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https://www.readbyqxmd.com/read/28394005/-buddy-wire-for-facilitation-of-femoral-venous-access-for-cryoablation-a-preliminary-report
#1
Aleksander Maciąg, Michał Farkowski, Jan Ciszewski, Mariusz Pytkowski, Hanna Szwed
BACKGROUND: Some electrophysiological techniques, such as balloon cryoablation, involve the use of steerable sheaths of large diameter (outer diameter 15Fr or more). Their introduction to the femoral vein may be difficult, especially in patients who have had numerous venipunctures in this area. The authors describe a modification of typical venous access with the use of a "buddy wire" technique, facilitating the insertion of the cryoablation sheaths to the femoral vein. METHODS: A case-control study...
April 10, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28363466/primary-prophylaxis-in-haemophilia-care-guideline-update-2016
#2
Kathelijn Fischer, Rolf Ljung
This paper reviews the current status on recommendations or guidelines for primary prophylaxis based on recent published papers from organizations or group of experts as well as some original key papers. A rather uniform view exists that prophylaxis should be initiated at an early age before or after no more than a single joint bleed and, if possible, preferably be continued for life. The dose and dose frequency of prophylaxis is dependent on the goal of treatment, bleeding phenotype, compliance, venous access and economic resources in the health care system and should be tailored individually based on clinical outcome and pharmacokinetics...
March 18, 2017: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/28349586/transfemoral-access-when-superior-venous-approach-is-not-feasible-equals-overall-success-of-permanent-pacemaker-implantation-ten-year-series
#3
Juan J García Guerrero, Joaquín Fernández de la Concha Castañeda, Manuel Doblado Calatrava, Ángel Redondo Méndez, Manuel Lázaro Medrano, Antonio Merchán Herrera
BACKGROUND: When permanent pacemaker implantation is not possible or advisable via superior venous access (i.e., axillary or subclavian veins), safe and feasible surgical alternatives are required. The femoral approach is relatively unknown and seldom studied. This single-centre study analysed 10-year outcomes of a femoral implantation approach. METHODS: Data about the implantation procedure (indication, approach, lead and pacemaker models, complications), patient characteristics (age, sex, medications, comorbidities), and follow-up were analysed for all permanent pacemaker implantations using the femoral approach between June 2001 and June 2011...
March 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28342192/intravenous-versus-non-intravenous-benzodiazepines-for-the-abortion-of-seizures-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Abdussalam Alshehri, Ahmad Abulaban, Rakan Bokhari, Suleiman Kojan, Majid Alsalamah, Mazen Ferwana, Mohammad Hassan Murad
BACKGROUND: The acquisition of intravenous access in the actively convulsing patient is difficult. This often delays the administration of the intravenous benzodiazepine necessary for seizure abortion. Delays in seizure abortion are associated with increased pharmacoresistance, increased risk of neuronal injury, worse patient outcomes and increased morbidity. OBJECTIVE: To assess whether the delay imposed by IV access acquisition is justified by improved outcomes...
March 25, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28319286/a-successful-model-to-learn-and-implement-ultrasound-guided-venous-catheterization-in-apheresis
#5
Nigopan Gopalasingam, Anna-Marie Eller Thomsen, Lars Folkersen, Peter Juhl-Olsen, Erik Sloth
BACKGROUND: Apheresis treatments can be performed with peripheral venous catheters (PVC), although central venous catheters (CVC) are inserted when PVCs fail or patient with history of difficult vascular access prior to the apheresis. Ultrasound guidance for PVC has shown promising results in other settings. PURPOSE: To investigate if ultrasound guidance for PVC could be implemented among apheresis nurses. Second, how implementation of ultrasound guidance affected the number of CVCs used for apheresis per patient...
March 20, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28303559/-thoracic-outlet-syndrome
#6
Sven Seifert, Pavel Sebesta, Marian Klenske, Mirko Esche
Introduction Thoracic outlet syndrome (TOS) is one of the most extensively discussed diagnoses. There is neither a clear and homogenous clinical presentation nor an accepted definition. The term describes a complex of symptoms and complaints caused by the compression of nerves and vascular structures at one of the three defined constrictions of the upper thoracic aperture. Methods Based on a comprehensive literature review, this article presents the etiology, epidemiology and clinical diagnostics as well as the possibilities and outcomes of surgical treatment...
February 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28302350/primary-prophylaxis-in-haemophilia-care-guideline-update-2016
#7
Kathelijn Fischer, Rolf Ljung
This paper reviews the current status on recommendations or guidelines for primary prophylaxis based on recent published papers from organizations or group of experts as well as some original key papers. A rather uniform view exists that prophylaxis should be initiated at an early age before or after no more than a single joint bleed and, if possible, preferably be continued for life. The dose and dose frequency of prophylaxis is dependent on the goal of treatment, bleeding phenotype, compliance, venous access and economic resources in the health care system and should be tailored individually based on clinical outcome and pharmacokinetics...
February 17, 2017: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/28279404/strategies-for-hemodialysis-access-a-vascular-surgeon-s-perspective
#8
Larry A Scher, Saadat Shariff
Problems related to hemodialysis access are a significant cause of morbidity and mortality in patients with end-stage renal disease. Physicians of all specialties who are involved in the placement and maintenance of vascular access for hemodialysis must have a long-term strategy for sequential placement of autogenous fistulas, transpositions, and prosthetic grafts to preserve access sites and to avoid long-term use of tunneled dialysis catheters. The Fistula First and KDOQI initiatives have provided strategies and algorithms for access placement in patients with chronic kidney disease...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28243995/septic-pulmonary-emboli-detected-by-18-f-fdg-pet-ct-in-children-with-s-aureus-catheter-related-bacteremia
#9
A Méndez-Echevarria, M Coronado-Poggio, F Baquero-Artigao, T Del Rosal, S Rodado-Marina, C Calvo, L Domínguez-Gadea
PURPOSE: The role of (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET/CT) in the diagnosis of metastatic infectious foci in children with catheter-related blood stream infection has been hardly studied, although some authors have reported it benefit in the screening of metastatic foci in adult population. Septic pulmonary emboli are among the most difficult to identify, because many cases do not present pulmonary complaints or abnormal chest radiography...
February 27, 2017: Infection
https://www.readbyqxmd.com/read/28223086/long-term-10-year-outcomes-after-laparoscopic-roux-en-y-gastric-bypass
#10
Shanu N Kothari, Andrew J Borgert, Kara J Kallies, Matthew T Baker, Brandon T Grover
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the "gold standard" for weight loss surgery. Long-term data are limited, and reporting methods for LRYGB outcomes vary in the literature. In addition, follow-up compliance within bariatric centers is poor due to insurance and access to care issues, making long-term follow-up evaluation difficult. OBJECTIVE: Evaluate long-term LRYGB outcomes using standard outcome reporting definitions. SETTING: Integrated multispecialty health system...
December 22, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28169811/-improve-the-extravasation-assessment-of-peripheral-venous-catheter-by-nurses-with-the-establishment-of-a-standardized-instrument-and-suitable-for-children
#11
Nathalie Bochaton, Anne Sylvie Ramelet, Peter Rimensberger, Jean-Marie Januel
In pediatric and neonatal intensive care units, severity assessment of extravasation is difficult, considering the specificity of this population. The purpose of this study was to demonstrate the ability to improve the measurement of extravasation by nurses with the establishment of a standardized instrument and suitable for children. 66 nurses, randomly assigned to two groups, assessed the severity of extravasations using 15 clinical vignettes.The intervention group with the Pediatric Peripheral Intravenous Infiltration Scale (PIV Scale) (n=33) and the control group based on clinical judgment only (n=33)...
2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28165645/prevalence-of-difficult-venous-access-and-associated-risk-factors-in-highly-complex-hospitalised-patients
#12
Victoria Armenteros-Yeguas, Lucía Gárate-Echenique, Maria Aranzazu Tomás-López, Estíbaliz Cristóbal-Domínguez, Breno Moreno-de Gusmão, Erika Miranda-Serrano, Maria Inmaculada Moraza-Dulanto
AIMS AND OBJECTIVES: To estimate the prevalence of difficult venous access in complex patients with multimorbidity and to identify associated risk factors. BACKGROUND: In highly complex patients, factors like ageing, the need for frequent use of irritant medication and multiple venous catheterisations to complete treatment could contribute to exhaustion of venous access. DESIGN: A cross-sectional study was conducted. METHODS: 'Highly complex' patients (n = 135) were recruited from March 2013-November 2013...
February 6, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27995292/initial-experience-with-elective-perventricular-melody-valve-placement-in-small-patients
#13
Aamisha Gupta, Damien Kenny, Massimo Caputo, Zahid Amin
Perventricular Melody valve placement has been described as a bailout approach or alternative RVOT approach in patients >30 kg. We present three patients <20 kg and two patients with limited venous access, where we electively performed the perventricular approach. Retrospective analysis of patients <30 kg and vascular access limitation undergoing elective hybrid pulmonary valve replacement were reviewed. The subcostal approach was performed without sternotomy with the sheath introduced through the diaphragmatic surface of the right ventricle...
March 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27984318/systemic-inflammatory-response-syndrome-is-not-an-indicator-of-bateremia-in-hemodialysis-patients-with-native-accesses-a-multicenter-study
#14
Daisuke Uchida, Sho Sasaki, Hiroo Kawarazaki, Masahito Miyamoto, Atsushi Nomura, Kenichiro Koitabashi, Hiroki Nishiwaki, Yugo Shibagaki
Bloodstream infection (BSI) in hemodialysis (HD) patients is often difficult to diagnose. Systemic inflammatory response syndrome (SIRS) is a sensitive predictor of BSI in the general population. We aimed to assess the usefulness of SIRS in predicting BSI in HD patients.We designed a multi-center retrospective observational study of adult (age > 18 years) HD patients who underwent 2 sets of blood cultures for suspected BSI at first hospital visit from August 2011 to July 2012. Clinical, biological, and microbial data were evaluated to evaluate SIRS as a predictor of BSI upon initial presentation to the hospital...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27813144/arterio-venous-fistula-for-automated-red-blood-cells-exchange-in-patients-with-sickle-cell-disease-complications-and-outcomes
#15
Marianne Delville, Sandra Manceau, Nassim Ait Abdallah, Jan Stolba, Sameh Awad, Thibaud Damy, Barnabas Gellen, Laurent Sabbah, Karima Debbache, Vincent Audard, Jean-Louis Beaumont, Cécile Arnaud, Christelle Chantalat-Auger, Françoise Driss, François Lefrère, Marina Cavazzana, Gilbert Franco, Frederic Galacteros, Jean-Antoine Ribeil, Justine Gellen-Dautremer
Erythrocytapheresis (ER) can improve outcome in patients with sickle cell disease (SCD). A good vascular access is required but frequently it can be difficult to obtain for sickle cell patients. Arterio-venous fistulas (AVFs) have been suggested for ER in SCD supported by limited evidence. We report the largest cohort of ER performed with AVFs from three French SCD reference centers. Data of SCD patients undergoing ER with AVFs in the French SCD reference center were retrospectively collected. The inclusion criteria were: SS or Sβ-Thalassemia and AVF surgery for ER...
February 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/27809922/analysis-of-thromboelastography-pt-aptt-and-fibrinogen-in-intraosseous-and-venous-samples-an-experimental-study
#16
Gunnar Strandberg, Miklós Lipcsey, Mats Eriksson, Norbert Lubenow, Anders Larsson
BACKGROUND: Laboratory analysis of coagulation is often important in emergencies. If vascular access is challenging, intraosseous catheterization may be necessary for treatment. We studied the analysis of coagulation parameters in intraosseous aspirate during stable conditions and after major haemorrhage in a porcine model. METHODS: Ten anesthetized pigs received central venous and intraosseous catheters and samples were taken for analysis of thromboelastography (TEG), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen concentration...
November 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27791256/a-systematic-review-of-management-of-inadvertent-arterial-injury-during-central-venous-catheterisation
#17
Oliver G B Dixon, George E Smith, Daniel Carradice, Ian C Chetter
INTRODUCTION: Central venous catheterisation (CVC) is a technique commonly used to obtain vascular access and over five million CVCs are inserted annually. This systematic review of CVC-related arterial injury aims to compare outcomes reported with different management strategies. METHODS: PRISMA guidelines were followed. A search of Medline, Embase, Central and CINAHL was performed. Results were limited to papers in humans and in English with duplicates removed...
October 22, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27780607/ultrasound-guided-deep-arm-veins-insertion-of-long-peripheral-catheters-in-patients-with-difficult-venous-access-after-cardiac-surgery
#18
Adam Fabiani, Lorella Dreas, Gianfranco Sanson
OBJECTIVES: To analyze success rate, dwell-time, and complications of long peripheral venous catheters (L-PVCs) inserted under ultrasound guidance. BACKGROUND: In difficult venous access (DVA) patients, L-PVC can represent an alternative to central or midline catheters. METHODS: Prospective observational study. L-PVCs were positioned in DVA patients. The outcome of the cannulation procedure and the times and reasons for catheters removal were analyzed...
January 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27779964/intraosseous-infusion-as-a-bridge-to-definitive-access
#19
Megan Johnson, Kenji Inaba, Saskya Byerly, Erika Falsgraf, Lydia Lam, Elizabeth Benjamin, Aaron Strumwasser, Jean-Stephane David, Demetrios Demetriades
Intraosseous (IO) needle placement is an alternative for patients with difficult venous access. The purpose of this retrospective study was to examine indications and outcomes associated with IO use at a Level 1 trauma center (January 2008-May 2015). Data points included demographics, time to insertion, intravenous (IV) access points, indications, infusions, hospital and intensive care unit length of stay, and mortality. Of 68 patients with IO insertion analyzed (63.2% blunt trauma, 29.4% penetrating trauma, and 7...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27766056/aspects-of-prophylactic-treatment-of-hemophilia
#20
REVIEW
Rolf Ljung
Retrospective and prospective studies unambiguously show that prophylactic treatment of severe hemophilia A or B should be started as primary prophylaxis at 1-2 years' of age and ideally before the first joint bleed. The dose and dose frequency should be individually tailored depending on the goal of treatment, venous access and the bleeding phenotype. The circumstances during the first exposures of factor VIII concentrates in hemophilia A may have an impact on the risk of developing inhibitors. Enhanced half-life products, in particular in hemophilia B, will facilitate treatment in patients with difficult venous access but also in achieving a higher trough level...
2016: Thrombosis Journal
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