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Central venous access

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https://www.readbyqxmd.com/read/28634641/a-novel-technique-for-ultrasound-guided-central-venous-catheterization-under-short-axis-out-of-plane-approach-stepwise-flashing-with-triangulation
#1
Toshinori Horiuchi, Chie Okuda, Naoko Kurita, Ayako Yamaguchi, Kazuhiko Kitagawa, Masafumi Takeda, Keiichi Sha, Toshihiro Nagahata
In ultrasound-guided central venous catheterization, there is no standard technique either for the needle tip visualization or for the adequate needle angle and entry to the skin with short-axis view under out-of-plane technique. In the present study, we propose a novel technique named "stepwise flashing with triangulation", and the efficacy of this technique is assessed. Before and after a didactic session in which the technique was explained, 12 novice residents were asked to position the needle tip on or into the imitation vessels and to avoid deeper penetration by using an agar tissue phantom with ultrasound guidance...
June 20, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28633595/central-venous-catheter-insertion-into-the-false-lumen-of-a-complicated-aortic-dissection
#2
Ahmet Bas, Deniz Goksedef, Sedat G Kandemirli, Fatih Gulsen, Furuzan Numan
Thoracic endovascular repair is considered the first-line treatment in complicated acute type B dissection. Central venous catheters provide valuable vascular access during endovascular treatments. However, central venous catheters are not without complications. Herein, we report a case of central venous catheter insertion into the false lumen of a complicated acute type B aortic dissection by direct aortic puncture. The tip of the central venous catheter was in the false lumen. The central venous catheter was left in place initially and was removed after graft stent deployment...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28623994/placement-of-tunneled-cuffed-vascular-catheter-through-superior-vena-cava-puncture
#3
Songhui Zhai, Qiuyan Zhao, Yanhuan Feng, Yang Yu, Li Zhou, Tianlei Cui, Ping Fu
OBJECTIVE: The purpose of this study was to assess the feasibility and safety of placement of tunneled cuffed catheters through direct percutaneous puncture of the superior vena cava (SVC) in patients with occluded right and left innominate veins. METHODS: This was a retrospective review of all patients with right and left innominate vein occlusions who underwent tunneled catheter placement with direct SVC puncture between January 2012 and December 2014. Under fluoroscopic guidance with the patient in a supine position, a 5F catheter was placed at the distal end of the SVC through the femoral vein, iliac vein, or hepatic vein...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28614258/the-malposition-of-a-central-venous-catheter-through-a-sheath-introducer-via-the-left-internal-jugular-vein-a-case-report
#4
Jung A Lim, Chan Hee Jee, Kyung-Hwa Kwak
RATIONALE: The misplacement of central venous catheter (CVC) can occur more often at the left jugular vein than the right side due to anatomic differences. And many of the previously reported cases are about catheter misplacement resulting from vessel penetration associated with guidewire. This case differs that the catheter itself through the sheath introducer can cause venous injury that may lead to the malposition of CVC particularly through an approach to the left internal jugular vein...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28599902/cost-effectiveness-analysis-of-vascular-access-referral-policies-in-ckd
#5
Steven M Shechter, Talon Chandler, M Reza Skandari, Nadia Zalunardo
BACKGROUND: The optimal timing of vascular access referral for patients with chronic kidney disease who may need hemodialysis (HD) is a pressing question in nephrology. Current referral policies have not been rigorously compared with respect to costs and benefits and do not consider patient-specific factors such as age. STUDY DESIGN: Monte Carlo simulation model. SETTING & POPULATION: Patients with chronic kidney disease, referred to a multidisciplinary kidney clinic in a universal health care system...
June 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28599498/sequential-administration-of-xelox-and-xeliri-is-effective-feasible-and-well-tolerated-by-patients-with-metastatic-colorectal-cancer
#6
Taro Fukui, Koichi Suzuki, Kosuke Ichida, Yuji Takayama, Nao Kakizawa, Yuta Muto, Fumi Hasegawa, Fumiaki Watanabe, Rina Kikugawa, Masaaki Saito, Shingo Tsujinaka, Yasuyuki Miyakura, Toshiki Rikiyama
Sequential administration of the chemotherapy regimes capecitabine and oxaliplatin (XELOX) and capecitabine and irinotecan (XELIRI) in the first- to second-line treatment setting would allow patients to be managed more easily in an outpatient unit. However, a small number of studies have raised concerns of cumulative adverse events as a consequence of the continuous use of capecitabine. To investigate this, the present study conducted a retrospective review of 81 consecutive metastatic colorectal cancer (mCRC) patients treated with the oxaliplatin, fluorouracil and leucovorin-irinotecan, fluorouracil and leucovorin (FOLFOX-FOFIRI/F-F) regimen (n=40) or the XELOX-XELIRI (X-X) regimen (n=41) in first- to second-line chemotherapy in Saitama Medical Center between 2006 and 2012...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28586700/injection-into-the-jugular-vein-among-people-who-inject-drugs-in-the-united-kingdom-prevalence-associated-factors-and-harms
#7
Vivian D Hope, Jenny Iversen, Katelyn J Cullen, John V Parry, Lisa Maher, Fortune Nucbe
BACKGROUND: While people who inject drugs (PWID) typically use peripheral veins, some inject into their central veins, including the femoral and jugular veins. Injection into the jugular vein can have serious adverse health consequences, including jugular vein thrombosis, deep neck infections, pneumothorax, endocarditis and sepsis. This study examined the prevalence of, and factors associated with, jugular vein injection among a large sample of PWID in the United Kingdom. METHOD: Unlinked anonymous surveys (2011-14) recruited PWID from agencies providing services to this population...
June 3, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28585784/-use-of-ultrasound-for-placement-of-central-venous-catheters-in-pediatrics-results-of-a-national-survey
#8
Á Sánchez Sánchez, O Girón Vallejo, R Ruiz-Pruneda, M Fernández Ibieta, P Y Reyes Ríos, V Villamil, I Martínez-Castaño, J Rojas Ticona, M C Giménez Aleixandre, J I Ruiz Jiménez
OBJECTIVES: To study the variability of techniques used for vascular access of central venous devices, totally implanted and external tunneled, as well as polling the use of ultrasound by pediatric surgeons in Spain. MATERIAL AND METHODS: Descriptive study of a survey results, conducted by phone, email and online, about 20 items related to the placement of these devices in children and the use of ultrasound in this procedure. RESULTS: We analyzed 71 surveys from 31 national hospitals...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28584903/incidence-and-outcome-of-retained-port-a-cath-fragments-during-removal
#9
Olugbenga Michael Aworanti, Niall Linnane, Farhan Tareen, Alan Mortell
PURPOSE: Port-A-Cath devices are frequently used for long-term venous access. We postulate that long-term use predisposes them to getting stuck and retained in a central vein at the time of removal. We aim to report the incidence and outcome of this complication. METHODS: Between January 2006 and July 2016, a retrospective review of all Port-A-Cath removals that were performed at our centre was conducted. At the time of removal, catheters that could not be removed from the vein were considered retained...
June 5, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28583617/totally-implantable-intravenous-treprostinil-therapy-in-pulmonary-hypertension-assessment-of-the-implantation-procedure
#10
Aaron B Waxman, Hugh T McElderry, Mardi Gomberg-Maitland, Martin C Burke, Edgar L Ross, Malcolm M Bersohn, Sanjog S Pangarkar, James H Tarver, Diane L Zwicke, Jeremy P Feldman, Murali M Chakinala, Robert P Frantz, Geoffrey B Thompson, Fernando Torres, Richard L Rauck, Kathy Clagg, Louise Durst, Pei Li, Marty Morris, Kara L Southall, Leigh Peterson, Robert C Bourge
BACKGROUND: Prostacyclins improve symptoms and survival in pulmonary arterial hypertension (PAH). In response to risks associated with external delivery systems, an implantable intravenous infusion system was developed. A multicenter, prospective, single-arm, clinical trial (DelIVery for PAH) was conducted to evaluate this system for treprostinil in PAH. This analysis describes the findings related to the implant procedure. METHODS: Patients (n=64) with PAH (WHO Group 1) receiving stable intravenous treprostinil were enrolled...
June 2, 2017: Chest
https://www.readbyqxmd.com/read/28579360/complications-of-long-and-intermediate-term-venous-catheters-in-cystic-fibrosis-patients-a-multicenter-study
#11
Teresa L May, Alex H Gifford, Thomas Lahiri, Adam Black, Janet Trang, Alexandra G Cornell, Karyll Gonzalez, Scott Morin, Mark Napier, Christine W Duarte, Jonathan B Zuckerman
BACKGROUND: Totally implantable venous access devices (TIVADs) or peripherally inserted central venous catheters (PICCs) are commonly used in the care of patients with cystic fibrosis (CF), but they are associated with various complications, including thrombosis, infection, and insertion site symptoms. METHODS: We conducted a retrospective review of PICC and TIVAD use in adults and children with CF over an 8-year period at 3 accredited care centers. Patient attributes included CFTR genotype, comorbidities, lung function, body mass index, use of anticoagulation, and respiratory tract microbiology...
June 1, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28577269/catheterization-via-direct-cannulation-of-superior-vena-cava-for-a-hemodialysis-patient-with-an-original-dysfunctional-catheter-on-the-left-internal-jugular-vein
#12
Li Zhou, Lin Chen, Yang Yu, Tianlei Cui, Xiao Li, Ping Fu
Establishing a long-term vascular access in patients exhibiting vascular access exhaustion is challenging. In this study, we reported a case of a direct catheterization in the superior vena cava of a hemodialysis patient with vascular access exhaustion and original dysfunctional catheter inserted via the left internal jugular vein. The direct catheterization was performed with cuffed tunnel catheter (CUFF) and guided by digital subtraction angiography (DSA) and multidetector computed tomography venography (MDCTV)...
June 3, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28574141/totally-implantable-venous-access-devices-in-children-with-medical-complexity-preliminary-data-from-a-tertiary-care-hospital
#13
Caterina Geremia, Maria Antonietta De Ioris, Alessandro Crocoli, Ottavio Adorisio, Raffaella Scrocca, Mary Haywood Lombardi, Susanna Staccioli, Pietro Stella, Paola Amendola, Gaetano Ciliento, Francesco De Peppo, Andrea Campana
INTRODUCTION: Children with special health-care needs are an emerging and consistent population. In a subset of children with medical complexity (CMC) a continuous access to the central vascular system is advisable to eliminate unnecessary pain and stress and to improve home management and palliative care. METHODS: The surgical registry of a tertiary hospital was checked in order to identify CMC who underwent totally implantable venous access device (VAD) placement...
May 24, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28562239/vascular-access-in-pediatric-patients-in-the-emergency-department-types-of-access-indications-and-complications
#14
Rachel Whitney, Melissa Langhan
Vascular access is a potentially life-saving procedure that is a mainstay of emergency medicine practice. There are a number of challenges associated with obtaining and maintaining vascular access, and the choice of the route of access and equipment used will depend on patient- and provider-specific factors. In this issue, the indications and complications of peripheral intravenous access, intraosseous access, and central venous access are reviewed. Timely and effective assessment and management of difficult-access patients, pain control techniques that can assist vascular access, and contraindications to each type of vascular access are also discussed...
June 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28558699/incidence-of-and-factors-associated-with-catheter-related-bloodstream-infection-in-patients-with-advanced-solid-tumors-on-home-parenteral-nutrition-managed-using-a-standardized-catheter-care-protocol
#15
Pankaj G Vashi, Natasha Virginkar, Brenten Popiel, Persis Edwin, Digant Gupta
BACKGROUND: Catheter-related bloodstream infections (CRBSIs) are associated with high morbidity and mortality as well as increased medical costs. Cancer patients, who are often immunocompromised, are susceptible to CRBSI while receiving home parenteral nutrition (HPN). We evaluated the incidence of and factors associated with CRBSIs in cancer patients undergoing HPN managed using a standardized catheter care protocol. METHODS: This is a retrospective cohort study of 335 cancer patients receiving HPN between January 2012 and July 2015...
May 30, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28549710/complication-rates-observed-in-silicone-and-polyurethane-catheters-of-totally-implanted-central-venous-access-devices-implanted-in-the-upper-arm
#16
Jasmin D Busch, Maren Vens, Catherine Mahler, Jochen Herrmann, Gerhard Adam, Harald Ittrich
PURPOSE: To present frequency and types of complications related to silicone (SI) versus polyurethane (PUR) catheters of totally implanted venous access devices (TIVADs) placed in the upper arm. MATERIAL AND METHODS: A cohort of 2,491 consecutive patients with TIVADs implanted between 2006 and 2015 was retrospectively analyzed. Complications were classified according to SIR guidelines. Pearson χ(2) test was used for categorical variables, and Student t test was used for continuous variables...
May 24, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28544163/the-impact-of-clinical-practice-on-the-outcome-of-central-venous-access-devices-in-children-with-haemophilia
#17
K Khair, S Ranta, A Thomas, K Lindvall
INTRODUCTION: Central venous access devices facilitate home treatment in boys with haemophilia. These are usually fully implanted lines, referred to as ports. Caregivers are taught to manage the port using sterile techniques and maintaining patency by flushing with saline or heparin solution. National and international guidelines for the home care of ports are lacking. AIM: To evaluate if infection or occlusion rates differ between home care regimens used for ports in children with haemophilia...
May 24, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28541018/balloon-angioplasty-with-selective-stenting-strategy-in-treatment-of-hemodialysis-related-central-vein-occlusive-lesions
#18
Mahmoud Saleh, Haitham Ali, Ahmed Elbadawy, Ayman Hasaballah
BACKGROUND: The aim of this study was to evaluate the safety and efficacy of balloon angioplasty and selective stenting in treatment of symptomatic central vein occlusive lesions (CVOL) in patients with upper extremity hemodialysis access. METHODS: Seventy-four hemodialysis patients with symptomatic CVOL underwent endovascular therapy between March 2014 and November 2015. Both the primary and secondary patency rates were analyzed by the Kaplan-Meier plot method...
May 24, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28534860/hemophilia-care-in-the-pediatric-age
#19
REVIEW
Marta Bertamino, Francesca Riccardi, Laura Banov, Johanna Svahn, Angelo Claudio Molinari
Hemophilia is the most common of the severe bleeding disorders and if not properly managed since early infancy can lead to chronic disease and lifelong disabilities. However, it enjoys the most efficacious and safe treatment among the most prevalent monogenic disorders. Hemophilia should be considered in the neonatal period in the case of unusual bleeding or in the case of positive family history. Later, hemophilia should be suspected mainly in males because of abnormal bruising/bleeding or unusual bleeding following invasive procedures-for example, tonsillectomy or circumcision...
May 19, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28523170/a-comparison-of-longitudinal-and-transverse-approaches-to-ultrasound-guided-axillary-vein-cannulation-by-experienced-operators
#20
Yi-Zhou He, Ming Zhong, Wei Wu, Jie-Qiong Song, Du-Ming Zhu
BACKGROUND: The axillary vein is an easily accessible vessel that can be used for ultrasound-guided central vascular access and offers an alternative to the internal jugular and subclavian veins. The objective of this study was to identify which transducer orientation, longitudinal or transverse, is better for imaging the axillary vein with ultrasound. METHODS: We analyzed 236 patients who had undergone central venous cannulation of axillary vein in this retrospective study...
April 2017: Journal of Thoracic Disease
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