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https://www.readbyqxmd.com/read/28169811/am%C3%A3-lioration-de-la-mesure-d%C3%A2-extravasation-des-cath%C3%A3-ters-veineux-p%C3%A3-riph%C3%A3-riques-par-les-infirmi%C3%A3-res-en-p%C3%A3-diatrie-gr%C3%A3-ce-%C3%A3-l%C3%A2-utilisation-d%C3%A2-un-instrument-d%C3%A2-%C3%A3-valuation-sp%C3%A3-cifique
#1
Nathalie Bochaton, Anne Sylvie Ramelet, Peter Rimensberger, Jean-Marie Januel
<ce:para>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)...
October 27, 2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28165645/prevalence-of-difficult-venous-access-and-associated-risk-factors-in-highly-complex-hospitalized-patients
#2
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
#3
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...
December 20, 2016: 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27743023/a-technique-for-re-utilizing-catheter-insertion-sites-in-children-with-difficult-central-venous-access
#11
S M Johnson, G M Garnett, R K Woo
Maintenance of central venous access in patients with chronic medical conditions such as short bowel syndrome demands forethought and ingenuity. We describe an innovative technique for re-utilizing central venous access sites in patients who have chronic central venous access needs. Records of patients undergoing this technique were reviewed between August 2012 and December 2015. The technique involves "cutting-down" to the sterile fibrous tunnel that naturally forms around tunneled catheters. The fibrous sheath is then isolated and controlled much as would be done for a venous "cut-down...
October 14, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27695218/hickman-to-central-venous-catheter-a-case-of-difficult-venous-access-in-a-child-suffering-from-acute-lymphoblastic-leukemia
#12
Arunangshu Chakraborty, Sanjit Agrawal, Taniya Datta, Suparna Mitra, Rakhi Khemka
Chemotherapy in children suffering from cancer usually requires placement of an indwelling central venous catheter (CVC). A child may need to undergo repeated procedures because of infection and occlusion of previous access devices. We present a case of CVC insertion in a child suffering from acute lymphoblastic leukemia where an innovative technique was employed.
October 2016: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/27658558/safety-and-efficacy-of-the-easy-internal-jugular-ij-an-approach-to-difficult-intravenous-access
#13
Siamak Moayedi, Michael Witting, Matthew Pirotte
BACKGROUND: The easy internal jugular (Easy IJ) technique involves placement of a single-lumen catheter in the internal jugular vein using ultrasound guidance. This technique is used in patients who do not have suitable peripheral or external jugular venous access. The efficacy and safety of this procedure are unknown. OBJECTIVE: We aimed to estimate efficacy and safety parameters for the Easy IJ when used in emergency department (ED) settings. METHODS: We conducted a prospective study of the Easy IJ in stable ED patients with severe intravenous access difficulty...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27629755/ultrasound-guided-peripheral-intravenous-catheter-training-results-in-physician-level-success-for-emergency-department-technicians
#14
Petra Duran-Gehring, Laurie Bryant, Jennifer A Reynolds, Petra Aldridge, Colleen J Kalynych, Faheem W Guirgis
OBJECTIVES: To report our success and complication rates with emergency department (ED) technician-performed ultrasound (US)-guided peripheral intravenous (IV) catheter placement and to compare our results to similar studies in the literature. METHODS: We conducted a retrospective review of a prospective database of patients who underwent US-guided peripheral IV catheter placement attempts for clinical care in the ED. All patients meeting difficult IV access criteria who had a US-guided peripheral IV catheter placement attempted by a trained ED technician were included...
November 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27623619/treatment-with-high-dose-recombinant-human-hyaluronidase-facilitated-subcutaneous-immune-globulins-in-patients-with-juvenile-dermatomyositis-who-are-intolerant-to-intravenous-immune-globulins-a-report-of-5-cases
#15
Fabian Speth, Johannes-Peter Haas, Claas H Hinze
BACKGROUND: High-dose intravenous immune globulins (IVIg) are frequently used in refractory juvenile dermatomyositis (JDM) but are often poorly tolerated. High-dose recombinant human hyaluronidase-facilitated subcutaneous immune globulins (fSCIg) allow the administration of much higher doses of immune globulins than conventional subcutaneous immune globulin therapy and may be an alternative to IVIg. The safety and efficacy of fSCIg therapy in JDM is unknown. CASE PRESENTATION: In this retrospective case series, five patients with steroid-refractory severe JDM were treated with high-dose fSCIg due to IVIg adverse effects (severe headaches, nausea, vomiting, difficult venous access)...
September 13, 2016: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/27524271/-insulinoma-and-pregnancy-anesthesia-and-perioperative-management
#16
Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, José Hélio Zen Junior, Maria José Nascimento Brandão, Giancarlo Antonio Marcondes, Thales Daniel Alves Barbosa
: Insulinoma is a functional neuroendocrine tumor derived from beta cells of the pancreatic islets of Langerhans, usually solitary, benign, and curable with surgery (enucleation). It rarely occurs during pregnancy and is clinically manifested by hypoglycemia, particularly in the first trimester of pregnancy. During pregnancy, both conservative therapeutic measures (medication) and surgical treatment are challenging regarding the impossibility of studies on drug teratogenicity as well as the maternal-fetal repercussions during surgery, such as hypoglycemia and changes due to stress...
August 11, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27494822/endoscope-assisted-transsphenoidal-puncture-of-the-cavernous-sinus-for-embolization-of-carotid-cavernous-fistula-in-a-neurosurgical-hybrid-operating-suite
#17
Chien-Lun Tang, Chih-Hsiang Liao, Wen-Hsien Chen, Shih-Chieh Shen, Chung-Hsin Lee, Hsu-Tung Lee, Yuang-Seng Tsuei
Endovascular embolization is the treatment of choice for carotid-cavernous fistulas (CCFs), but failure to catheterize the cavernous sinus may occur as a result of vessel tortuosity, hypoplasia, or stenosis. In addition to conventional transvenous or transarterial routes, alternative approaches should be considered. The authors present a case in which a straightforward route to the CCF was accessed via transsphenoidal puncture of the cavernous sinus in a neurosurgical hybrid operating suite. This 82-year-old man presented with severe chemosis and proptosis of the right eye...
August 5, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27397766/the-midline-catheter-a-clinical-review
#18
Daniel Z Adams, Andrew Little, Charles Vinsant, Sorabh Khandelwal
BACKGROUND: Venous access in the emergency department (ED) is an often under-appreciated procedural skill given the frequency of its use. The patient's clinical status, ongoing need for laboratory investigation, and intravenous therapeutics guide the size, type, and placement of the catheter. The availability of trained personnel and dedicated teams using ultrasound-guided insertion techniques in technically difficult situations may also impact the selection. Appropriate device selection is warranted on initial patient contact to minimize risk and cost...
September 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27342656/venous-window-needle-guide-for-deep-vessels-and-difficult-arteriovenous-fistula-cannulation
#19
Giacomo Forneris, Marco Trogolo, Pasqualina Cecere, Daniele Savio, Dario Roccatello
The Venous Window Needle Guide (VWING™) has recently been proposed for patients with difficult arteriovenous fistula (AVF) access for hemodialysis due to deep vessels or other cannulation-related problems. This totally subcutaneous titanium device is sutured onto the upper wall of the matured fistula and may facilitate cannulation by the button-hole technique. We describe our initial experience with nine implants in six patients with a cumulative follow-up of 83 months, and make some experience-based technical suggestions for implant and surveillance radiological imaging...
June 24, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27324945/factors-affecting-difficult-peripheral-intravenous-cannulation-in-adults-a-prospective-observational-study
#20
Michela Piredda, Valentina Biagioli, Beatrice Barrella, Ilaria Carpisassi, Roberta Ghinelli, Diana Giannarelli, Maria Grazia De Marinis
BACKGROUND: Early recognition of patients at risk for difficult peripheral intravenous (IV) catheterisation is important in order to adopt strategies able to increase the likelihood of success in IV cannulation, as well as to critically evaluate the use of alternative administration routes or venous devices. AIMS AND OBJECTIVES: This study aimed to identify risk factors for difficult IV cannulation in relation to characteristics of patients, healthcare providers, and devices in adult patients accessing a radiology service...
June 21, 2016: Journal of Clinical Nursing
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