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Central Vascular access

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https://www.readbyqxmd.com/read/28335676/physiopathological-approach-to-infective-endocarditis-in-chronic-hemodialysis-patients-left-heart-versus-right-heart-involvement
#1
Yassamine Bentata
Infectious endocarditis (IE), a complication that is both cardiac and infectious, occurs frequently and is associated with a heavy burden of morbidity and mortality in chronic hemodialysis patients (CHD). About 2-6% of chronic hemodialysis patients develop IE and the incidence is 50-60 times higher among CHD patients than in the general population. The left heart is the most frequent location of IE in CHD and the different published series report a prevalence of left valve involvement varying from 80% to 100%...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28325945/surveillance-of-dialysis-events-one-year-experience-at-33-outpatient-hemodialysis-centers-in-china
#2
Hui Zhang, Liuyi Li, Huixue Jia, Yunxi Liu, Jianguo Wen, Anhua Wu, Qun Lu, Tieying Hou, Yun Yang, Huai Yang, Weiguang Li, Zhiyong Zong
A multicenter prospective surveillance on dialysis events was carried in 33 dialysis centers in China. Maintenance hemodialysis (HD) outpatients who were dialyzed on the first two days of each month during 2014 were monitored for dialysis events and other infections. During the one-year period, 52,680 patient-months were monitored. Fistula and tunneled or non-tunneled central line were used for 73.70%, 15.70% and 8.85% of vascular access, respectively. There were 773 dialysis events occurred in 671 patients including 589 IV antimicrobial starts, 74 positive blood cultures and 110 local access site infections (LASI)...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28323880/randomized-controlled-trials-in-central-vascular-access-devices-a-scoping-review
#3
Mari Takashima, Gillian Ray-Barruel, Amanda Ullman, Samantha Keogh, Claire M Rickard
BACKGROUND: Randomized controlled trials evaluate the effectiveness of interventions for central venous access devices, however, high complication rates remain. Scoping reviews map the available evidence and demonstrate evidence deficiencies to focus ongoing research priorities. METHOD: A scoping review (January 2006-December 2015) of randomized controlled trials evaluating the effectiveness of interventions to improve central venous access device outcomes; including peripherally inserted central catheters, non-tunneled, tunneled and totally implanted venous access catheters...
2017: PloS One
https://www.readbyqxmd.com/read/28319286/a-successful-model-to-learn-and-implement-ultrasound-guided-venous-catheterization-in-apheresis
#4
Nigopan Gopalasingam, Anna-Marie Eller Thomsen, Lars Folkersen, Peter Juhl-Olsen, Erik Sloth
BACKGROUND: Apheresis treatments can be performed with peripheral venous catheters (PVC), although central venous catheters (CVC) are inserted when PVCs fail or patient with history of difficult vascular access prior to the apheresis. Ultrasound guidance for PVC has shown promising results in other settings. PURPOSE: To investigate if ultrasound guidance for PVC could be implemented among apheresis nurses. Second, how implementation of ultrasound guidance affected the number of CVCs used for apheresis per patient...
March 20, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28306627/novel-microspheres-reduce-the-formation-of-deep-venous-thrombosis-and-repair-the-vascular-wall-in-a-rat-model
#5
Bingyang Dai, Lan Li, Qiangqiang Li, Xiaoxiao Song, Dongyang Chen, Jin Dai, Yao Yao, Wenjin Yan, Huajian Teng, Fang Yang, Zhihong Xu, Qing Jiang
L-Arginine (L-arg), widely known as a substrate for endogenous nitric oxide synthesis, can improve endothelial function associated with the vasculature, inhibit platelet aggregation, and alter the activity of vascular smooth muscle cells. P-selectin is a membrane component of the platelet alpha-granule and the endothelial cell-specific Wiebel-Palade body that plays a central role in mediating interactions between platelets and both leukocytes and the endothelium. The experiment was designed to evaluate the effect of novel microspheres with L-arg targeting P-selectin on the formation of deep vein thrombosis and repair of vascular wall in a rat model...
March 16, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28297057/dialysis-access-issues-related-to-conversion-from-peritoneal-dialysis-to-hemodialysis-and-vice-versa
#6
Maurizio Gallieni, Antonino Giordano, Anna Ricchiuto, Davide Gobatti, Maurizio Cariati
ABSTRACTHemodialysis (HD) and peritoneal dialysis (PD) represent two complementary modalities of renal replacement therapy (RRT) for end-stage renal disease patients. Conversion between the two modalities is frequent and more likely to happen from PD to HD. Every year, 10% of PD patients convert to HD, suggesting the need for recommendations on how to proceed with the creation of a vascular access in these patients. Criteria for selecting patients who would likely fail PD, and therefore take advantage of a backup access, are undefined...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297054/optimal-timing-for-vascular-access-creation
#7
Tamara K Jemcov, Wim Van Biesen
Many guidelines recommend that end-stage renal disease (ESRD) patients should have a permanent vascular access, preferably an autologous arteriovenous fistula (AVF), at the start of renal replacement therapy. Nevertheless, a large proportion of patients still start hemodialysis with a central venous catheter (CVC). On the other hand, there are increasing numbers of patients in whom an AVF has been created, but who never actually end up on dialysis, as well as a substantial number of patients in whom creation of a vascular access has been attempted unsuccessfully...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297051/endovascular-treatment-to-boost-av-fistula-maturation
#8
Lars Kamper, Patrick Haage
Impaired fistula maturation is associated with puncture-related complications, insufficient dialysis and potential permanent access failure. Non-maturation is frequently initiated by stenotic vascular access vessels comprising the outflow veins, the arteriovenous anastomosis and infrequently the inflow artery. Further findings in maturation protraction are central venous stenoses or accessory outflow veins. Depending on the underlying pathology, several endovascular approaches to boost fistula maturation are possible...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28286186/placement-of-upper-extremity-arteriovenous-access-in-patients-with-central-venous-occlusions-a-novel-technique
#9
Allen G Murga, Jason T Chiriano, Christian Bianchi, Neha Sheng, Sheela Patel, Ahmed M Abou-Zamzam, Theodore H Teruya
OBJECTIVE: Central venous occlusion is a common occurrence in patients with end stage renal disease. Placement of upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins is often not an option. Avoidance of lower extremity vascular access can decrease morbidity and infection. TECHNIQUE: The central venous lesions were crossed centrally via femoral access. The wire was retrieved in the neck extravascular. A HeRo catheter was then placed in the right atrium and completed with an arterial anastomosis...
March 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#10
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOAâ„¢ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28284100/the-relationship-between-perceived-role-and-appropriate-use-of-peripherally-inserted-central-catheters-a-survey-of-vascular-access-nurses-in-the-united-states
#11
Sarah L Krein, Latoya Kuhn, David Ratz, Suzanne Winter, Valerie M Vaughn, Vineet Chopra
BACKGROUND: The presence and proliferation of vascular access nursing in hospital settings has been identified as a potential contributor to growing demand, and possible overuse, of peripherally inserted central catheters (PICCs). OBJECTIVE: We examined vascular access nurses' perceived role related to use of PICCs and the association with appropriateness of PICC use in hospitals. DESIGN: A web-based survey was administered to members of two vascular access professional organizations...
March 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28279409/central-venous-interventions
#12
Masahiro Horikawa, Keith B Quencer
Central venous stenosis or occlusion is a common and vexing problem in patients undergoing hemodialysis. Typical presenting symptoms include arm swelling and prolonged bleeding after hemodialysis. Despite multiple treatment approaches, these stenoses tend to recur and progress over time. A thorough preprocedure evaluation, methodical procedural approach and awareness of potential complications are all essential to try to preserve vascular access and improve patients' quality of life.
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28279405/vascular-access-guidelines-summary-rationale-and-controversies
#13
Adrian Sequeira, Mihran Naljayan, Tushar J Vachharajani
Dialysis vascular access management in the United States changed significantly after National Kidney Foundation-Kidney Disease Outcome Quality Initiative (NKF-KDOQI) clinical practice guidelines were first published in 1997. The Centers for Medicare and Medicaid Service adopted these guidelines and in collaboration with the End-Stage Renal Disease Networks established the Fistula First Breakthrough Initiative (FFBI) in 2003 to improve the rate of arteriovenous fistula use over arteriovenous graft and central venous catheter in the dialysis population...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28267032/effects-of-methods-used-to-achieve-hemostasis-on-radial-artery-occlusion-following-percutaneous-coronary-procedures-a-systematic-review
#14
Ritin S Fernandez, Astin Lee
BACKGROUND: Transradial access to percutaneous coronary procedures is becoming the preferred access route, and it is being increasingly used for emergent and elective procedures. However, radial artery occlusion (RAO) continues to remain an adverse occurrence following sheath removal or in the first 24 hours following sheath removal due to the smaller diameter of the artery. OBJECTIVES: The overall objective of this study was to synthesize the best available research evidence related to the effects of methods used to achieve hemostasis on RAO rates after percutaneous coronary procedures...
March 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28255132/extra-anatomical-veno-venous-surgical-bypass-for-central-vein-occlusion-in-patients-with-ipsilateral-arterio-venous-fistula-avf-for-haemodialysis-a-single-centre-experience
#15
K S Saravana, A A Zainal
OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face. MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28250291/the-type-of-vascular-access-and-the-incidence-of-mortality-in-japanese-dialysis-patients
#16
Toshikazu Ozeki, Hideaki Shimizu, Yoshiro Fujita, Daijo Inaguma, Shoichi Maruyama, Yukako Ohyama, Shun Minatoguchi, Yukari Murai, Maho Terashita, Tomoki Tagaya
Objective The National Kidney Foundation (NKF) Kidney Disease Outcome Quality Initiative (KDOQI) guidelines have recommended the use of arteriovenous fistula (AVF) at the initiation of dialysis. However, there are significant differences in the dialysis environments of Japan and the United States, and there are few people who receive hemodialysis via a central venous catheter (CVC) in Japan. The aim of the present study was to examine the association between the type of vascular access at the initiation of dialysis and the incidence of mortality in Japan...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28248811/efficacy-of-reducing-alteplase-dose-to-restore-patency-in-nonhemodialysis-central-vascular-access-devices
#17
Ann Plohal, Krishna Schiller
Central line-associated bloodstream infections (CLABSIs) are preventable through vigilant and thorough care. When CLABSIs occurred at a facility in Southwest Arizona, the root cause analysis discovered that declotting agents, such as alteplase, were not given routinely when nonhemodialysis (non-HD) central vascular access devices (CVADs) lacked blood return. A PICO question was developed that guided the review of literature and central line care standards of practice: In the adult patients with non-HD central lines, what medications are currently recommended to restore patency? As a result of this project, our facility instituted a new protocol using a reduced dose of alteplase to restore patency to non-HD CVADs...
March 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28244238/peripheral-arteries-may-be-reliable-indicators-of-coronary-vascular-disease
#18
Christopher L Hoehmann, Bennett Futterman, Brian Lee Beatty
Atherosclerosis is a stronger predictor for ischemic cardiovascular events than traditional risk factors such as race, age, sex, history, and metabolic profile. Previous research had primarily used ultrasound; however, we performed a study using histopathology to more accurately grade atherosclerosis development using the American Heart Association's grading scale. We cross-sectioned 13 different arteries from 48 cadavers and placed them into three separate groups based on anatomic location: central arteries, peripheral arteries, and carotid arteries...
February 28, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28240718/a-peripherally-inserted-central-catheter-line-inserted-the-day-before-surgery-decreases-the-time-from-induction-to-incision-for-spinal-deformity-surgery-and-safely-provides-central-venous-access-during-surgery-a-pilot-study
#19
Anne E Stuedemann, Richard M Schwend, Valorie K Thomas, Julia M Leamon, Tammy S Lightner
Pediatric patients undergoing surgery for spinal deformity may benefit from central venous access to provide intraoperative monitoring and fluid resuscitation. For pediatric surgical patients requiring central access, we hypothesized that placing a peripherally inserted central catheter (PICC) line preoperatively should decrease time from induction of anesthesia to incision and result in improved patient safety and decreased operating room charges. This was a retrospective, nonrandomized, and case comparison study...
February 24, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28240699/central-venous-access-the-missed-patient-safety-goal
#20
Matthew Herring
Hospital-acquired conditions are conditions that never should happen to a patient while in the care of physicians, nurses, and the health care facility. Central line-associated bloodstream infections plague the nation's health care facilities. With increasing rates of infections being reported during hospitalization, hospital-acquired conditions, namely, infections, and more specifically central line-associated bloodstream infections, are now at the top of patient safety concerns and impact organization's reimbursement...
April 2017: Critical Care Nursing Quarterly
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