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Dia Byrne, Linda Penwarden
The purpose of this article is to share the efforts of one institution in reducing risk of central line-associated bloodstream infections (CLABSIs). The aim is to review alteplase use as a marker for peripherally inserted central catheter (PICC) occlusions, which may increase risk of CLABSIs. The discovery that alteplase use increased with the number of PICC lumens allowed for exploration of ordering and placement practices. Following education, placement of double-lumen PICCs decreased.
March 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Ralph Gnannt, Nicolas Waespe, Michael Temple, Afsaneh Amirabadi, Kuan Liu, Leonardo R Brandão, Bairbre L Connolly
BACKGROUND: Peripherally inserted central catheters (PICCs) are associated with superficial and deep venous thrombosis of the arm. OBJECTIVE: The purpose of this study was to analyze the sequelae of repeated upper limb PICC insertions in children, in terms of the frequency of upper limb thrombosis in this patient group. MATERIALS AND METHODS: The study population included all children who underwent their first successful arm PICC insertion between January 2010 and December 2015...
February 27, 2018: Pediatric Radiology
Jonathan Tak Loong Lee, James Ricketts
Displacement of peripherally inserted central catheter (PICC) lines during contrast-enhanced computed tomography examinations is an underappreciated phenomenon. We report a case of iatrogenic PICC line displacement following the power injection of contrast during a computed tomography pulmonary angiogram. During the study, the PICC line was shown to move on 2 occasions, resulting in 2 nondiagnostic studies. We review the available literature on the topic and suggest possible strategies to avoid this phenomenon...
December 2017: Radiology Case Reports
Vidit Bhargava, Lovya George, Michael Malloy, Rafael Fonseca
OBJECTIVE:  Peripherally inserted central catheter (PICC) line removal is associated with bloodstream infections and clinical sepsis. We aim to investigate the role of a single prophylactic dose of vancomycin in decreasing the incidence of central line associated bloodstream infection associated with PICC removal. METHODS:  A retrospective chart review of patients in the neonatal intensive care unit was conducted. Patients were divided into two study groups based on whether a single dose of vancomycin was administered (exposed) or not (nonexposed)...
February 23, 2018: American Journal of Perinatology
Deepak Sharma, Nazanin Farahbakhsh, Seyyed Ahmad Tabatabaii
Central catheters are known as "life lines" in intensive care units and are used frequently in neonatal intensive care unit (NICU) for multiple indications. The central catheters used in NICU includes umbilical venous catheter (UVC), umbilical arterial catheter (UAC) and peripherally inserted central catheter (PICC) lines. The tip of these central lines need to be in correct position as malpositioned central line tips leads to many neonatal complications. Radiograph either abdomen or chest is the most widely used modality for locating the tip of central catheter...
February 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
Wensen Chen, Yiqun Yang, Huifen Li, Xiaoqiang Huang, Weihong Zhang
No abstract text is available yet for this article.
January 2018: Infection Control and Hospital Epidemiology
Cristen N Litz, Jordan G Tropf, Paul D Danielson, Nicole M Chandler
PURPOSE: There is debate regarding the optimal timing of central line removal in the neonatal intensive care unit (NICU). The purpose was to evaluate outcomes of idle peripherally inserted central catheters (PICCs) and tunneled central venous catheters (TCVCs) and determine the incidence of line-related infections and replacements. METHODS: Patients in the NICU with T-CVCs placed between 11/2008 and 8/2015 (n=134) or PICCs placed between 7/2013 and 10/2015 (n=467) were included...
November 9, 2017: Journal of Pediatric Surgery
Kristen M Tecson, Anupama Vasudevan, Amarinder Bindra, Susan M Joseph, Joost Felius, Shelley A Hall, Parag Kale
The pulmonary artery catheter (PAC) remains the gold standard to calculate Fick cardiac outputs (FCOs) in patients with heart failure admitted to the intensive care unit (ICU). The peripherally inserted central catheter (PICC) provides long-term intravenous access and is used outside the ICU; however, there is scant literature validating venous oxygen saturations (VOSs) from PICC lines. Heart failure patients in the ICU with an existing PAC requiring a PICC line to transition were enrolled. Three blood samples were taken per person (1 at PICC, 1 at central venous pressure [CVP], and 1 at distal PAC)...
January 1, 2018: American Journal of Cardiology
Nitin Rajput, Julia Filipovska, Michael Hewson
Rajput N, Filipovska J, Hewson M. The effects of routine administration of probiotics on the length of central venous line usage in extremely premature infants. Turk J Pediatr 2017; 59: 20-27. The objective of this study was to determine whether the routine use of probiotics was associated with earlier removal of peripherally inserted central catheter (PICC) lines in extremely premature infants born ≤28 weeks' gestation. This study was a retrospective, observational, cohort study in infants born ≤28 weeks gestation in the 2 years before [No Probiotic Group (NPG)] and after [Probiotic Group (PG)] the commencement of the routine use of probiotics (lnfloran®) in a large tertiary neonatal intensive care unit in the North Island of New Zealand...
2017: Turkish Journal of Pediatrics
Petter Holmlund, Anders Eklund, Lars-Owe D Koskinen, Elias Johansson, Nina Sundström, Jan Malm, Sara Qvarlander
Recent interest in intracranial pressure (ICP) in the upright posture has revealed that the mechanisms regulating postural changes in ICP are not fully understood. We have suggested an explanatory model where the postural changes in ICP depend on well-established hydrostatic effects in the venous system and where these effects are interrupted by collapse of the internal jugular veins (IJVs) in more upright positions. The aim of this study was to investigate this relationship by simultaneous invasive measurements of ICP, venous pressure and IJV collapse in healthy volunteers...
November 8, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Stefano Benvenuti, Rosanna Ceresoli, Giovanni Boroni, Filippo Parolini, Fulvio Porta, Daniele Alberti
INTRODUCTION: The aim of our study was to present our experience with the use of peripherally inserted central catheters (PICCs) in pediatric patients receiving autologous or allogenic blood stem-cell transplantation. The insertion of the device in older children does not require general anesthesia and does not require a surgical procedure. METHODS: From January 2014 to January 2017, 13 PICCs were inserted as a central venous device in 11 pediatric patients submitted to 14 autologous or allogeneic stem-cell transplantation, at the Bone Marrow Transplant Unit of the Children's Hospital of Brescia...
October 31, 2017: Journal of Vascular Access
Ulas M Camsari, Claudia R Libertin
Background  An active intravenous substance use disorder is often the primary cause of infectious diseases in this population of users and creates a barrier to successful parenteral antimicrobial management. The dilemma is compounded by dramatically limited resources in small US towns. Methods This retrospective review from January 2014 through July 2016 aimed to develop a risk stratification approach to aid rural healthcare providers in determining who among patients with addictive disorders could safely be discharged for outpatient antimicrobial therapy with a peripherally inserted central catheter (PICC)...
August 18, 2017: Curēus
Hyunkwang Lee, Mohammad Mansouri, Shahein Tajmir, Michael H Lev, Synho Do
A peripherally inserted central catheter (PICC) is a thin catheter that is inserted via arm veins and threaded near the heart, providing intravenous access. The final catheter tip position is always confirmed on a chest radiograph (CXR) immediately after insertion since malpositioned PICCs can cause potentially life-threatening complications. Although radiologists interpret PICC tip location with high accuracy, delays in interpretation can be significant. In this study, we proposed a fully-automated, deep-learning system with a cascading segmentation AI system containing two fully convolutional neural networks for detecting a PICC line and its tip location...
October 5, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
James D Stewart, Naomi Runnegar
BACKGROUND: Management of Staphylococcus aureus bacteraemia (SAB) includes prolonged intravenous antibiotics often administered through a peripherally inserted central catheter (PICC). Optimal timing of PICC insertion for SAB treatment is unknown. There are concerns that early insertion may increase the risk of subsequent line infection. AIMS: This retrospective audit aims to determine if early PICC insertion is safe. The outcomes considered included crude mortality, attributable mortality, PICC line infections, duration of bacteraemia and relapsed SAB...
January 2018: Internal Medicine Journal
J S Garland, S Kanneberg, K A Mayr, D M Porter, A Vanden Heuvel, J Kurziak, T L McAuliffe
OBJECTIVE: We hypothesized that infectious morbidities following percutaneously inserted central venous catheter (PICC) removal would be greater among neonates with central-line associated bloodstream infection (CLBASI). STUDY DESIGN: This retrospective cohort study, included all neonates who required a PICC over a ten-year period. Outcomes assessed following PICC removal included: late bloodstream infection, rule-out sepsis workups, need for a subsequent PICC and antibiotic days and PICC days after PICC removal...
2017: Journal of Neonatal-perinatal Medicine
Michael Martyak, Ishraq Kabir, Rebecca Britt
Peripherally inserted central venous catheters (PICCs) are now commonly used for central access in the intensive care unit (ICU) setting; however, there is a paucity of data evaluating the complication rates associated with these lines. We performed a retrospective review of all PICCs placed in the inpatient setting at our institution during a 1-year period from January 2013 to December 2013. These were divided into two groups: those placed at the bedside in the ICU and those placed by interventional radiology in non-ICU patients...
August 1, 2017: American Surgeon
Erica Herc, Payal Patel, Laraine L Washer, Anna Conlon, Scott A Flanders, Vineet Chopra
BACKGROUND Peripherally inserted central catheters (PICCs) are associated with central-line-associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. OBJECTIVE To operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual's risk of PICC-CLABSI prior to device placement. METHODS Using data from the Michigan Hospital Medicine Safety consortium, patients that experienced PICC-CLABSI between January 2013 and October 2016 were identified...
October 2017: Infection Control and Hospital Epidemiology
Bradley J Stringer, Spencer B Shumway, Matthew D Holbrook, Cameron G Copeland, Alexander A Gosch, Kai Kück
There are a limited number of methods to guide and confirm the placement of a peripherally-inserted central catheter (PICC) at the cavoatrial junction. The aim of this study was to design, test, and validate a dual wavelength, diode laser-based, single optical fiber instrument that would accurately confirm PICC tip location at the cavoatrial junction of an animal heart, in vivo. This was accomplished by inserting the optical fiber into a PICC and ratiometrically comparing simultaneous visible and near-infrared reflection intensities of venous and atrial tissues found near the cavoatrial junction...
August 3, 2017: Journal of Biophotonics
Nagsen Telang, Deepak Sharma, Oleti Tejo Pratap, Hemasree Kandraju, Srinivas Murki
BACKGROUND & OBJECTIVES: Securing long-term venous access is an essential part of sick newborn care. The malposition of central line tip leads to several complications. There is a need for an easily available bedside investigating tool to diagnose these malpositions. This study was done to compare the effectiveness of real-time ultrasound (RTUS) with X-ray in identifying the peripherally inserted central catheter (PICC) line tip. METHODS: This pilot observational study was conducted in a level III Neonatal Intensive Care Unit of a tertiary care hospital in India, from June 2012 to June 2013...
March 2017: Indian Journal of Medical Research
Sarah Keulemans, M Voormolen, M Deplancke, H Blom
No abstract text is available yet for this article.
November 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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