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Central Vascular access

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https://www.readbyqxmd.com/read/29331162/unnecessary-removal-of-central-venous-catheters-in-cancer-patients-with-bloodstream-infections
#1
Anne Marie Chaftari, Ray Hachem, Sammy Raad, Ying Jiang, Elizabeth Natividad, Patrick Chaftari, Issam Raad
We evaluated the rate of central venous catheter (CVC) removal in 283 cancer patients with bloodstream infections (BSIs). Removal of CVCs occurred unnecessarily in 57% of patients with non-central-line-associated BSI (non-CLABSI), which was equivalent to the rate of CVC removal in patients with CLABSIs. Physician education and safe interventions to salvage the vascular access are warranted. Infect Control Hosp Epidemiol 2018;1-4.
January 14, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29319771/peritoneal-dialysis-as-the-first-dialysis-treatment-option-initially-unplanned
#2
Marcela Lara Mendes, Camila Albuquerque Alves, Edwa Maria Bucuvic, Dayana Bitencourt Dias, Daniela Ponce
Most patients with stage 5 CKD start RRT of unplanned manner. Unplanned dialysis, also known as urgent start, may be defined as hemodialysis (HD) started without permanent vascular access, i.e., using a central venous catheter (CVC), or as peritoneal dialysis (PD) started within seven days after implantation of the catheter, without family training. Although few studies have evaluated the PD as an immediate treatment option for patients starting urgent RRT, theirs results suggest that it is a feasible and safe alternative, with infectious complications and survival similar to patients treated with unplanned HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29301135/a-retrospective-analysis-of-dialysis-events-over-a-3-year-period-in-an-outpatient-dialysis-unit-in-the-state-of-kuwait
#3
Moustapha Ramadan, Gautam Hebbar
OBJECTIVE: To determine the difference in the rates of dialysis events stratified by vascular access type and to describe the microbiological profile and sensitivity patterns of positive blood cultures over a 3-year period. SUBJECTS AND METHODS: The dialysis event data of 10751 chronic hemodialysis patients collected from March 2013 to February 2016 at an Outpatient Dialysis Unit in Kuwait were reviewed. The dialysis events studied were; use of intravenous (IV) antimicrobials, positive blood culture and signs of inflammation at the vascular access site...
January 4, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29300281/the-ios-have-it-a-prospective-observational-study-of-vascular-access-success-rates-in-patients-in-extremis-using-video-review
#4
Kristen M Chreiman, Ryan P Dumas, Mark J Seamon, Patrick K Kim, Patrick M Reilly, Lewis J Kaplan, Jason D Christie, Daniel N Holena
BACKGROUND: Quick and successful vascular access in injured patients arriving in extremis is crucial to enable early resuscitation and rapid OR transport for definitive repair. We hypothesized that intraosseous (IO) access would be faster and have higher success rates than peripheral IVs (PIVs) or central venous catheters (CVCs). METHODS: High-definition video recordings of resuscitations for all patients undergoing Emergency Department Thoracotomy (EDT) from 4/2016-7/2017 were reviewed as part of a quality improvement initiative...
January 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#5
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29272445/evaluation-of-intraosseous-fluid-as-an-alternative-biological-specimen-in-postmortem-toxicology
#6
Luke N Rodda, Justin A Volk, Ellen Moffat, Chinyere M Williams, Kara L Lynch, Alan H B Wu
The postmortem redistribution phenomenon is an important factor in the interpretation of blood drug concentrations as a cause or factor in death. Intraosseous fluid (IOF) may serve as an alternative matrix for drug testing. Intraosseous fluid was collected from the left and right tibias and humerus of 29 decedents using the Arrow EZ-IO Intraosseous Vascular Access System. Standard autopsy specimens including blood were also collected at the same time during autopsy. Blood and IOF specimens were screened by immunoassay for opioids, fentanyl analogs, oxycodone, methadone, cocaine, methamphetamine, amphetamines, phencyclidine, tricyclic antidepressants, benzodiazepines and cannabinoids, using commercially available enzyme-linked immunosorbent assay (ELISA) kits...
December 20, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29189249/a-nurse-led-ultrasound-enhanced-vascular-access-preservation-program
#7
Turena Reeves, Dolores Morrison, Gerry Altmiller
: Insertion of peripheral iv catheters is a common practice in medical-surgical care settings. The frequency with which attempts are made to insert catheters causes rapid peripheral vessel depletion (a reduction in the number of usable veins), leading to the overuse of unnecessary central line catheters. Reducing central line-associated bloodstream infections is a national health care priority. In this quality improvement report, the authors describe the implementation of a nurse-led vascular access preservation program using ultrasound technology as a method to reduce the use of nonessential peripherally inserted central catheters...
December 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/29187653/-investigation-of-status-for-vascular-access-in-hemodialysis-patients-at-xiangya-hospital-of-central-south-university
#8
Yong Zhong, Jiaxi Pu, Xiang Ao, Weisheng Peng, Zhangzhe Peng, Xiaozhao Li, Xiangcheng Xiao, Qiaoling Zhou, Ping Xiao
To investigate the status of vascular access in hemodialysis patients in our center.
 Methods: The general information of hemodialysis patients and types and complications of vascular access at Xiangya Hospital of Central South University from April 2015 to April 2016, were retrospectively analyzed.
 Results: Among 258 prevalent patients, 87.60% of them had arteriovenous fistula (AVF), while 12.40% showed tunneled cuffed catheter. Of the 61 incident patients, 80.33% of them initiated dialysis with a non-tunneled and non-cuffed catheter, 8...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29170348/51%C3%A2-paediatric-emergency-clinicians-are-rarely-exposed-to-non-airway-critical-procedures-a-predict-pern-study
#9
Juan P Garrahan, Mark Lyttle, Ed Oakley, Stuart Dalziel, Lucia Nguyen, Arjun Rao, Santiago Mintegi, Franz Babl
BACKGROUND: Recent studies suggest that approximately one per thousand paediatric ED attendances may require some sort of critical procedure, with intubation being by far the most common. It is unknown how often critical non-airway procedures such as chest decompression, CPR, ED thoracotomy, defibrillation, pacing, and advanced vascular access techniques are performed by paediatric emergency clinicians. OBJECTIVE: To determine the recent performance or supervision, and confidence for various paediatric critical non-airway procedures by senior paediatric emergency clinicians...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29151284/association-between-initial-vascular-access-and-survival-in-hemodialysis-according-to-age
#10
Ha Yeon Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
Background/Aims: This study aims to demonstrate whether the association between initial vascular access and mortality among hemodialysis patients varies by age. Methods: We conducted a retrospective study that included 2,552 patients who started hemodialysis. Vascular access was divided into three categories: percutaneous catheter, tunneled cuffed catheter, and arteriovenous (AV) access. Results: Survival rates for patients who received a central venous catheter, such as percutaneous or tunneled cuffed catheter, aged 65 to 74 years and those ≥ 75 years were reduced, but not for those aged < 65 years (log-rank test; p < 0...
November 20, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29148007/how-to-treat-arteriovenous-graft-infection-total-versus-partial-graft-excision
#11
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
November 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#12
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29120892/ce-original-research-does-certification-in-vascular-access-matter-an-analysis-of-the-picc1-survey
#13
Vineet Chopra, Latoya Kuhn, Valerie Vaughn, David Ratz, Suzanne Winter, Nancy Moureau, Britt Meyer, Sarah Krein
: Background: Although certification by an accredited agency is often a practice prerequisite in health care, it is not required of vascular access specialists who insert peripherally inserted central catheters (PICCs). Whether certification is associated with differences in practice among inserters is unknown. PURPOSE: The purpose of this study was to gather information regarding whether certified and noncertified PICC inserters differ with respect to their practices and views about PICC use...
December 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/29117059/vascular-access-in-critically-ill-pediatric-patients-with-obesity
#14
Elizabeth E Halvorson, Doug Case, Joseph A Skelton, Michael C McCrory
OBJECTIVES: Pediatric obesity is highly prevalent and has been associated with poor outcomes for hospitalized children. Vascular access is essential in critically ill patients. The aim of this study was to evaluate whether critically ill children with obesity are more likely to undergo vascular device insertion (excluding peripheral IV catheters) and develop related complications. DESIGN: Multi-institutional retrospective observational cohort study. SETTING: Ninety-four U...
November 7, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29112580/the-role-of-the-registered-nurse-in-the-insertion-of-nontunneled-central-vascular-access-devices
#15
Ann Plohal, Cheryl Dumont, Cathy Perry, Velda Biddix, Diedre B Bird, Teresa Darst, Candee J Eisenhart, Melanie Pugh
As the result of requests from several state boards of nursing, the Infusion Nurses Society (INS) convened a task force to determine whether insertion of central vascular access devices by appropriately trained registered nurses (RNs) should be recommended. The task force consisted of RNs and advanced practice registered nurses with infusion therapy experience in various practice settings. The results are presented in INS' newest position paper, adopted by the INS Board of Directors, September 2017.
November 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#16
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29098715/central-venous-catheters-for-chronic-hemodialysis-is-last-choice-never-the-right-choice
#17
EDITORIAL
Chance S Dumaine, Robert S Brown, Jennifer M MacRae, Matthew J Oliver, Pietro Ravani, Robert R Quinn
Since the publication of the first vascular access clinical practice guidelines in 1997, the global nephrology community has dedicated significant time and resources toward increasing the prevalence of arteriovenous fistulas and decreasing the prevalence of central venous catheters for hemodialysis. These efforts have been bolstered by observational studies showing an association between catheter use and increased patient morbidity and mortality. To date, however, no randomized comparisons of the outcomes of different forms of vascular access have been conducted...
January 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29097334/brainstem-cavernous-malformations-surgical-indications-based-on-the-natural-history-and-surgical-outcomes
#18
REVIEW
Ming-Guo Xie, Da Li, Fang-Zhou Guo, Li-Wei Zhang, Jun-Ting Zhang, Zhen Wu, Guo-Lu Meng, Xin-Ru Xiao
Cavernous malformations (CMs) are uncommon lesions occurring in the central nervous system (CNS), with an incidence of approximately 0.5% in the general population and constituting 5-10% of all intracranial vascular malformations. Among CMs, prevalence within the brainstem as reported in the literature has ranged from 4 to 35%. With their precarious location and potentially devastating clinical events, brainstem CMs have attracted attention from neurosurgeons, and with their unrelenting efforts, the microsurgical techniques to treat these lesions in the brainstem have greatly improved in recent decades...
October 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29072869/research-protocol-intravenous-access-during-resuscitation-the-ivar-trial
#19
Pwb Nanayakkara, Y M Smulder
OBJECTIVE: To compare the effects of central versus peripheral drug administration on the rate of return of organised electrical activity and/or spontaneous circulation during CPR. STUDY DESIGN: Randomized clinical trial. STUDY POPULATION: Hospitalized patients and patients presenting at the emergency department, older than 18 years, requiring CPR. INTERVENTION: Central venous access Main study parameters/endpoints: Combined primary endpoint: rate of appearance of organised electrical activity or return of spontaneous circulation...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29068728/tissue-adhesive-for-vascular-access-devices-who-what-where-and-when
#20
Amanda Corley, Nicole Marsh, Amanda J Ullman, Claire M Rickard
Despite vascular access devices (VADs) being vital for patient care, device failure rates are unacceptably high with around 25% of central venous devices, and 30-40% of peripheral venous devices, developing complications that result in VAD failure. The use of tissue adhesive is a novel method of securing VADs and is gaining popularity, however the evidence base guiding its clinical use is still emerging. This article aims to review the types and properties of tissue adhesives, provide an overview of the existing evidence base, and discuss how tissue adhesives may be used in clinical practice...
October 26, 2017: British Journal of Nursing: BJN
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