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"Intravenous Cannula" OR "Intravenous Cannulation" OR "Intravenous Access" OR "Vascular Access"

Amanda J Hessels, Mani Paliwal, Susan H Weaver, Deeba Siddiqui, Theresa A Wurmser
BACKGROUND: A strong patient safety culture (PSC) may be associated with improved patient outcomes in hospitals. The mechanism that explains this relationship is underexplored; missed nursing care may be an important link. PURPOSE: The purpose of this study was to describe relationships among PSC, missed nursing care, and 4 types of adverse patient events. METHODS: This cross-sectional study employed primary survey data from 311 nurses from 29 units in 5 hospitals and secondary adverse event data from those same units...
December 12, 2018: Journal of Nursing Care Quality
Zeel Shah, M Chadi Alraies, Mohamad Soud, Amir Kaki
Successful cardiac catheterization procedure begins with safe vascular access and ends with effective hemostasis after equipment removal. These new and advanced technologies in the cath lab require large-bore arterial accesses. Large-bore sheaths are associated with blood flow obstruction resulting in limb ischemia. In this case we present a 48-year-old woman was admitted NSTEMI and cardiogenic shock requiring mechanical circulatory support. Selective left common iliac angiography demonstrated obstructive flow at the level of the left CFA (access site)...
December 13, 2018: Catheterization and Cardiovascular Interventions
Lance A Williams, Christine Arnesen, Christina Gunn, Michael N Boshell, Huy P Pham, Bryan Guillory, Jill Adamski, Marisa B Marques
Many vascular access options, such as subcutaneous ports, are currently on the market for use in both medication infusion and for procedures, such as therapeutic plasma exchange and extracorporeal photopheresis. We compared the cost and time necessary to complete apheresis procedures using either Angiodynamic's Vortex or Bard's PowerFlow subcutaneous ports by reviewing our experience on two patients undergoing long-term apheresis treatments with at least 10 procedures with each type of port. We analyzed the cost of needles and thrombolytic therapy, staff time, overall procedure length, and the total time the patient was in the apheresis unit...
December 12, 2018: Journal of Clinical Apheresis
Timmy Lee, Joyce Qian, Mae Thamer, Michael Allon
BACKGROUND: Despite national vascular access guidelines promoting the use of arteriovenous fistulas (AVF) over arteriovenous grafts (AVGs) for dialysis, AVF use is substantially lower in females. We assessed clinically relevant AVF and AVG surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). METHODS: Using the United States Renal Data System standard analytic files linked with Medicare claims, we assessed incident hemodialysis patients in the United States, 9,458 elderly patients (≥67 years; 4,927 males and 4,531 females) initiating hemodialysis from July 2010 to June 2011 with a catheter and had an AVF or AVG placed within 6 months...
December 13, 2018: American Journal of Nephrology
Lucas A Mutch, Samuel T Klinker, Jody J Janecek, Melanie N Niewinski, Rachael M Z Lee, Melanie L Graham
Vascular access ports (VAPs) are an essential tool for long-term vascular access in preclinical studies and disease modeling in non-human primates (NHPs). We retrospectively reviewed central (inferior vena cava, IVC) and portal VAP implantation with the maintenance at our center from 15 January 2010 to 31 January 2018. In total, 209 VAPs were implanted for long-term drug administration and sampling. Patency was >95% at 6 months and >80% at 1 year for IVC VAPs and >90% at 6 months and >85% at 1 year for portal VAPs...
December 13, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Qingcai Meng, Jin Xu, Chen Liang, Jiang Liu, Jie Hua, Yiyin Zhang, Quanxing Ni, Si Shi, Xianjun Yu
Given the dense stroma and poor vascularization, access to nutrients is limited in the microenvironment of pancreatic ductal adenocarcinoma (PDA). PDA cells can efficiently recycle various metabolic substrates through the activation of different rescuing pathways, including the autophagy pathway. However, the precise roles of autophagy in cancer metabolism are not yet fully understood. In the present study, we first monitored the effect of glucose deprivation on autophagy and on the expression of glutathione peroxidase-1 (GPx1) in PDA cells under the glucose-free environment...
December 11, 2018: Cell Death & Disease
Daniel B Chastain, Anthony Davis
Osteomyelitis remains difficult to treat, typically requiring a prolonged course of intravenous (IV) antibiotics. The optimal route and duration of antibiotics remains ill-defined due to limited prospective clinical trials. Oritavancin is a long acting, semisynthetic, lipoglycopeptide antibiotic with rapid, concentration-dependent bactericidal activity against many Gram-positive organisms. Favorable pharmacokinetics makes oritavancin an appealing alternative for currently available antibiotics requiring daily infusions to decrease the risk of vascular access complications associated with outpatient antimicrobial therapy...
December 8, 2018: International Journal of Antimicrobial Agents
Thierry Corcos
Since its introduction by Lucien Campeau three decades ago, percutaneous radial artery approach at the forearm has been shown to provide advantages over the femoral approach and has become the standard approach for coronary angiography and intervention. Though infrequent, vascular complications still remain, mainly radial artery occlusion. Therefore, a more distal radial approach at the snuffbox or at the dorsum of hand has been suggested, initially by anethesiologists for perioperative patient monitoring, and more recently by Babunashvili et al...
December 11, 2018: Catheterization and Cardiovascular Interventions
Leticia Fernandez-Lopez, Bernard Chevalier, Thierry Lefèvre, Marco Spaziano, Thierry Unterseeh, Stéphane Champagne, Hakim Benamer, Francesca Sanguineti, Philippe Garot, Thomas Hovasse
OBJECTIVE: This study sought to assess the potential benefits of the transradial approach (TRA) as an alternative vascular access to the classical contralateral femoral approach for transcatheter aortic valve replacement (TAVR). BACKGROUND: Vascular and bleeding complications in TAVR have gradually decreased owing to operator experience and downsizing of the delivery system. However, about 1/4 of vascular access site complications are related to the transfemoral (TF) secondary access...
December 10, 2018: Catheterization and Cardiovascular Interventions
Ahmed Amro, Kanaan Mansoor, Mohammad Amro, Amal Sobeih, Rameez Sayyed
We report a case of cardiac catheterization that was done entirely by accidentally accessing the inferior epigastric artery (IEA) through an unintentional puncture of the U-shaped portion of the inferior epigastric artery. Luckily the patient did not have any trauma to the IEA and was d/c home with no complications. A 48-year-old female with history of hypertension and CAD S/P left circumflex stent many years ago who presented to our facility with persistent crescendo angina for which decision was made to proceed with LHC...
2018: Case Reports in Cardiology
A V Maksimov, A K Feĭskhanov, É Sh Makarimov, A R Akhmadieva
Presented herein are two clinical case reports concerning surgical treatment for superior vena cava syndrome in patients suffering from end-stage renal disease and undergoing programmed haemodialysis. Initially attempted roentgen-endovascular recanalization turned out to be unsuccessful. The patients were then subjected to ipsilateral extrathoracic bypass grafting, which made it possible to preserve the vascular access for programmed haemodialysis and to relieve venous hypertension of the limb and the brain, as well as to improve quality of life...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Francesco Garzotto, Marta Zaccaria, Enrico Vidal, Zaccaria Ricci, Anna Lorenzin, Mauro Neri, Luisa Murer, Federico Nalesso, Alfredo Ruggeri, Claudio Ronco
OBJECTIVES: Renal replacement therapy in infants and small children is the treatment of choice for severe oligoanuric renal dysfunction, with an increasing consensus that early initiation might contribute to preventing acute kidney injury complications. Safer renal replacement therapy devices specifically designed for neonates may contribute to ameliorating outcomes and increasing chances of survival. One of the crucial factors to achieve an effective renal replacement therapy in small infants is adequate vascular access...
December 7, 2018: Pediatric Critical Care Medicine
Deokbi Hwang, Sujin Park, Hyung-Kee Kim, Seung Huh
OBJECTIVE: The advantage of arteriovenous fistulas (AVFs) in older patients requiring dialysis is controversial. We reviewed our vascular access experience in patients ≥70 years of age (older group) compared with younger patients. METHODS: We analyzed consecutive patients who underwent access surgery between 2013 and 2016. Primary success (PS) and primary patency (PP) data were analyzed between the older and younger groups before and after propensity score matching of the patients' characteristics and access composition...
October 24, 2018: Journal of Vascular Surgery
Johannes W Drouven, Cor de Bruin, Arie M van Roon, Job Oldenziel, Clark J Zeebregts
BACKGROUND: Radial-cephalic arteriovenous fistula and brachial-cephalic arteriovenous fistula are the first and second choices for creating vascular access in dialysis patients as recommended by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative. Basilic vein transposition or use of a forearm (polytetrafluoroethylene [PTFE]) loop graft is recommended thereafter. The aim of this study was twofold: first, to compare the outcomes and patency rates of patients treated with a basilic vein transposition with those of patients treated with a PTFE loop; and second, to identify patient-related factors of influence on patency rates...
October 24, 2018: Journal of Vascular Surgery
Bohan Chen, Pei Wang, Andrew Brem, Lance Dworkin, Zhangsuo Liu, Rujun Gong
Hemodialysis vascular access dysfunction is a common and intractable problem in clinical practice with no definitive therapy yet available. As a key mediator of vascular and cardiac maladaptive remodeling, mineralocorticoid receptor (MR) plays a pivotal role in vascular fibrosis and intimal hyperplasia (IH) and is potentiated locally in hemodialysis vascular access following diverse injuries, like barotrauma, cannulation and shear stress. MR-related genomic and non-genomic pathways are responsible for triggering vascular smooth muscle cell activation, proliferation, migration and extracellular matrix overproduction...
December 5, 2018: EBioMedicine
Mary Hammes, Rita L McGill, Anindita Basu, Tom Blicharski, Kristie Delaney
AIM: Arteriovenous fistulas (AVF) are the optimal vascular access for hemodialysis although many fistulas fail. The impetus to increase hemodialyzer blood flow (QB) in order to maximize solute clearances may be counterbalanced if AVF suffer adverse hemodynamic effects from accelerated pump flows. The optimal QB to maintain adequate hemodialysis without potentially contributing to AVF dysfunction is unknown. The aim of this study was to measure the hemodynamic effects of increased QB on AVF...
December 11, 2018: Clinical Nephrology
Ines Aragoncillo, Jose Manuel Ligero, Covadonga Hevia, Angel Luis Morales, Yésika Amézquita, Teresa Cervera, Almudena Vega, Soraya Abad, Nicolás Macías, Jose Luño
Background: A good vascular access (VA) is vital for haemodialysis (HD) patients. HD with an autologous arteriovenous fistula (AVF) is associated with higher survival, lower health care costs and fewer complications. Although a distal forearm AVF is the best option, not all patients are good candidates for this approach and the primary failure rate ranges from 20% to 50%. The optimal AVF depends mainly on the anatomical and haemodynamic characteristics of the artery and the vein chosen for the anastomosis...
December 2018: Clinical Kidney Journal
Laura M Rosales, Hanjie Zhang, Marilou Mateo, Brenda Chan, Israel Campos, Nikolas Harbord, Stephan Thijssen, Peter Kotanko
BACKGROUND: The time between the creation of an arteriovenous fistula (AVF) and its successful use is significantly longer in hemodialysis (HD) patients in the United States compared to those in other countries, and there is an urgent need to reduce the residence time of central-venous catheters (CVC). METHODS: Successful AVF creation and maturation results in typical hemodynamic changes, such as an increase in cardiac output and upper body blood flow (UBBF). In patients with CVC as vascular access, we measured once per minute intradialytic central-venous oxygen saturation (ScvO2) and hemoglobin levels simultaneously using the Crit-Line Monitor...
December 6, 2018: Blood Purification
Hanjie Zhang, Israel Campos, Lili Chan, Anna Meyring-Wösten, Leticia M Tapia Silva, Lemuel Rivera Fuentes, Priscila Preciado, Stephan Thijssen, Jeroen P Kooman, Frank M van der Sande, Peter Kotanko
BACKGROUND: Central venous oxygen saturation (ScvO2) is correlated with cardiac output. In most patients, ScvO2 declines during hemodialysis (HD) due to factors such as reduced preload, myocardial stunning, and intermittent arrhythmias. Previous research has shown that low ScvO2 is associated with higher mortality in chronic HD patients. In this research, we tested the hypothesis that ScvO2 variability is associated with all-cause mortality. METHODS: We conducted a retrospective study in 232 chronic HD patients with central venous catheter as vascular access...
December 6, 2018: Blood Purification
Arif Asif, Mohamed M Bakr, Michael Levitt, Tushar Vachharajani
BACKGROUND: Conflicting data continue to surround the optimal dialysis access for the elderly. Many propose that catheters are the best option for this population; others emphasize the creation of an arteriovenous fistula. SUMMARY: While an arteriovenous access is the best available access, it has a high early failure rate, particularly in the elderly. However, significant differences exist in forearm (men ≥65 years ~70%; women ≥65 years ~80%) versus upper arm (men ≥65 years ~40%; women ≥65 years ~38%) fistula failure rates in the elderly, with upper arm having much lower failure rates...
December 5, 2018: Blood Purification
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