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Central venous catheter insertion

Teryl K Nuckols, Emmett Keeler, Sally C Morton, Laura Anderson, Brian Doyle, Marika Booth, Roberta Shanman, Jonathan Grein, Paul Shekelle
Importance: Although quality improvement (QI) interventions can reduce central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI), their economic value is uncertain. Objective: To systematically review economic evaluations of QI interventions designed to prevent CLABSI and/or CRBSI in acute care hospitals. Evidence Review: A search of Ovid MEDLINE, Econlit, Centre for Reviews & Dissemination, New York Academy of Medicine's Grey Literature Report, Worldcat, prior systematic reviews (January 2004 to July 2016), and IDWeek conference abstracts (2013-2016), was conducted from 2013 to 2016...
October 24, 2016: JAMA Internal Medicine
Chiara Vendramin, Siobhan McGuckin, Ferras Alwan, John-Paul Westwood, Mari Thomas, Marie Scully
BACKGROUND: Patients presenting with acute episodes of thrombotic microangiopathies (TMAs) require urgent access to plasma exchange (PEX). OctaplasLG, a solvent/detergent fresh-frozen plasma product that has undergone viral inactivation and prion reduction step, has been used in our institution since 2013, replacing Octaplas. STUDY DESIGN AND METHODS: We prospectively reviewed 981 PEX procedures where OctaplasLG was the replacement fluid in 90 patients admitted acutely with a TMA presentation within our institution from January 1, 2013, to December 31, 2015...
October 23, 2016: Transfusion
Amitoj Singh Chhina, Arvind Shenoi, R Kishore Kumar, Anubhava Patel
No abstract text is available yet for this article.
September 8, 2016: Indian Pediatrics
Soichi Kojima, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Toshiharu Mitsuhashi, Susumu Kanazawa
PURPOSE: To evaluate retrospectively the fracture risk of totally implanted venous access devices connected to Groshong silicone (SC) versus polyurethane (PU) catheters, inserted via the internal jugular vein. MATERIALS AND METHODS: The study population comprised 384 SC and 221 PU central venous catheters implanted via the internal jugular vein. The presence of catheter fracture was evaluated. Variables possibly related to catheter fracture were evaluated. First, in order to determine the factors associated with fracture, fracture rates were compared with the log-rank test between the two groups divided by each of the variables...
October 21, 2016: Journal of Vascular Access
M J Blans, H Endeman, F H Bosch
BACKGROUND: After insertion of a central venous catheter (CVC) a conventional chest X-ray (CXR) is usually taken to check for complications and correct position. Ultrasound might be equally effective as CXR and is less time consuming. We studied the use of ultrasound versus CXR after insertion of a CVC in general ward patients. METHODS: General ward patients in need of a CVC were included. CVCs were inserted under direct ultrasound guidance. After insertion, ultrasound was performed and compared with CXR to check for complications and position...
October 2016: Netherlands Journal of Medicine
Silvia Riondino, Fiorella Guadagni, Vincenzo Formica, Patrizia Ferroni, Mario Roselli
Venous thromboembolism (VTE) is a commonly diagnosed multifactorial condition with significant morbidity and mortality, occurring in up to 20% of cancer patients. Indeed, patients with cancer are in a higher pro-thrombotic state due to alterations in their haemostatic-coagulative system, stasis and blood flow slowdown, endothelial dysfunction, vascular inflammation and platelet activation. Moreover, several cancer-dependent factors can sum up to trigger a first episode of VTE or to cause its recurrence in the course of anticoagulant treatment...
October 18, 2016: Current Medicinal Chemistry
S M Johnson, G M Garnett, R K Woo
Maintenance of central venous access in patients with chronic medical conditions such as short bowel syndrome demands forethought and ingenuity. We describe an innovative technique for re-utilizing central venous access sites in patients who have chronic central venous access needs. Records of patients undergoing this technique were reviewed between August 2012 and December 2015. The technique involves "cutting-down" to the sterile fibrous tunnel that naturally forms around tunneled catheters. The fibrous sheath is then isolated and controlled much as would be done for a venous "cut-down...
October 14, 2016: Pediatric Surgery International
Thandar Aye, Thanh Trung Phan, Douglas Findlay Muir, Nicholas John Linker, Richard Hartley, Andrew John Turley
AIM: This new laser facilitated 'inside-out' technique was used for transvenous pacemaker insertion in a pacemaker-dependent patient with bilateral subclavian occlusion and a failed epicardial system who is not suitable for a transfemoral approach. METHOD AND RESULTS: Procedure was undertaken under general anaesthesia with venous access obtained from right femoral vein and left axillary vein. 7F multipurpose catheter was used to enter proximal edge of the occluded segment of subclavian vein via femoral approach, which then supported stiff angioplasty wires and microcatheters to tunnel into the body of occlusion...
October 14, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Max B van Gent, Wendeline J van der Made, Perla J Marang-van de Mheen, Koen E van der Bogt
OBJECTIVE: To analyze the rate of infections and complications after surgeon-performed, largely ultrasound-guided, central venous catheter (CVC) placement in a pediatric population and to identify patients at high risk of complications. METHODS: All children aged between 4 months and 19 years with a percutaneous CVC inserted between January 1, 2000, and July 31, 2013, were included. Patient records were reviewed retrospectively for the occurrence of infection and other complications until CVC removal or the last outpatient clinic visit and compared between patient groups and with the recent literature...
October 14, 2016: Surgical Infections
Silvia Calviño Günther, Carole Schwebel, Rebecca Hamidfar-Roy, Agnès Bonadona, Maxime Lugosi, Claire Ara-Somohano, Clémence Minet, Leïla Potton, Jean-Charles Cartier, Aurelien Vésin, Magalie Chautemps, Lenka Styfalova, Stephane Ruckly, Jean-François Timsit
PURPOSE: To describe all post-insertion complications involving most used intravascular access, and to determine whether the use of a new-generation transparent dressing (3M™ IV Advanced) might reduce their number and impact on ICU patient outcomes. METHODS: Patients older than 18, with an expected length of stay ≥48 h and requiring at least one central venous catheter (CVC), arterial catheter (AC), haemodialysis catheter (HDC), pulmonary arterial catheters (PAC) or peripheral venous catheter (PVC) were randomized into two groups: a new-generation transparent dressing, or the hospital's classical transparent dressing, and were followed daily for any infectious and non-infectious complications...
October 12, 2016: Intensive Care Medicine
Michał Ławiński, Karol Forysiński, Agnieszka Bzikowska, Justyna Z Kostro, Aleksandra Gradowska, Marek Pertkiewicz
INTRODUCTION: The ESPEN guidelines on long-term (> 3 months) parenteral nutrition recommend the use of tunnelled central venous catheters (CVCs) to minimise the risk of insertion site infection. A developed symptomatic infection of the soft tissue tunnel surrounding a CVC may rapidly become directly life threatening if the infection progresses along the catheter tunnel towards its end inserted into the venous system. This requires immediate management to eliminate infection and limit its effects...
2016: Przegla̜d Gastroenterologiczny
Amanda J Ullman, Marie Cooke, Tricia Kleidon, Claire M Rickard
AIM: To identify the prevalence, management and complications associated with central venous access devices (CVADs) within Australian paediatric facilities, providing a map for clinicians, researchers and managers to focus solutions. METHODS: A point prevalence audit and survey of CVAD practices in Australian tertiary paediatric hospitals between September and November 2015, using validated data collection tools. RESULTS: Across the six sites, 1027 patients were screened with CVADs prevalent in 26...
October 6, 2016: Journal of Paediatrics and Child Health
Sara C Keller, Deborah Williams, Mitra Gavgani, David Hirsch, John Adamovich, Dawn Hohl, Amanda Krosche, Sara Cosgrove, Trish M Perl
BACKGROUND Patients are frequently discharged with central venous catheters (CVCs) for home infusion therapy. OBJECTIVE To study a prospective cohort of patients receiving home infusion therapy to identify environmental and other risk factors for complications. DESIGN Prospective cohort study between March and December 2015. SETTING Home infusion therapy after discharge from academic medical centers. PARTICIPANTS Of 368 eligible patients discharged from 2 academic hospitals to home with peripherally inserted central catheters and tunneled CVCs, 222 consented...
October 4, 2016: Infection Control and Hospital Epidemiology
Arunangshu Chakraborty, Sanjit Agrawal, Taniya Datta, Suparna Mitra, Rakhi Khemka
Chemotherapy in children suffering from cancer usually requires placement of an indwelling central venous catheter (CVC). A child may need to undergo repeated procedures because of infection and occlusion of previous access devices. We present a case of CVC insertion in a child suffering from acute lymphoblastic leukemia where an innovative technique was employed.
October 2016: Journal of Indian Association of Pediatric Surgeons
Chung-Sik Oh, Ka Young Rhee, Tae-Gyoon Yoon, Seong-Hyop Kim
OBJECTIVE: We evaluated the incidence of percutaneous superior vena cava catheter-related thrombosis and identified risk factors for developing the condition in patients undergoing cardiovascular surgery with cardiopulmonary bypass. METHODS: A total of 121 patients were evaluated. A percutaneous superior vena cava catheter was inserted into the right internal jugular vein during cardiovascular surgery with cardiopulmonary bypass. The right internal jugular vein was evaluated using ultrasonography, including cross-sectional area and velocity just before insertion of the percutaneous superior vena cava catheter (preoperative) and 24 hours and 48 hours after its insertion...
August 28, 2016: Journal of Thoracic and Cardiovascular Surgery
Andrew S Griffin, Shawn M Gage, Jeffrey H Lawson, Charles Y Kim
OBJECTIVE: This study evaluated whether the use of a staged Hemodialysis Reliable Outflow (HeRO; Merit Medical, South Jordan, Utah) implantation strategy incurs increased early infection risk compared with conventional primary HeRO implantation. METHODS: A retrospective review was performed of 192 hemodialysis patients who underwent HeRO graft implantation: 105 patients underwent primary HeRO implantation in the operating room, and 87 underwent a staged implantation where a previously inserted tunneled central venous catheter was used for guidewire access for the venous outflow component...
September 26, 2016: Journal of Vascular Surgery
Adam D Jakes, Poonam Jani, Victoria Allgar, Archie Lamplugh, Ahmed Zeidan, Sunil Bhandari
BACKGROUND: Dialysis in elderly patients (>80-years-old) carries a poor prognosis, but little is known about the most effective vascular access method in this age group. An arteriovenous fistula (AVF) is both time-consuming and initially expensive, requiring surgical insertion. A central venous catheter (CVC) is initially a cheaper alternative, but carries a higher risk of infection. We examined whether vascular access affected 1-year and 2-year mortality in elderly patients commencing haemodialysis...
2016: PloS One
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
Michelle Ribeiro Viana Taveira, Luciana Santana Lima, Cláudia Corrêa de Araújo, Maria Júlia Gonçalves de Mello
BACKGROUND: Totally implantable venous access ports (TIVAPs) are used for prolonged central venous access, allowing the infusion of chemotherapy and other fluids and improving the quality of life of children with cancer. TIVAPs were developed to reduce the infection rates associated with central venous catheters; however, infectious events remain common and have not been fully investigated in pediatric oncology patients. PROCEDURE: A retrospective cohort was formed to investigate risk factors for central line-associated bloodstream infection (CLABSI) in pediatric cancer patients...
September 26, 2016: Pediatric Blood & Cancer
Alexandra Marquez, Veronika Shabanova, Edward Vincent S Faustino
OBJECTIVE: We determined whether in critically ill children with an untunneled central venous catheter, the risk of catheter-associated deep venous thrombosis can be predicted within 24 hours after insertion of the catheter. DESIGN: Secondary analysis of two multicenter prospective cohort studies. SETTING: PICUs in Northeastern United States. PATIENTS: A total of 175 children admitted to the PICU within 24 hours after insertion of an untunneled central venous catheter who did not receive anticoagulation were included...
September 22, 2016: Pediatric Critical Care Medicine
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