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Ultrasound central venous

Mauro Pittiruti, Giancarlo Scoppettuolo, Laura Dolcetti, Alessandro Emoli
INTRODUCTION: Intracavitary electrocardiogram technique is recognized as a safe, accurate, and inexpensive method for verifying the tip location of central venous access devices. While the technique can be carried out with any standard electrocardiogram monitor, dedicated electrocardiogram monitors specifically designed for the intracavitary electrocardiogram are also available. One of these dedicated monitors is Sherlock-3CG® , characterized by the integration of a magnetic-based tip navigation method with an electrocardiogram-based tip location method...
October 18, 2018: Journal of Vascular Access
Hui Du, Honglin Zhao, Mei Li, Huihui Ji, Fan Ren, Pan Wang, Xin Li, Ming Dong, Rehman Dawar, Gang Chen, Jun Chen
BACKGROUND: Venous thromboembolism (VTE) is a recognized complication in lung cancer patients with higher morbidity and mortality. The purpose of this study is to determine the incidence of lower extremity venous thrombosis (LEDVT) in lung cancer patients and to reveal the risk factors for LEDVT during admission in our center. METHODS: We first connected 231 patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from July 2017 to December 2017...
October 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Alice Luehr
Individuals who require renal replacement therapy overwhelmingly choose outpatient hemodialysis. Appropriate cannulation techniques are an essential element in access preservation and in the prevention of access-related complications. Missed cannulations can result in damage of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs). Ultrasound-guided cannulation is an effective technique for the placement of peripheral intravenous (IV) catheters and central venous catheters (CVCs) for hemodialysis. The purposes of this project were to determine if ultrasound-guided cannulation of AVFs decreased the number of missed cannulations, to determine staff and patient perceptions regarding cannulation, and to implement a quality incentive program (QIP) to implement an evidence-based ultrasound-guided policy and procedure, training program, and competency evaluation at a hospital-based dialysis facility...
September 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Cory N Criss, Samir K Gadepalli, Niki Matusko, Marcus D Jarboe
BACKGROUND: Use of ultrasound-guidance for central venous access in adults is the standard of care. There is, however, less clarity in the role of routine ultrasound use in obtaining venous access in children. We sought to evaluate safety and efficiency of the placement of central lines utilizing an ultrasound-guided approach compared to the traditional, landmark approach in pediatric patients. STUDY DESIGN: A single-institution retrospective chart review, using CPT codes, was performed for all tunneled central venous catheters in children between 2005 and 2017 by the same pediatric surgery group...
September 13, 2018: Journal of Pediatric Surgery
Timothy R Spencer, Mauro Pittiruti
Ultrasound technology has revolutionized the practice of safer vascular access, for both venous and arterial cannulation. The ability to visualize underlying structures of the chest, neck, and upper/lower extremities provides for greater success, speed, and safety with all vascular access procedures. Ultrasound not only yields superior procedural advantages but also provides a platform to perform a thorough assessment of the vascular structures to evaluate vessel health, viability, size, and patency, including the location of other important and best avoided anatomical structures-prior to performing any procedures...
October 4, 2018: Journal of Vascular Access
Shayne D Hauglum, Nichole A Crenshaw, Karina A Gattamorta, Greta Mitzova-Vladinov
INTRODUCTION: Ultrasound-guided central venous catheter insertion (UGCVC) is a commonly performed procedure taught through simulation. The aims of the study were to examine the utilization of an animal model and compare it with two currently used Blue Phantom central line models to determine whether an animal model provides good or better simulated conditions for the performance of UGCVC insertion. METHODS: Using a randomized cross-over study, 46 advanced practice nursing students were assessed using a task-specific performance tool in their performance of UGCVC insertion on both the animal model and the Blue Phantom models...
October 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Kunitaro Watanabe, Joho Tokumine, Alan Kawarai Lefor, Akira Motoyasu, Kumi Moriyama, Tomoko Yorozu
The short-axis out-of-plane approach (SAX-OOP) is commonly used in ultrasound-guided internal jugular vein catheterization. However, this approach has a risk of posterior vein wall injuries. The authors hypothesized that a shallow angle of approach may reduce the rate of posterior wall injuries compared with the conventional steep angle approach. The present study aimed to evaluate whether a difference in the angle of approach of the needle affects the rate of posterior wall injuries. The present study was a randomized crossover-controlled trial involving 40 medical residents, conducted in the clinical training center at a hospital with a residency program...
2018: BioMed Research International
Jun Takeshita, Kei Nishiyama, Atsushi Fukumoto, Nobuaki Shime
OBJECTIVE: Visualizing the needle tip using the short-axis out-of-plane (SA-OOP) ultrasound-guided central venous catheterization approach is difficult and results in posterior wall puncture (PWP). To improve needle tip visualization in the long-axis view, combining the SA-OOP and the long-axis in-plane approaches has been suggested. The authors, who previously reported on the utility of this technique using a manikin model, examined the feasibility of this novel method (referred to as the combined short-axis and long-axis [CSLA] approach) and compared the CSLA approach with the SA-OOP approach in humans for the present study...
August 9, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Terrell Caffery, Tonya Jagneaux, Glenn N Jones, Erik Stopa, Nathan Freeman, Cara Cantelli Quin, Ann C Long, Lauren Zatarain, Mandi W Musso
Background: Obtaining central venous cannulation of the internal jugular vein is an important skill for physicians to master. To our knowledge, no studies to date have examined residents' preferences or the safety of the oblique approach compared to other approaches. This study compared medical residents' preferences for and performance of ultrasound-guided central venous access using the transverse, longitudinal, and oblique approaches. Methods: Emergency medicine and internal medicine residents (n = 72) at an urban community hospital participated in a central venous access course...
2018: Ochsner Journal
Michael Wagner, Kirstin Hauser, Francesco Cardona, Georg M Schmölzer, Angelika Berger, Monika Olischar, Tobias Werther
OBJECTIVES: Critically ill neonatal and pediatric patients often require central vascular access. Real-time ultrasound guidance for central venous catheterization is beneficial. Because the diameter of central veins is much smaller in neonates than in adults, extensive training is needed to master the visualization and catheterization of central veins in neonates. This study assessed the learning effect of a standardized simulation-based teaching program on ultrasound-guided cannulation in a low-cost cadaver tissue model...
September 18, 2018: Pediatric Critical Care Medicine
Stacy Libricz, Ayan Sen, Victor Davila, Jeff Mueller, Alyssa Chapital, Samuel Money
INTRODUCTION: Despite ultrasound use, accidental carotid cannulation is possible during placement of a central venous catheter (CVC), requiring operative repair of the carotid artery and removal of the catheter. CASE PRESENTATION: We report 2 cases-a 59-year-old Hispanic man and an 86-year-old white man-of inadvertent placement of a CVC into the left common carotid artery, removed via a pull-and-pressure technique under real-time ultrasound guidance. No complications occurred and follow-up imaging was negative for fistula creation, hematoma, or cerebral infarcts...
August 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
Takuma Nakatsuka, Yoko Soroida, Hayato Nakagawa, Takahiro Shindo, Masaya Sato, Katsura Soma, Ryo Nakagomi, Tamaki Kobayashi, Momoe Endo, Hiromi Hikita, Mamiko Sato, Hiroaki Gotoh, Tomomi Iwai, Mariko Yasui, Aya Shinozaki-Ushiku, Kazuhiro Shiraga, Hiroko Asakai, Yoichiro Hirata, Masashi Fukayama, Hitoshi Ikeda, Yutaka Yatomi, Ryosuke Tateishi, Ryo Inuzuka, Kazuhiko Koike
AIM: Liver fibrosis caused by congestive hepatopathy has emerged as an important complication after Fontan procedure. We evaluated the utility of the hepatic vein (HV) waveform using Doppler ultrasound for identification of liver fibrosis in Fontan patients. METHODS: We investigated the HV waveforms in 41 Fontan patients and assessed correlations with clinical parameters, liver fibrosis markers, and hemodynamic data. RESULTS: Based on our preliminary analysis of 64 adult patients with chronic liver disease who underwent liver biopsy, we classified HV waveforms into five types with reference to the degree of flattening (from type 1, normal triphasic waveform; to type 5, a monophasic waveform indicating cirrhosis), and confirmed a significant correlation between waveform pattern and fibrosis stage...
September 4, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Mojtaba Chardoli, Mitra Ahmadi, Omid Shafe, Hooman Bakhshandeh
Background: Knowledge of intravascular volume (IV) status of a hypotensive patient is of utmost importance. Clinical evaluation and central venous pressure (CVP) measurement are routinely used as a guide for evaluation of IV in these patients. However, clinical assessment may be inaccurate, and CVP measurement is invasive. Moreover, CVP changes slowly with saline therapy, which is unfavorable for fluid resuscitation. Aim: Our aim is to find the correlation and sensitivity of inferior vena cava (IVC) diameter measured by ultrasound to provide a noninvasive method for evaluation of IV among patients with hypotension and hypovolemia in the emergency department (ED)...
July 2018: International Journal of Critical Illness and Injury Science
Hao Feng, Zhanqiang Jin, Wen He, Xingquan Zhao
Cerebrospinal venous anatomy and hemodynamics changes are associated with many central nervous system disorders.The aim of this study was to detect whether perihematomal edema (PHE) after spontaneous intracerebral hemorrhage (sICH) is associated with cerebral venous outflow volume (CVFV) in the internal jugular veins and vertebral veins.Newly diagnosed cases of sICH between April 2016 and March 2017 were enrolled and patients were grouped to the mean value of PHE according to previous study. On computed tomography, absolute PHE volume was calculated as the difference between total lesion volume and intracerebral hemorrhage (ICH) volume...
August 2018: Medicine (Baltimore)
Tülay Şahin, Onur Balaban
Ultrasonography has gained popularity in recent years among anaesthesiologists and being used widely for regional blocks and central venous catheterization. Ultrasonography for neuraxial blocks was found beneficial especially for determining the correct needle insertion site and estimating the needle insertion depth of epidural space. In many recent studies, ultrasound guided epidural and spinal blocks have been evaluated among obstetric patients. Pre-procedural lumbar ultrasonography and real time ultrasound guidance for neuraxial blocks was the subject of these studies...
August 2018: Turkish Journal of Anaesthesiology and Reanimation
Sander Rozemeijer, Jelle L G Haitsma Mulier, Jantine G Röttgering, Paul W G Elbers, Angélique M E Spoelstra-de Man, Pieter Roel Tuinman, Monique C de Waard, Heleen M Oudemans-van Straaten
INTRODUCTION: Shock is characterised by micro- and macrovascular flow impairment contributing to acute kidney injury (AKI). Routine monitoring of the circulation regards the macrocirculation but not the renal circulation which can be assessed with Doppler ultrasound as renal resistive index (RRI). RRI reflects resistance to flow. High RRI predicts persistent AKI. Study aims were to determine whether RRI is elevated in shock and to identify determinants of RRI. MATERIALS AND METHODS: This prospective observational cohort study included two cohorts of patients, with and without shock <24-h after intensive care admission...
August 14, 2018: Shock
Matthew J Kaptein, John S Kaptein, Zayar Oo, Elaine M Kaptein
Background: Ultrasound (US) assessment of intravascular volume may improve volume management of dialysis patients. We investigated the relationship of intravascular volume evaluated by inferior vena cava (IVC) US to net volume changes with intermittent hemodialysis (HD) in critically ill patients. Methods: A retrospective cohort of 113 intensive care unit patients in 244 encounters had clinical assessment of intravascular volume followed by US of respiratory/ventilatory variation of IVC diameter, and had HD within 24 h...
2018: International Journal of Nephrology and Renovascular Disease
Xingwei Sun, Jin Xu, Rui Xia, Caishan Wang, Ziyang Yu, Jian Zhang, Xuming Bai, Yong Jin
BACKGROUND: Totally implantable venous access ports (TIVAPs) are widely used and are an essential tool in the efficient delivery of chemotherapy. This study aimed to evaluate the feasibility and safety of implantation of ultrasound (US)-guided TIVAPs via the right innominate vein (INV) for adult patients with cancer. METHODS: This study retrospectively reviewed the medical records of 283 adult patients with cancer who underwent US-guided INV puncture for TIVAPs between September 2015 and September 2017...
July 26, 2018: European Journal of Surgical Oncology
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
A Michon, S Jammal, A Passeron, G De Luna, C Bomahou, V Jullien, J Pouchot, J-B Arlet, B Ranque
INTRODUCTION: Point of care ultrasound (POCUS) is routinely used by intensivists and emergency physicians for many years. Its interest is not arguable any more for these specialists, despite the large variety of diseases they care. Hospitalists and internists also should find some interest in POCUS, which convenience and wide range of indications responds well to the variety of their practice. However, it is still not widely used in internal medicine departments. METHODS: We here report our experience of using a pocket-sized ultrasound device in a French internal medicine department...
August 2, 2018: La Revue de Médecine Interne
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