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Central Vascular access

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https://www.readbyqxmd.com/read/28523170/a-comparison-of-longitudinal-and-transverse-approaches-to-ultrasound-guided-axillary-vein-cannulation-by-experienced-operators
#1
Yi-Zhou He, Ming Zhong, Wei Wu, Jie-Qiong Song, Du-Ming Zhu
BACKGROUND: The axillary vein is an easily accessible vessel that can be used for ultrasound-guided central vascular access and offers an alternative to the internal jugular and subclavian veins. The objective of this study was to identify which transducer orientation, longitudinal or transverse, is better for imaging the axillary vein with ultrasound. METHODS: We analyzed 236 patients who had undergone central venous cannulation of axillary vein in this retrospective study...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522650/examining-the-association-between-hemodialysis-access-type-and-mortality-the-role-of-access-complications
#2
Pietro Ravani, Robert Quinn, Matthew Oliver, Bruce Robinson, Ronald Pisoni, Neesh Pannu, Jennifer MacRae, Braden Manns, Brenda Hemmelgarn, Matthew James, Marcello Tonelli, Brenda Gillespie
BACKGROUND AND OBJECTIVES: People receiving hemodialysis to treat kidney failure need a vascular access (a fistula, a graft, or a central venous catheter) to connect to the blood purification machine. Higher rates of access complications are considered the mechanism responsible for the excess mortality observed among catheter or graft users versus fistula users. We tested this hypothesis using mediation analysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied incident patients who started hemodialysis therapy from North America, Europe, and Australasia (the Dialysis Outcomes and Practice Patterns Study; 1996-2011)...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28521822/central-nervous-system-manganese-induced-lesions-and-clinical-consequences-in-patients-with-hereditary-hemorrhagic-telangiectasia
#3
M M Serra, C H Besada, A Cabana Cal, A Saenz, C V Stefani, D Bauso, A B Golimstok, J C Bandi, D H Giunta, C M Elizondo
BACKGROUND: Around 47-74% of patients with hereditary hemorrhagic telangiectasia (HHT) have hepatic vascular malformations (HVMs); magnetic resonance images (MRI) of the central nervous system (CNS) might show in T1 sequences a hyper-intensity signal in different areas, mainly in the basal ganglia (BG) as consequence of manganese (Mn) deposits as observed in cirrhotic patients. These patients might suffer from different neuropsychiatric disorders (hepatic encephalopathy). In HHT patients, even in the presence of hepatic shunts, hepatocellular function is usually preserved...
May 18, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28514785/effect-of-age-on-the-association-of-vascular-access-type-with-mortality-in-a-cohort-of-incident-end-stage-renal-disease-patients
#4
Tarek Saleh, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Geeta G Gyamlani, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND/AIMS: All hemodialysis (HD) patients are generally recommended to create a fistula first; but to create a mature arteriovenous fistula (AVF) can be challenging in elderly individuals. It is unclear if elderly incident HD patients derive a survival benefit from an AVF over an arteriovenous graft (AVG) or a tunneled central venous catheter (TDC). METHODS: We examined the association of vascular access type (AVF, AVG, and TDC with and without a maturing AVF/AVG at dialysis transition) at HD initiation with all-cause, cardiovascular (CV), and infection-related mortality in 46,786 US veterans using Cox models with adjustment for confounders...
May 18, 2017: Nephron
https://www.readbyqxmd.com/read/28511483/a-study-of-morbidity-and-cost-of-peripheral-venous-cannulation-in-neonates-admitted-to-paediatric-surgical-intensive-care-unit
#5
Sushama Raghunath Tandale, Nandini Dave, Madhu Garasia, Shalil Patil, Sandesh Parelkar
INTRODUCTION: Peripheral venous access in sick neonates is indicated for administration of fluids, drugs or nutrients. AIM: We conducted an audit of peripheral venous access in neonates admitted to paediatric surgical intensive care unit to study the morbidity, time spent on cannulation and cost with its use. MATERIALS AND METHODS: One hundred consecutive neonates requiring hospital admission to paediatric surgical intensive care unit in a period of one year were included in the study...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28511151/peripheral-arteriovenous-fistula-as-vascular-access-for-long-term-chemotherapy
#6
Oleksiy O Kovalyov, Oleksandr G Kostyuk, Tetyana V Tkachuk
INTRODUCTION: To provide long-term vascular access in clinical oncology peripheral forearm veins (up to 95% of patients in Ukraine), central venous access and "complete implanted vascular systems" are used most often. Many oncology patients have contraindications to catheterization of superior vena cava. Besides, exploitation of central veins is associated with potential technical and infectious complications. The aim - to study short-term and long-term results of arteriovenous fistula exploitation as vascular access for continuous anticancer therapy...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28509723/determinants-of-retinal-microvascular-features-and-their-relationships-in-two-european-populations
#7
Mirna Kirin, Reka Nagy, Thomas J MacGillivray, Ozren Polašek, Caroline Hayward, Igor Rudan, Harry Campbell, Sarah Wild, Alan F Wright, James F Wilson, Veronique Vitart
OBJECTIVES: To examine factors influencing retinal vasculature in two environmentally contrasted, cross-sectional studies of adult participants of European descent and to estimate the extent and specificity of genetic contributions to each retinal vasculature feature. METHODS: Retinal images from 1088 participants in the Orkney Complex Disease Study and 387 in the CROATIA-Korčula study, taken using the same nonmydriatic camera system and graded by the same person, were evaluated...
May 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28478624/persistent-left-superior-vena-cava-and-partially-left-inferior-vena-cava-a-case-report-of-a-dangerous-central-venous-catheterization
#8
Biagio Ricciardi, Carlo Alberto Ricciardi, Antonio Lacquaniti, Giuseppe Carella, Domenico Puzzolo, Antonina Pisani, Debora Di Mauro, Antonio Micali
BACKGROUND: The coexistence of a double superior vena cava (SVC) and a partially left inferior vena cava (PLIVC) with a circumaortic collar, associated with other congenital malformations, was not described previously. CASE DESCRIPTION: We present a 33-year-old woman in hemodialysis with complete exhaustion of the brachial routes for vascular access, admitted to our Nephrology Unit for a long-term central venous catheter (CVC) implant, usually by us performed under EchoScopic Technique (EST), an echographic venipuncture followed by continuous radioscopic control of guidewire and catheter in all the steps of implant...
May 5, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28478621/ultrasound-guided-costoclavicular-approach-infraclavicular-brachial-plexus-block-for-vascular-access-surgery
#9
Zhi Yuen Beh, Mohd Shahnaz Hasan
INTRODUCTION: We report the use of a newly described regional technique, ultrasound-guided costoclavicular approach infraclavicular brachial plexus block for surgical anesthesia in two high-risk patients undergoing 2nd stage transposition of basilic vein fistula. METHODS: Both patients had features of difficult airway, American Society of Anesthesiologists (ASA) physical status class III and central venous occlusive disease. The common approach, i.e., ultrasound-guided supraclavicular brachial plexus block was technically difficult with inherent risk of vascular puncture due to dilated venous collaterals at the supraclavicular area possibly compromising block quality...
April 28, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28430315/adding-access-blood-flow-surveillance-reduces-thrombosis-and-improves-arteriovenous-fistula-patency-a-randomized-controlled-trial
#10
Inés Aragoncillo, Soraya Abad, Silvia Caldés, Yésika Amézquita, Almudena Vega, Antonio Cirugeda, Cristina Moratilla, José Ibeas, Ramón Roca-Tey, Cristina Fernández, Nicolás Macías, Borja Quiroga, Ana Blanco, Maite Villaverde, Caridad Ruiz, Belén Martín, Asunción M Ruiz, Jara Ampuero, Fernando de Alvaro, Juan M López-Gómez
PURPOSE: Stenosis is the main cause of arteriovenous fistula (AVF) failure. It is still unclear whether surveillance based on vascular access blood flow (QA) enhances AVF function and longevity. METHODS: We conducted a three-year follow-up randomized, controlled, multicenter, open-label trial to compare QA-based surveillance and pre-emptive repair of subclinical stenosis with standard monitoring/surveillance techniques in prevalent mature AVFs. AVFs were randomized to either the control group (surveillance based on classic alarm criteria; n = 104) or to the QA group (QA measured quarterly using Doppler ultrasound [M-Turbo®] and ultrasound dilution [Transonic®] added to classic surveillance; n = 103)...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28430309/variation-in-use-of-technology-among-vascular-access-specialists-an-analysis-of-the-picc1-survey
#11
Vineet Chopra, Latoya Kuhn, David Ratz, Suzanne Winter, Peter J Carr, David Paje, Sarah L Krein
BACKGROUND: While the use of technologies such as ultrasound and electrocardiographic (ECG) guidance systems to place peripherally inserted central catheters (PICCs) has grown, little is known about the clinicians who use these tools or their work settings. METHODS: Using data from a national survey of vascular access specialists, we identified technology users as PICC inserters that: (a) use ultrasound to find a suitable vein for catheter placement; (b) measure catheter-to-vein ratio; and (c) use ECG for PICC placement...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28419013/standardizing-best-nursing-practice-for-implanted-ports-applying-evidence-based-professional-guidelines-to-prevent-central-line-associated-bloodstream-infections
#12
Susanne B Conley, Paula Buckley, Lisa Magarace, Candace Hsieh, Lillian Vitale Pedulla
Nearly 3 million central vascular access devices (CVADs) are used in the United States each year. These devices are an important advance in health care and essential to oncology patients. However, CVADs are the most frequent cause of central line-associated bloodstream infections (CLABSIs). CLABSI can be prevented when evidence-based practices are followed consistently over time. Professional organizations establish valid standards and guidelines to guide CVAD practice. This article identifies strategies implemented at a comprehensive ambulatory cancer center to integrate professional evidence-based standards and guidelines for implanted port care into nursing practice at the point of care...
May 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28393000/clinical-experience-with-ultrasound-guided-angioplasty-for-vascular-access
#13
Seong Cho, Yu-Ji Lee, Sung-Rok Kim
BACKGROUND: The use of ultrasound guided percutaneous transluminal angioplasty (UG-PTA), which use ultrasound as an imaging modality, is an evolving strategy. But, in Korea, this method is rarely used. We report our experiences with UG-PTA with respect to technical success rates and complication rates compared to conventional PTA (C-PTA), performed between 2010 and 2015 at Samsung Changwon Hospital, Korea. METHODS: In our series, 53 cases of UG-PTA and 90 cases of C-PTA were reviewed, respectively...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28374282/a-randomised-crossover-study-to-compare-the-cross-sectional-and-longitudinal-approaches-to-ultrasound-guided-peripheral-venepuncture-in-a-model
#14
James Griffiths, Amadeus Carnegie, Richard Kendall, Rajeev Madan
BACKGROUND: Ultrasound-guided peripheral intravenous access may present an alternative to central or intraosseous access in patients with difficult peripheral veins. Using venepuncture of a phantom model as a proxy, we investigated whether novice ultrasound users should adopt a cross-sectional or longitudinal approach when learning to access peripheral veins under ultrasound guidance. This result would inform the development of a structured training method for this procedure. METHODS: We conducted a randomised controlled trial of 30 medical students...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28367623/emerging-insights-for-better-delivery-of-chemicals-and-stem-cells-to-the-brain
#15
Abdul Mannan Baig
The human central nervous system and its vascularity has evolved a complex yet useful barricade, called the blood-brain barrier. The understanding of this barrier and the transport proteins that allow a selective access across it remains fundamental in designing chemicals and molecules that could cross it and prove therapeutically beneficial. After the recent findings of the brain-lymphatic link and the movement of chemical molecules from the central nervous system into general circulation, the model of the blood-brain barrier needs to be revisited...
April 3, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28365108/hybrid-interventions-for-catheter-placement-in-pediatric-intestinal-rehabilitation-patients-with-end-stage-venous-access
#16
Ludger Sieverding, Andreas Busch, Jens Gesche, Gunnar Blumenstock, Ekkehard Sturm, Ilias Tsiflikas, Femke Piersma, Anja Hauser, Gesa Wiegand, Steffen Hartleif, Michael Hofbeck, Jörg Fuchs, Steven W Warmann
PURPOSE: The purpose of this study is to analyze the combined approach of endovascular and open surgical procedures for insertion of permanent central venous catheters in children with intestinal failure and end-stage venous access. METHODS: Data of 14 children (16 interventions) with intestinal failure and end-stage venous access, treated within the pediatric intestinal rehabilitation program at our institution between September 2011 and November 2016, were retrospectively reviewed...
March 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28356575/ejection-time-influence-of-hemodynamics-and-site-of-measurement-in-the-arterial-tree
#17
Yurie Obata, Maki Mizogami, Sarabdeep Singh, Daniel Nyhan, Dan E Berkowitz, Jochen Steppan, Viachaslau Barodka
The left ventricular ejection time is routinely measured from a peripheral arterial waveform. However, the arterial waveform undergoes constant transformation as the pulse wave propagates along the arterial tree. Our goal was to determine if the left ventricular ejection time measured peripherally in the arterial tree accurately reflected the ejection time measured through the aortic valve. Moreover, we examined/accessed the modulating influence of hemodynamics on ejection time measurements. Continuous wave Doppler waveform images through the aortic valve and the simultaneously obtained radial artery pressure waveforms were analyzed to determine central and peripheral ejection times, respectively...
March 30, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28355402/budd-chiari-syndrome-secondary-to-catheter-associated-inferior-vena-cava-thrombosis
#18
Gustavo N Araujo, Luciane M Restelatto, Carlos A Prompt, Cristina Karohl
INTRODUCTION: Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD. CASE REPORT: A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28353488/management-of-central-venous-access-device-associated-skin-impairment-an-evidence-based-algorithm
#19
Daphne Broadhurst, Nancy Moureau, Amanda J Ullman
Patients relying on central venous access devices (CVADs) for treatment are frequently complex. Many have multiple comorbid conditions, including renal impairment, nutritional deficiencies, hematologic disorders, or cancer. These conditions can impair the skin surrounding the CVAD insertion site, resulting in an increased likelihood of skin damage when standard CVAD management practices are employed. Supported by the World Congress of Vascular Access (WoCoVA), developed an evidence- and consensus-based algorithm to improve CVAD-associated skin impairment (CASI) identification and diagnosis, guide clinical decision-making, and improve clinician confidence in managing CASI...
May 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28341502/significance-of-blunted-venous-waveforms-seen-on-upper-extremity-ultrasound
#20
Xuan-Binh D Pham, Ezinne J Ihenachor, Hoover Wu, Jerry J Kim, Amy H Kaji, Matthew C Koopmann, Timothy J Ryan, Christian de Virgilio
INTRODUCTION: Current guidelines recommend vascular mapping ultrasound (US) prior to arteriovenous fistula creation. Blunted venous waveforms (BVW) suggest central venous stenosis; however, this relationship and one between BVW and the presence of a central venous catheter (CVC) remain unclear. MATERIAL AND METHODS: All patients who received upper-extremity vascular mapping US between January 2013 and October 2014 at a single institution were retrospectively reviewed...
March 21, 2017: Annals of Vascular Surgery
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