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Ultrasound central venous

Zain A AlRstum, Tam T Huynh, Steven Y Huang, George T Pisimisis
INTRODUCTION: We sought to assess the incidence and risk factors of bleeding after ultrasound-guided internal jugular (USGIJ) catheter insertion in severely thrombocytopenic cancer patients, as safe platelet (PLT) count threshold remains controversial. METHODS: Retrospective study of 52 patients with hematologic malignancies and severe thrombocytopenia who underwent USGIJ catheter insertion between 2014 and 2016. Group A included patients with prophylactic PLT transfusion and Group B without...
January 2019: American Journal of Surgery
German Devia Jaramillo, Jenny Castro Canoa, Emiro Valverde Galván
Sepsis and septic shock constitute a complex disease condition that requires the engagement of several medical specialties. A great number of patients with this disease are constantly admitted to the emergency department, which warrants the need for emergency physicians to lead in the recognition and early management of septic patients. Timely and appropriate interventions may help reduce mortality in a disease with an unacceptably high mortality rate. Poor control of cellular hypoperfusion is one of the most influential mechanisms contributing to the high mortality rate in these patients...
2018: Open Access Emergency Medicine: OAEM
Hong-En Chen, Cheyenne C Sonntag, David F Pepley, Rohan S Prabhu, David C Han, Jason Z Moore, Scarlett R Miller
BACKGROUND: The objective of this study was to determine whether gaze patterns could differentiate expertise during simulated ultrasound-guided Internal Jugular Central Venous Catheterization (US-IJCVC) and if expert gazes were different between simulators of varying functional and structural fidelity. METHODS: A 2017 study compared eye gaze patterns of expert surgeons (n = 11), senior residents (n = 4), and novices (n = 7) during CVC needle insertions using the dynamic haptic robotic trainer (DHRT), a system which simulates US-IJCVC...
November 13, 2018: American Journal of Surgery
Monica L Schoch, Judy Currey, Liliana Orellana, Paul N Bennett, Vicki Smith, Alison M Hutchinson
Background: Point-of-care ultrasound (POCUS) has been used in various vascular access contexts; however, to date, it has not been widely adopted in haemodialysis clinics. People with end-stage kidney disease receiving haemodialysis require an arteriovenous fistula (AVF), arteriovenous graft (AVG), or central venous access device (CVAD) in order to access their blood for therapy/treatment. Cannulation issues, such as haematoma and extravasation, related to AVFs and AVGs are common. This pilot and feasibility study will assess the feasibility of a randomised controlled trial aimed at evaluating whether POCUS-guided cannulation results in more successful and accurate AVF needle placement than the standard practice of blind cannulation...
2018: Pilot and Feasibility Studies
Hong-En Chen, Mary A Yovanoff, David F Pepley, Rohan S Prabhu, Cheyenne C Sonntag, David C Han, Jason Z Moore, Scarlett R Miller
BACKGROUND: Training for ultrasound-guided central venous catheterization (CVC) is typically conducted on static manikin simulators with real-time feedback from a skilled observer. Dynamic haptic robotic trainers (DHRTs) are an alternative method that simulates various patient anatomies and provides consistent feedback for each insertion. This study evaluates CVC needle insertion efficiency and skill gains of both methods. MATERIALS AND METHODS: Fifty-two first-year surgical residents were trained by placing internal jugular (IJ) CVC needles in manikins (n = 26) or robots (n = 26)...
January 2019: Journal of Surgical Research
Joseph R Pare, Samara E Pollock, James H Liu, Megan M Leo, Kerrie P Nelson
OBJECTIVES: Ultrasound guided peripheral intravenous catheters (USPIV) are frequently utilized in the Emergency Department (ED) and lead to reduced central venous catheter (CVC) placements. USPIVs, however, are reported to have high failure rates. Our primary objective was to determine the proportion of patients that required CVC after USPIV. Our secondary objective was to determine if classic risk factors for difficult vascular access were predictive of future CVC placement. METHODS: We performed a retrospective review for patients treated at a large academic hospital...
November 17, 2018: American Journal of Emergency Medicine
Mariela Dore, S Barrena, Paloma Triana Junco, Alba Sánchez Galán, Javier Jimenez Gomez, Leopoldo Martinez
INTRODUCTION:  Central venous port (CVP) placement is traditionally performed under fluoroscopy guidance. However, efforts for radiation dose reduction in children have allowed the introduction of ultrasound guidance (USG) and anatomic landmarks as an alternative technique for CVP placement. The aim of this study is to determine whether intraoperative fluoroscopy (IF) is required to confirm the correct position of the catheter tip in children. PATIENTS AND METHODS:  A prospective, single-center study was performed between July and December 2017...
November 23, 2018: European Journal of Pediatric Surgery
Michael Pak-Kai Wong, Zalina Zahari, Mohd Shafie Abdullah, Rosnelifaizur Ramely, Mohd Nizam Md Hashim, Zaidi Zakaria, Andee Dzulkarnaen Zakaria
Surgical patients are at high risk for developing deep vein thrombosis (DVT). There are many reports concerning DVT, but little is known about silent deep vein thrombosis (sDVT). This study aimed to determine the incidence of sDVT. Secondary objective is to identify the associated factors for the use of DVT prophylaxis and Caprini risk scores among major surgery patients. This prospective observational study involved postoperative surgical patients who are at risk of developing sDVT. The Caprini risk-assessment scores were calculated, and each subject had a preoperative and postoperative compression ultrasound complemented by duplex venous ultrasonography of deep venous system...
December 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
J Govender, I Postma, D Wood, W Sibanda
Introduction: Early assessment of volume status is paramount in critically ill patients. Central venous pressure (CVP) measurement and ultrasound assessment of the inferior vena cava (IVC) are both used for volume assessment in the emergency centre. Recent data is conflicting over whether there is a correlation between CVP and ultrasound assessment of the IVC. Methods: This was a retrospective review of an audit previously performed in the Emergency Unit of Ngwelezane Hospital in Kwazulu-Natal...
September 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Malgorzata Chlabicz, Remigiusz Kazimierczyk, Paulina Lopatowska, Monika Gil-Klimek, Bartosz Kudlinski, Marcin Ligowski, Bozena Sobkowicz, Marek Gierlotka, Karol Kaminski, Agnieszka Tycinska
PURPOSE: Fluid therapy in congestive acute decompensated heart failure (ADHF) patients might be inappropriate and worsening the prognosis. The aim of our study was to analyze the effect of fluid administration on mortality in non-septic, ADHF patients with reduced ejection fraction. MATERIAL AND METHODS: We analyzed 41 ADHF consecutive 'cold-wet' patients (mean age 69.3 ± 14.9 years, 27 men, LVEF 22.8 ± 11.1%, lactates 2.2 ± 1.6 mmol/L) without sepsis...
November 13, 2018: Advances in Medical Sciences
I-K Song, E-H Kim, J-H Lee, Y-E Jang, H-S Kim, J-T Kim
BACKGROUND: Central venous catheterisation in neonates is difficult. The purpose of this study was to compare the Seldinger and modified Seldinger techniques for ultrasound-guided internal jugular vein catheterisation in neonates. METHODS: In this randomised, controlled trial, 120 neonates (≤1 month old) requiring central venous catheterisation under general anaesthesia were allocated into either the Seldinger (n=60) or the modified Seldinger (n=60) group. The primary outcome was the incidence of successful catheterisation on the first attempt...
December 2018: British Journal of Anaesthesia
Raymond L Merritt, Michael E Hachadorian, Kristof Michaels, Eric Zevallos, Kubwimana M Mhayamaguru, Zuheily Closser, Charlotte Derr
Context: Previous studies have shown that safe venous cannulation is difficult when the internal jugular vein (IJV) overlies the carotid artery (CA) as the probability of inadvertent arterial penetration is greatly increased. Aims: The goal of this study was to examine the anatomical relationships of the IJV and CA as a function of the degree of head rotation in order to minimize the risk for CA puncture. Settings and Design: Our study was a prospective study using a sample of 496 Emergency Department patients...
July 2018: Journal of Emergencies, Trauma, and Shock
Aref El Nasasra, Hilmi Alnsasra, Doron Zahger, Tsahi T Lerman, Sergio Kobal, Carlos Cafri, Moti Haim, Lior Fuchs, Avi Shimony
BACKGROUND: The standard approach for urgent trans-venous temporary cardiac pacemaker (TVTP) implantation is fluoroscopy guidance. The delay in activation of the fluoroscopy-room and the transfer of unstable patients may be life-threatening. Echocardiography-guided TP implantation may increase the safety of the patients by obviating the need for in-hospital transfer. We examined the feasibility and safety of echocardiography-guided vs. fluoroscopy-guided TVTP implantation. METHODS: From January 2015 to September 2017 data for consecutive patients who needed emergent TVTP implantation were retrospectively reviewed...
November 13, 2018: Journal of Echocardiography
F Herd, T Miller, F W van Delft, H O Gabra
INTRODUCTION: Adolescent patients with chronic conditions rely on permanent venous access for safe treatment and supportive care. Traditionally this is provided by a central venous access device (CVAD) e.g. Hickmann catheter or totally implanted subcutaneous port or also called Port-a-Cath (PaC). We reviewed the patient experience, safety and feasibility of insertion of peripheral inserted implanted subcutaneous port (peripheral PaC). METHODS: Medical records of patients who underwent insertion of peripheral PaC under ultrasound guidance at our institution since between 2012-2017 were reviewed to ascertain specific details including duration of insertion and complication rate...
September 12, 2018: Journal of Pediatric Surgery
Ross G McFall, Tony Lu
Central venous occlusive disease is frequently observed in patients with end-stage renal disease. Venography remains the gold standard for diagnosis, but intravascular ultrasound is a potentially beneficial adjunct that may positively influence intervention.
July 2018: Methodist DeBakey Cardiovascular Journal
Justinas Silickas, Stephen A Black, Alkystis Phinikaridou, Adam M Gwozdz, Alberto Smith, Prakash Saha
Successful management of acute deep vein thrombosis and post-thrombotic syndrome depends on careful patient selection and detailed investigation of thrombus extent, composition, and anatomy. This article reviews the use of computerized tomography and magnetic resonance imaging in the assessment of central deep veins of the pelvis and addresses new developments within the field. Despite drawbacks of each imaging modality, when contemplating deep venous reconstruction, cross-sectional imaging should be considered for preoperative planning and to compliment intraoperative imaging tools, including intravascular ultrasound and contrast venography...
July 2018: Methodist DeBakey Cardiovascular Journal
Kenneth Ouriel
Chronic venous insufficiency (CVI) is responsible for significant costs to society in the form of medical and surgical treatment and, importantly, unmeasurable lost work productivity due to pain and disability. Symptomatic chronic central vein obstruction, a cause of CVI, is potentially treatable using open surgical and endovascular techniques to restore vessel patency. Although upper extremity central vein obstruction often requires an open surgical procedure for durable relief, endovascular stents have proven remarkably useful for iliofemoral disease...
July 2018: Methodist DeBakey Cardiovascular Journal
Thomas Ritzenthaler, Mickael Beraud, Florent Gobert, Frédéric Dailler
BACKGROUND: An efficient vascular access is mandatory for the proper conduction of therapeutic plasma exchanges (TPE). Peripheral and central venous catheters may be used, with respective advantages and limitations. In this study, vascular access devices (IV catheter, dialysis cannula, central venous catheter) and anatomic vein characteristics were evaluated. METHOD: From January to June 2016, 162 TPE in 29 patients were reviewed. Only TPE using centrifugation method (Spectra Optia apheresis system) were evaluated...
November 8, 2018: Journal of Clinical Apheresis
Pierfrancesco Fusco, Vincenza Cofini, Stefano Di Carlo, Antonio Luciani, Paolo Scimia, Emiliano Petrucci, Astrid U Behr, Stefano Necozione, Laura Brigitta Colantonio, Gilberto Fiore, Alessandro Vergallo, Franco Marinangeli
PURPOSE: In recent years, ultrasound has seen a rapid development with numerous applications in anesthesia, intensive-care medicine, and pain medicine, increasing efficacy and safety of procedures. We investigated the prevalence of ultrasound use among Italian anesthetists. METHODS: A cross-sectional prevalence study was carried out on a sample of 735 anesthetists. The research was conducted during the ultrasound training in anesthesia and intensive care, in the Italian Associazione Anestesisti Rianimatori Ospedalieri - Emergenza Area Critica "SimuLearn® " training centre (Bologna, Italy)...
November 1, 2018: Journal of Ultrasound
Nahla Zaghloul, Laura Watkins, Jennie Choi-Rosen, Shahana Perveen, Dalibor Kurepa
The primary objective was to study agreement between X-rays and point of care ultrasound (POC-US) in determining central venous line (CVL) tip position. The secondary objective was to examine malposition rates over time using POC-US. Fifty-six neonates were enrolled who had a CVL placed. Initial X-rays and POC-US were obtained. POC-US was performed daily thereafter for the total of 6 days. US video clips were acquired in four standard echocardiographic views: subcostal, four-chamber, and short- and long-axis parasternal views...
October 29, 2018: European Journal of Pediatrics
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