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Central Vascular access

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https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#1
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27911460/retrospective-comparison-of-two-different-approaches-for-ultrasound-guided-internal-jugular-vein-cannulation-in-hemodialysis-patients
#2
Antonio Treglia, Dario Musone, Francesco Amoroso
BACKGROUND: Prevalent hemodialysis patients with vascular access consisting of a central venous catheter (CVC) are continuously increasing over the years. Improvement in evolution and CVC placement procedures represents therefore an essential tool to enhance performance and reduce intraoperative and long-term CVC complications. Internal jugular vein (IJV) catheterization techniques are different according to ultrasound probe position in relation to vein axis and to needle direction in relation to ultrasound beam...
December 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27890630/arteriovenous-renal-replacement-therapy-in-end-stage-left-sided-heart-failure-patients-has-detrimental-effect-on-patients-with-impaired-right-ventricular-function
#3
Evangelos Repasos, Elisabeth Kaldara, Christos Pantsios, Chris Kapelios, Emmeleia Nana, Spiridon Vernadakis, Christina Melexopoulou, Konstantinos Malliaras, John Boletis, John N Nanas
INTRODUCTION: Chronic intermittent renal replacement therapy(RRT) is an alternate method of decongestion for patients presenting with diuretic-resistant, end-stage heart failure(HF) and cardiorenal syndrome. The optimal method of vascular access has not been confirmed. This study compared the 6-month outcomes of patients with end-stage HF after the creation of arteriovenous communications (AVC) versus other means of RRT. METHODS: We treated 40 patients with chronic, intermittent, ambulatory RRT, of whom 15 (37...
November 23, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27886366/utility-of-blind-percutaneous-jugular-venous-cannulation-in-resource-limited-settings
#4
Opeyemi Komolafe, Olalekan Olatise
BACKGROUND: For the nephrologist practicing in resource-limited settings, vascular ultrasound is often unavailable; consequently, blind percutaneous puncture of large veins is often employed to establish vascular access for hemodialysis. METHODS: To examine the efficacy and safety of this approach we evaluated 53 consecutive patients in whom central vascular access was required. The vascular access route utilized was primarily the right internal jugular vein. In the majority of cases, the indication for central vascular access was hemodialysis...
November 14, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27886362/balloon-assisted-venous-access-salvage-through-a-thrombosed-arteriovenous-graft
#5
Chen Pong Wong, Karthikeyan Damodharan, Thijs A J Urlings, Sivanathan Chandramohan
INTRODUCTION: Maintaining vascular access by means of radiological intervention has become the mainstay of management of patients with central venous stenoses and occlusions (CVO), which can be challenging. We present a case of balloon-assisted percutaneous puncture of an occluded left subclavian vein, through a thrombosed arteriovenous graft, for a tunneled dialysis catheter insertion. METHODS: A thrombosed left arm arteriovenous graft was accessed, and the occluded left subclavian vein was traversed with 0...
November 22, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27884849/access-hd-pilot-a-randomised-feasibility-trial-comparing-catheters-with-fistulas-in-elderly-patients-starting-haemodialysis
#6
Robert Quinn, Pietro Ravani
INTRODUCTION: The selection of the type of vascular access for haemodialysis is an important intervention question. However, only observational studies are available to inform decision-making in this area, and they are at high risk of selection bias. While a clinical trial comparing the effects of the 2 most frequently chosen strategies for haemodialysis access (fistulas and catheters) on patient important and 'hard' clinical end points is needed, the feasibility of such a trial is uncertain...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27879141/-complete-mesocolic-excision-during-right-hemicolectomy
#7
V Procházka, A Zetelová, T Grolich, L Frola, Z Kala
INTRODUCTION: Complete mesocolic excision (CME) ensures the removal of all sentinel and regional lymph nodes during colon cancer surgery. For right-sided hemicolectomy it is essential to dissect the wall of vena mesenterica superior, which increases the risk of injuring surrounding organs. So far, no randomized studies comparing long-term oncological results of standard right hemicolectomy and hemicolectomy with CME have been published. METHOD: 83 patients operated for colon carcinoma in 2014 and 2015 were included in this study, all of them undergoing right-sided hemicolectomy using laparotomy access...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27876561/tip-design-of-hemodialysis-catheters-influences-thrombotic-events-and-replacement-rate
#8
C Petridis, M Nitschke, W Lehne, E Smith, J P Goltz, H Lehnert, M Meier
OBJECTIVE/BACKGROUND: Central venous tunnelled hemodialysis catheters (CVTC) are used for initial vascular access in patients with renal failure. Tip design of the CVTC may play an important role in catheter function and complication rates, influencing adequate hemodialysis treatment of these patients. METHODS: This prospective, observational cohort study compared the function and complication rates of two CVTCs in patients with end stage renal disease (ESRD) within a follow-up period of 24 months...
November 19, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27868336/vascular-imaging-for-hemodialysis-vascular-access-planning
#9
Rita L McGill, Robin Ruthazer, Eduardo Lacson, Klemens B Meyer, Dana C Miskulin, Daniel E Weiner
Introduction Central venous catheters (CVC) increase risks associated with hemodialysis (HD), but may be necessary until an arteriovenous fistula (AVF) or graft (AVG) is achieved. The impact of vascular imaging on achievement of working AVF and AVG has not been firmly established. Methods Retrospective cohort of patients initiating HD with CVC in 2010-2011, classified by exposure to venography or Doppler vein mapping, and followed through December 31, 2012. Standard and time-dependent Cox models were used to determine hazard ratios (HRs) of death, working AVF, and any AVF or AVG...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#10
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27866375/pre-operative-assessment-for-arteriovenous-fistula-placement-for-dialysis
#11
REVIEW
Maria G Marques, Pedro Ponce
Native AV fistulas are considered to be the best VA for most dialysis patients. A careful preoperative process of care is essential to maximize the proportion of fistulas that achieve adequacy for dialysis. An individualized and timely evaluation of patients starts early with the identification of risk factors, followed by a physical examination which should be complemented by ultrasound vascular mapping in most cases. Vascular mapping includes any technique that leads to information on patient's inflow and outflow anatomy (± hemodynamics) as they relate to arteriovenous access creation and may predict maturation...
November 20, 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27824724/multiple-evanescent-white-dot-syndrome-with-central-visual-loss
#12
Gaetano R Barile, Sarah A Harmon
PURPOSE: To report the clinical case of a 64-year-old man who developed several features of multiple evanescent white dot syndrome (MEWDS) but with central visual loss that persisted because of significant structural macular disease. METHODS: A case report was generated by a review of the clinical course and imaging investigations of one patient, along with review of the literature. RESULTS: A 64-year-old man noted decreased vision in the right eye for 2 weeks, associated with a central scotoma with shimmering, gauze effect of the vision...
November 7, 2016: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/27819399/cytomegalovirus-encephalitis-in-a-hemodialysis-patient-a-rare-association
#13
Alberto Vera, Pablo Ruano, Esther Ortega, Borja Quiroga
Haemodialysis patients are at greater risk of infections than individuals not on dialysis due to their immunosuppressive state caused by several factors (uraemia, vascular access, inflammation, malnutrition). However, infections affecting the central nervous system are not frequent in this population. We present the case of a 77-year-old man with end-stage renal disease who was admitted to the emergency department for a decreased level of consciousness and fever. Although the initial clinical suspicion oriented to a urinary infection, the lack of improvement forced us to perform a lumbar puncture...
November 7, 2016: New Microbiologica
https://www.readbyqxmd.com/read/27813144/arterio-venous-fistula-for-automated-red-blood-cells-exchange-in-patients-with-sickle-cell-disease-complications-and-outcomes
#14
Marianne Delville, Sandra Manceau, Nassim Ait Abdallah, Jan Stolba, Sameh Awad, Thibaud Damy, Barnabas Gellen, Laurent Sabbah, Karima Debbache, Vincent Audard, Jean-Louis Beaumont, Cécile Arnaud, Christelle Chantalat-Auger, Françoise Driss, François Lefrère, Marina Cavazzana, Franco Gilbert, Frederic Galacteros, Jean-Antoine Ribeil, Justine Gellen-Dautremer
Erythrocytapheresis (ER) can improve outcome in patients with sickle cell disease (SCD). A good vascular access is required but frequently it can be difficult to obtain for sickle cell patients. Arterio-venous fistulas (AVFs) have been suggested for ER in SCD supported by limited evidence. We report the largest cohort of ER performed with AVFs from three French sickle cell disease reference centers. Data of SCD patients undergoing ER with AVFs in the French SCD reference center were retrospectively collected...
November 4, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27812087/identifying-early-target-cells-of-nipah-virus-infection-in-syrian-hamsters
#15
Laura Baseler, Dana P Scott, Greg Saturday, Eva Horne, Rebecca Rosenke, Tina Thomas, Kimberly Meade-White, Elaine Haddock, Heinz Feldmann, Emmie de Wit
BACKGROUND: Nipah virus causes respiratory and neurologic disease with case fatality rates up to 100% in individual outbreaks. End stage lesions have been described in the respiratory and nervous systems, vasculature and often lymphoid organs in fatal human cases; however, the initial target organs of Nipah virus infection have not been identified. Here, we detected the initial target tissues and cells of Nipah virus and tracked virus dissemination during the early phase of infection in Syrian hamsters inoculated with a Nipah virus isolate from Malaysia (NiV-M) or Bangladesh (NiV-B)...
November 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27809922/analysis-of-thromboelastography-pt-aptt-and-fibrinogen-in-intraosseous-and-venous-samples-an-experimental-study
#16
Gunnar Strandberg, Miklós Lipcsey, Mats Eriksson, Norbert Lubenow, Anders Larsson
BACKGROUND: Laboratory analysis of coagulation is often important in emergencies. If vascular access is challenging, intraosseous catheterization may be necessary for treatment. We studied the analysis of coagulation parameters in intraosseous aspirate during stable conditions and after major haemorrhage in a porcine model. METHODS: Ten anesthetized pigs received central venous and intraosseous catheters and samples were taken for analysis of thromboelastography (TEG), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen concentration...
November 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27807489/bacteremia-with-an-unusual-pathogen-mycobacterium-neoaurum
#17
Hesham Awadh, Munthir Mansour, Mahmoud Shorman
Mycobacterium neoaurum (M. neoaurum) is an infrequently encountered cause of infection in humans. It is a member of the rapidly growing mycobacteria family. It predominately afflicts those with a compromised immune status and a chronically indwelling vascular access. Isolation of this organism is challenging yet the advent of 16s ribosomal sequencing paved the way for more sensitive detection. No treatment guidelines are available and treatment largely depends on the experience of the treating physician and nature of the isolate...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27792447/ecg-based-picc-tip-verification-system-an-evaluation-5-years-on
#18
Gemma Oliver, Matt Jones
In 2011, the vascular access team at East Kent Hospitals University NHS Foundation Trust safely and successfully incorporated the use of electrocardiogram (ECG) guidance technology for verification of peripherally inserted central catheters (PICC) tip placement into their practice. This study, 5 years on, compared the strengths and limitations of using this ECG method with the previous gold-standard of post-procedural chest X-ray. The study was undertaken using an embedded case study approach, and the cost, accuracy and efficiency of both systems were evaluated and compared...
October 27, 2016: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/27792437/preventing-intraluminal-occlusion-in-peripherally-inserted-central-catheters
#19
Jan Hitchcock
Peripherally inserted central catheters (PICCs) are used in a variety of specialties. Infective and thrombotic complications are widely reported but little has been written about the complications of persistent withdrawal occlusion (PWO) or complete luminal occlusion in PICCs. An audit was conducted of all patients who had a PICC in situ for a 6-week period, using a combination of reviewing clinical documentation and local departmental databases, physical review of inpatients and discussion with the relevant clinical nurse specialists in haematology, oncology, outpatient antibiotic therapy and the vascular access team, to determine the degree of PWO or occlusion but also to review possible financial implications in the introduction of a more expensive product...
October 27, 2016: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/27792436/vascular-access-passports
#20
Andrew Jackson
Andrew Jackson, IV Nurse Consultant, Rotherham NHS Foundation Trust, outlines the rationale for, and elements of, the patient passport for central catheters developed at his trust.
October 27, 2016: British Journal of Nursing: BJN
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