the safety and efficacy of tunneled jugular central venous catheter placement performed under ultrasound (US) and fluoroscopic guidance in neonates and infants weighing <5 kg using the single-stick technique at three tertiary pediatric hospitals...
July 18, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28707497/complications-of-central-lines-in-neonates-admitted-to-a-level-iii-neonatal-intensive-care-unit
#10
Beatriz Nicolau Soares, Susana Pissarra, Ana Lídia Rouxinol-Dias, Sandra Costa, Hercília Guimarães
OBJECTIVE: To investigate the incidence and risk factors for central line related complications in neonates. METHODS: A retrospective cohort study of infants who underwent central line (CL) placement, from 1 July 2014 to 31 June 2016, was conducted in Neonatal Intensive Care Unit of Centro Hospitalar de São João. Infants hospitalized more than 2 d and CLs placed for more than 24 h were included. Patients' demographic characteristics, hospital data, and information on CLs were collected...
July 25, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#11
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28690942/cardiac-arrhythmias-resulting-from-a-peripherally-inserted-central-catheter-two-cases-and-a-review-of-the-literature
#12
Jonathan Gapp, Mridula Krishnan, Felicia Ratnaraj, Robert P Schroell, Douglas Moore
We present two cases of patients being treated for diabetic ketoacidosis in the intensive care unit who experienced cardiac arrhythmia secondary to peripherally inserted central catheters (PICCs). In one instance, the patient became bradycardic and experienced related loss of consciousness, ultimately requiring cardiopulmonary resuscitation. In the second case, the patient experienced an episode of nonsustained ventricular tachycardia. We explore the various types of arrhythmias that have been reported secondary to central venous catheters, as well as factors that place patients at an increased risk for arrhythmia while undergoing PICC insertion...
June 3, 2017: Curēus
https://www.readbyqxmd.com/read/28656388/indications-and-outcomes-for-tunneled-central-venous-line-placement-via-the-axillary-vein-in-children
#13
Allison F Linden, Chase Corvin, Keva Garg, Richard R Ricketts, A Alfred Chahine
PURPOSE: To assess the indications, safety and outcomes of tunneled central venous catheters (CVCs) placed via a cutdown approach into the axillary vein in children, an approach not well described in this population. METHODS: A retrospective cohort study was performed on pediatric patients who received CVCs via open cannulation of the axillary vein or one of its tributaries between January 2006 and October 2016 at two hospitals. RESULTS: A total of 24 axillary CVCs were placed in 20 patients [10 male (42%); mean weight 7...
June 27, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28649269/a-comprehensive-technique-for-artificial-hybridization-in-chickpea-cicer-arietinum
#14
Shweta Kalve, Million Tadege
BACKGROUND: Two crossing techniques for hybridization of chickpea have been reported and include pollination after emasculation and pollination without emasculation. Success of crossing with emasculation varied from 5 to 17%; while the success rate varied from 20 to 50% by pollination without emasculation. The important reason for the low success rate of the two procedures could be lack of detailed information on the flowering stages chosen for crossing together with the environment where plants grow...
2017: Plant Methods
https://www.readbyqxmd.com/read/28637552/standardized-interdepartmental-simulation-based-central-line-insertion-course-closes-an-educational-gap-and-improves-intern-comfort-with-the-procedure
#15
Joanna Grudziak, Blair Herndon, Ria D Dancel, Harendra Arora, Christopher J Tignanelli, Michael R Phillips, Jason R Crowner, Nicholas A True, Andy C Kiser, Rebecca F Brown, Harry P Goodell, Neil Murty, Michael O Meyers, Sean P Montgomery
Central line placement is a common procedure, routinely performed by junior residents in medical and surgical departments. Before this project, no standardized instructional course on the insertion of central lines existed at our institution, and few interns had received formal ultrasound training. Interns from five departments participated in a simulation-based central line insertion course. Intern familiarity with the procedure and with ultrasound, as well as their prior experience with line placement and their level of comfort, was assessed...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28604465/brachial-plexus-injury-associated-with-subclavian-vein-cannulation-a-case-report
#16
Ezgi Gozubuyuk, Mehmet I Buget, Turgut Akgul, Demet Altun, Suleyman Kuçukay
We documented brachial plexus injury by electromyography and magnetic resonance imaging secondary to needle sticks for central line insertion. This type of complication is rare in the literature, as few case reports exist. Brachial plexus injury can happen because of anatomic variations. Nevertheless, multiple attempts or introducer needle rotations should be avoided during subclavian vein catheterization. Pain that emerges in the ipsilateral arm after subclavian catheter placement should be taken into serious consideration...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28584925/peripherally-inserted-central-catheters-are-associated-with-lower-risk-of-bloodstream-infection-compared-with-central-venous-catheters-in-paediatric-intensive-care-patients-a-propensity-adjusted-analysis
#17
Ricardo Silveira Yamaguchi, Danilo Teixeira Noritomi, Natalia Viu Degaspare, Gabriela Ortega Cisternas Muñoz, Ana Paula Matos Porto, Silvia Figueiredo Costa, Otavio T Ranzani
PURPOSE: Central line-associated bloodstream infection (CLABSI) is an important cause of complications in paediatric intensive care units (PICUs). Peripherally inserted central catheters (PICCs) could be an alternative to central venous catheters (CVCs) and the effect of PICCs compared with CVCs on CLABSI prevention is unknown in PICUs. Therefore, we aimed to evaluate whether PICCs were associated with a protective effect for CLABSI when compared to CVCs in critically ill children. METHODS: We have carried out a retrospective multicentre study in four PICUs in São Paulo, Brazil...
August 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28538464/decreasing-peripherally-inserted-central-catheter-use-with-ultrasound-guided-peripheral-intravenous-lines-a-quality-improvement-project-in-the-acute-care-setting
#18
Lauren Morata, Carrie Ogilvie, Jackie Yon, Allison Johnson
An ultrasound-guided peripheral intravenous (UGPIV) quality improvement project occurred in an 849-bed tertiary care hospital with a goal to reduce the use of central lines, in particular, peripherally inserted central catheters (PICCs). Since implementation, PICCs have decreased by 46.7% overall, and 59 nurses in-hospital are competent in placing UGPIVs. Placement of UGPIVs by the bedside nurse is a key initiative in decreasing PICC use and, potentially, infections.
June 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28527874/pressor-support-during-a-jarisch-herxheimer-reaction-after-initiation-of-treatment-for-weil-s-disease
#19
Randi Connor-Schuler, Anee Khan, Nikhil Goyal, Erin Zimny
We present a case of Weil's disease complicated by a Jarisch-Herxheimer reaction (JHR) after initiation of antibiotics while in the emergency department requiring invasive monitoring and vasopressor support. The case is followed by a brief review of the JHR which is rarely observed with treatment of leptospirosis. A healthy 28-year-old female who recently returned from the Caribbean presented to the emergency department with flu-like symptoms. The patient appeared jaundiced with conjunctival suffusion and was ultimately treated with the appropriate antibiotics for leptospirosis in the ED...
August 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28492861/vena-cava-filter-use-in-trauma-and-rates-of-pulmonary-embolism-2003-2015
#20
MULTICENTER STUDY
Alan D Cook, Brian W Gross, Turner M Osler, Katelyn J Rittenhouse, Eric H Bradburn, Steven R Shackford, Frederick B Rogers
Importance: Vena cava filter (VCF) placement for pulmonary embolism (PE) prophylaxis in trauma is controversial. Limited research exists detailing trends in VCF use and occurrence of PE over time. Objective: To analyze state and nationwide temporal trends in VCF placement and PE occurrence from 2003 to 2015 using available data sets. Design, Setting, and Participants: A retrospective trauma cohort study was conducted using data from the Pennsylvania Trauma Outcome Study (PTOS) (461 974 patients from 2003 to 2015), the National Trauma Data Bank (NTDB) (5 755 095 patients from 2003 to 2014), and the National (Nationwide) Inpatient Sample (NIS) (24 449 476 patients from 2003 to 2013) databases...
August 1, 2017: JAMA Surgery
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