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central venous catheter technique

Guanggui Shen, Hongzhen Yin, Yingya Cao, Meijun Zhang, Jingyi Wu, Xiaogan Jiang, Tao Yu, Weihua Lu
BACKGROUND: To determine whether fibre optic bronchoscopy-guided percutaneous dilatational tracheostomy (FOB-PDT) is a better option in critically ill patients, we compared the efficacy and incidence of procedure complications between PDT with and without FOB. METHODS: We included 90 patients with oral intubation and mechanical ventilation who received PDT with (n = 45, FOB-PDT group) and without (n = 45, PDT group) FOB. For all patients, a simplification of the Griggs technique was used in this study with a central venous catheter set and dilating forceps...
August 11, 2018: Irish Journal of Medical Science
Danielle M Hundley, Aimee C Brooks, Elizabeth J Thomovsky, Paula A Johnson, Lynetta J Freeman, Ryan M Schafbuch, Hock Gan Heng, George E Moore
OBJECTIVE To compare time to achieve vascular access (TTVA) between an ultrasound-guided technique (UST) and landmark-based technique (LMT) for central venous catheter (CVC) placement in healthy anesthetized dogs. ANIMALS 39 purpose-bred hounds. PROCEDURES Anesthetized dogs that were hemodynamically stable following completion of a terminal surgical exercise were enrolled in the study during 2 phases, with a 45-day intermission between phases. For each dog, a UST and LMT were used for CVC placement via each external jugular vein by 2 operators (criticalist and resident)...
June 2018: American Journal of Veterinary Research
Lefeng Zhang, Yongqiang Jin, Fuqiang Zhang, Hongyin Li, Qingyu Wu
BACKGROUND: Acute kidney injury (AKI) is one of the common complications in infants and children after complex congenital heart surgery. Peritoneal dialysis (PD) is usually applied for renal replacement therapy (RRT), especially in infants. We investigated the efficacy and safety of modified PD for the treatment of acute renal failure and congestive heart failure after cardiac surgery for congenital heart disease in infants. METHODS: We retrospectively analyzed five consecutive patients from October 2015 to February 2017...
June 25, 2018: Heart Surgery Forum
AiMin Li, JianGuo Jiao, Ying Zhang, Li Tian, JinHong Miao, XiaoLi Hao, ZhenChang Sun, QiaoZhi Sun
Background & objectives: The peripherally inserted central catheter (PICC) has the advantages of higher safety, lower infection rate and longer retention time than peripherally inserted catheter. This study was aimed to evaluate the accuracy and safety of bedside electrocardiograph (ECG)-guided tip location technique in PICC in cancer patients, and compared with traditional chest radiography tip location technique. Methods: Patients were randomly assigned into two groups: The ECG test group patients underwent PICC insertion with ECG-guided tip location, while the control group patients had PICC insertion by the conventional method...
May 2018: Indian Journal of Medical Research
Abdulrahman Alshafei, Farhan Tareen, Nomsa Maphango, David White, Brendan O'Connor, Thambipillai Sriparan
BACKGROUND/PURPOSE: Tunneled central venous catheters (TCVCs) are commonly used to manage pediatric patients with chronic disease. The aim of this study is to compare the outcomes of external jugular vein (EJV) and internal jugular vein (IJV) tunneled catheters inserted using the open technique. METHODS: This is a single institution retrospective analysis of patients requiring an IJV or EJV TCVC in the period between 2009 and 2014. Data collected included the following: patient demographics, site/side of insertion, catheter size, number of lumens, duration of catheter in situ, and complications...
July 9, 2018: Journal of Pediatric Surgery
Enyo A Ablordeppey, Anne M Drewry, Daniel L Theodoro, LinLin Tian, Brian M Fuller, Richard T Griffey
PURPOSE: Although routine chest radiographs (CXR) to verify correct central venous catheter (CVC) position and exclude pneumothorax is commonly performed, emerging evidence suggests that this practice can be replaced by point of care ultrasound (POCUS). POCUS is advantageous over CXR because it avoids radiation while verifying correct placement and lack of pneumothorax without delay. We hypothesize that a knowledge translation gap exists in this area. We aim to describe the current clinical practice regarding POCUS alone for CVC position confirmation and pneumothorax exclusion as compared to chest radiography...
July 25, 2018: Shock
Chiara Palermo, Angelo Sanfiorenzo, Alessia Testo Giaquinta, Carla Virgilo, Massimiliano Veroux, Pierfrancesco Veroux
RATIONALE: Central venous catheter (CVC) placement, particularly in emergency setting, may be associated with significant morbidity and mortality. PATIENT CONCERNS: A 33-year old woman with suspected pulmonary embolism, developed a pseudoaneurysm of the neck three days after a CVC placement in the right internal jugular vein, determining compression to adjacent neck structures. DIAGNOSES: Computed tomography angiography and selective angiography demonstrated the presence of the pseudoaneurysm originating from the thyro-cervical trunk...
July 2018: Medicine (Baltimore)
G Abelenda Alonso, M D Corbacho Loarte, R Núñez Ramos, M Cervero Jiménez, J J Jusdado Ruiz-Capillas
OBJECTIVE: One of the most controversial issues in recent years has been the clinical significance of high vancomycin MIC in Staphylococcus aureus bacteremia. The aim of this study was to elucidate the clinical implication that this parameter has in the staphylococcal bacteremia of a second level hospital. METHODS: Retrospective descriptive study between January 2014 and September 2016 with 138 records from the blood culture Severo Ochoa University Hospital registry...
August 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Anders Svensson, Torkel B Brismar, Fabian Morsbach
Occlusion of the thoracic venous system and/or occlusion of central venous catheters (CVC) of unknown cause can, in selected cases, require advanced imaging. Here, we describe a case study of a patient with a failing central dialysis catheter (CDC) which was diagnosed by computed tomography (CT) in connection with a single-phase bilateral low-dose contrast medium (CM) injection using only 3.6 g of iodine. By injecting a low CM dose, the risk of streak artifacts from first-pass of high intravascular concentrations of CM can be avoided...
June 2018: Acta Radiologica Open
Akihito Tampo
Real-time ultrasound guidance for central venous catheterization has become a standard technique. This technique has been reported to yield high success rates and fewer complications compared with landmark techniques. However, it can be risky when the practitioner does not possess proper knowledge and skills. Lose sight of the needle tip can lead to severe complications such as arterial puncture or pneumothorax. Also, posterior wall penetration of the target vessels must be avoided. Misplacement of the catheter to other vessels can sometimes occur, and may only be discovered after the catheterization procedure...
June 13, 2018: Journal of Medical Ultrasonics
Lars Breimer, Håkan Geijer, Lars Berggren
Central venous catheter bloodstream infections are an important cause of hospital-acquired infection with increased morbidity, mortality and cost. The incidence varies between countries and even hospitals. Needleless connector hubs are used on virtually all intravascular devices and colonization of these is considered the cause of much of the postinsertion catheter-related infections through breaks in aseptic technique and failure to disinfect properly. This systematic review evaluated 165 search hits on hub disinfection practices with particular emphasis on the time of scrubbing the connector for 15 sec but also the impact of measures of education and compliance...
June 15, 2018: Läkartidningen
Marla Clifton, Stephen M Kralovic, Loretta A Simbartl, Lisa Minor, Rachael Hasselbeck, Tina Martin, Gary A Roselle
Nursing homes present a unique challenge for implementing infection prevention and control practices while striving to maintain a home-like environment. Medical devices such as urinary catheters and central venous catheters have become a part of nursing home care but can predispose residents to associated infections. Because evidence-based prevention bundles were implemented, catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs) were monitored in all U...
May 24, 2018: American Journal of Infection Control
Cathy E Langston, Adam E Eatroff
OBJECTIVE: To describe an intravascular fibrin sheath associated with a hemodialysis catheter in a dog. CASE SUMMARY: A 4-year-old dog presented for hemodialysis to treat acute kidney injury. Hemodialysis catheter dysfunction during the course of treatment was temporarily alleviated using a tissue plasminogen activator. A thrombus composed of fibrin and granulation tissue creating a sheath around the catheter and focally adherent to the vessel wall was identified on postmortem evaluation...
July 2018: Journal of Veterinary Emergency and Critical Care
Kalliopi-Maria Tasopoulou, Christos Argyriou, Michael Mantatzis, Konstantia Kantartzi, Ploumis Passadakis, George S Georgiadis
Central venous (CV) catheterization is not only an invaluable diagnostic modality but also an essential therapeutic tool for the treating physician, enabling rapid and reliable intravenous administration of drugs and fluids, providing venous access to patients undergoing long-term continuous or repeated intravenous treatment such as chemotherapy, or it can be used for hemodialysis in patients suffering from acute or chronic renal disease. On the other hand, CV catheterization can lead to a wide range of life-threatening complications for the patient especially if left untreated or become late-diagnosed...
August 2018: Annals of Vascular Surgery
Vaishali Chaskar, Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Objective: Central venous cannulation of the internal jugular vein is difficult in paediatric patients because of the small size of the vein and anatomic variations. Many studies have shown the accuracy of various formulae for calculating the depth of placement. The aim of this study was to assess the most reliable method for central venous catheter (CVC) tip placement in paediatric patients. Methods: Sixty-nine patients in the age groups from 0 to 12 years were divided in three groups for three published techniques for catheter tip placement...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
C Cleff, M Boensch, F Eifinger, J Hinkelbein
BACKGROUND: Correct positioning of a central venous catheter (CVC) tip in pediatric patients is very important. Malpositioning may lead to direct complications, such as arrhythmia and increase the risk of thrombosis, infections, valve failures or pericardial tamponade. OBJECTIVE: The aim of this review was to identify and summarize published formulae for the correct positioning of the CVC tip in children and to discuss the benefits of these formulae for the daily routine...
May 7, 2018: Der Anaesthesist
C Gudiol, S Nicolae, C Royo-Cebrecos, M Aguilar-Guisado, I Montero, C Martín-Gandul, M Perayre, D Berbel, M Encuentra, M Arnan, J M Cisneros-Herreros, J Carratalà
BACKGROUND: Catheter-related bloodstream infection (CRBSI) is one of the most frequent complications in patients with cancer who have central venous catheters (CVCs) implanted and is associated with substantial morbidity and mortality. Taurolidine is a non-antibiotic agent with broad-spectrum antimicrobial activity, which has been used as a lock solution to prevent CRBSI in some settings. However, little is known about its usefulness in high-risk adult neutropenic patients with cancer...
May 2, 2018: Trials
Liam Vierboom, Alexandre Darani, Catherine Langusch, Svs Soundappan, Jonathan Karpelowsky
PURPOSE: Ultrasound-guided (USG) percutaneous insertion of tunnelled central venous access devices (CVADs) has been shown to be safe and effective in adults. However, there have been concerns over the safety of this technique in small children. This paper analyses the safety of USG percutaneous CVAD insertion in the pediatric population weighing ten kilograms or less. METHOD: All surgically inserted CVADs for children weighing ten kilograms or less, between January 2010 and December 2015 at the Children's Hospital at Westmead were retrospectively reviewed...
April 5, 2018: Journal of Pediatric Surgery
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Roger Rodrigues, Alfredo Agostinho, Gabriel Anacleto, Paula Branco, Óscar Gonçalves
INTRODUCTION: Intravascular or catheter embolization of a foreign body, either by fracture or migration, is a rare condition, occurring in approximately 1%. This study is focused on the migration of catheters since they represent the majority of cases of embolization. We present one of the largest published series of removal of foreign bodies with endovascular techniques. The objective of the present study is to demonstrate the different locations where foreign bodies, in most cases catheters, can reach, the technique used to remove them and the affected population...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
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