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https://www.readbyqxmd.com/read/28932593/successful-removal-of-embolized-chemoport-catheter-within-the-heart-and-pericardium-3-case-reports
#1
Shin-Eui Yoon, Chang Hoon Lee
Central venous access devices are routinely used in patients with cancer. Although rare, catheter transaction with subsequent embolization is one of the major complications of intra-vascular devices. We describe two patients with embolized chemoport catheters within the heart that were successfully removed percutaneously using a goose-neck snare technique. We also describe a third patient with a fractured intra-vascular catheter in the pericardium removed by pericardiotomy, which can be the first case of the kind...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#2
Mariana Murea, W Mark Brown, Jasmin Divers, Shahriar Moossavi, Todd W Robinson, Benjamin Bagwell, John M Burkart, Barry I Freedman
BACKGROUND: Arteriovenous accesses (AVA) in patients performing hemodialysis (HD) are labeled "permanent" for AV fistulas (AVF) or grafts (AVG) and "temporary" for tunneled central venous catheters (TCVC). Durability and outcomes of permanent vascular accesses based on the sequence in which they were placed or used receives little attention. This study analyzed longitudinal transitions between TCVC-based and AVA-based HD outcomes according to the order of placement. METHODS: All 391 patients initiating chronic HD via a TCVC between 2012 and 2013 at 12 outpatient academic dialysis units were included in this study...
September 21, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#3
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28912977/isolated-persistent-left-superior-vena-cava-sick-sinus-syndrome-and-challenging-pacemaker-implantation
#4
Hatice S Kemal, Aziz Gunsel, Levent Cerit, Murat Kocaoglu, Hamza Duygu
Persistent left superior vena cava with absent right superior vena cava is a very rare venous anomaly and is known as isolated PLSVC. It is usually an asymptomatic anomaly and is mostly detected during difficult central venous access or pacemaker implantation, though it could also be associated with an increased incidence of congenital heart disease, arrhythmias, and conduction disturbances. Herein, we describe a dual-chamber pacemaker implantation in a patient with isolated PLSVC and sick sinus syndrome.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28892556/parenteral-anticoagulation-in-ambulatory-patients-with-cancer
#5
REVIEW
Elie A Akl, Lara A Kahale, Maram B Hakoum, Charbel F Matar, Francesca Sperati, Maddalena Barba, Victor E D Yosuico, Irene Terrenato, Anneliese Synnot, Holger Schünemann
BACKGROUND: Anticoagulation may improve survival in patients with cancer through a speculated anti-tumour effect, in addition to the antithrombotic effect, although may increase the risk of bleeding. OBJECTIVES: To evaluate the efficacy and safety of parenteral anticoagulants in ambulatory patients with cancer who, typically, are undergoing chemotherapy, hormonal therapy, immunotherapy or radiotherapy, but otherwise have no standard therapeutic or prophylactic indication for anticoagulation...
September 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28883293/usefulness-of-a-peripherally-inserted-central-catheter-for-total-parenteral-nutrition-in-patients-with-inflammatory-bowel-disease
#6
Hirofumi Chiba, Katsuya Endo, Yasuhiro Izumiyama, Takeru Nakano, Daisuke Okamoto, Ryo Ichikawa, Hiroshi Nagai, Shin Matsumoto, Naonobu Yokoyama, Katsutoshi Yamamoto, Yusuke Shimoyama, Takeo Naito, Motoyuki Onodera, Jun Kusaka, Keiichiro Hiramoto, Masatake Kuroha, Yoshitake Kanazawa, Tomoya Kimura, Yoichi Kakuta, Yoshitaka Kinouchi, Tooru Shimosegawa
BACKGROUNDS AND AIMS: Peripherally inserted central catheters (PICC) have been widely used as a blood access route for total parenteral nutrition (TPN) in recent years. However, there have been few reports that evaluated the usefulness of PICC for patients with inflammatory bowel disease (IBD). In this study, we compared the clinical courses in patients with IBD who received TPN during their hospitalization by conventional central venous catheters (CVC) and PICC. PATIENTS AND METHODS: A total of 137 IBD patients were enrolled...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28879566/success-rate-and-complications-of-sharp-recanalization-for-treatment-of-central-venous-occlusions
#7
Emil I Cohen, Christopher Beck, Jesse Garcia, Ryan Muller, Hyun J Bang, Keith M Horton, Farris Hakki
PURPOSE: To evaluate success and safety of needle (sharp) recanalization as a method to re-establish access in patients with chronic central venous occlusions. MATERIALS AND METHODS: Thirty-nine consecutive patients who underwent this procedure were retrospectively reviewed to establish success rate and associated complications. In all cases, a 21- or 22-gauge needle was used to restore connection between two chronically occluded segments after conventional wire and catheter techniques had failed...
September 6, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28866629/strategies-to-reduce-line-infections-in-a-small-child-with-homozygous-familial-hypercholesterolaemia-who-cannot-yet-receive-ldl-apheresis
#8
Misan Lee, Janet Barr, Stewart Kribs, Guido Filler
Patients with homozygous familial hypercholesterolaemia are optimally treated with low-density lipoprotein apheresis. Young patients who do not meet a weight threshold (25 kg) receive regular plasmapheresis. This approach may remove excessive immunoglobulins and vascular access set-up can be challenging. We report the case of a 4 year-old child who exhibited repeated septic infections (5 in 6 months) and had recurrent access issues before two interventions were implemented: (1) the percutaneous central venous line was modified to two implanted paediatric ports, and (2) the patient started receiving two bags of Octaplasma at the end of each plasmapheresis treatment to account for the excessive loss of immunoglobulins...
September 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28854967/innovative-dressing-and-securement-of-tunneled-central-venous-access-devices-in-pediatrics-a-pilot-randomized-controlled-trial
#9
Amanda J Ullman, Tricia Kleidon, Victoria Gibson, Craig A McBride, Gabor Mihala, Marie Cooke, Claire M Rickard
BACKGROUND: Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate. The aim of this study was to evaluate the feasibility of launching a full-scale randomized controlled efficacy trial of innovative dressing and securement products for pediatric tunneled CVAD to prevent complication and failure...
August 30, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28852577/sequential-venous-percutaneous-transluminal-angioplasty-and-balloon-dilatation-of-the-interatrial-septum-during-percutaneous-edge-to-edge-mitral-valve-repair
#10
Rezo Jorbenadze, Johannes Patzelt, Meinrad Gawaz, Peter Seizer, Harald F Langer
Percutaneous edge-to-edge mitral valve repair (PMVR) is widely used for selected, high-risk patients with severe mitral valve regurgitation (MR). This report describes a case of 81-year-old woman presenting with severe and highly symptomatic mitral valve regurgitation (MR) caused by a flail of the posterior mitral valve leaflet (PML). PMVR turned out to be challenging in this patient because of a stenosis and tortuosity of both iliac veins as well as sclerosis of the interatrial septum, precluding the vascular and left atrial access by standard methods, respectively...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28844205/ultrasound-guided-central-venous-catheter-placement-a-structured-review-and-recommendations-for-clinical-practice
#11
REVIEW
Bernd Saugel, Thomas W L Scheeren, Jean-Louis Teboul
The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In this review, we describe the rationale for the use of US during CVC placement, the basic principles of this technique, and the current evidence and existing guidelines for its use. In addition, we recommend a structured approach for US-guided central venous access for clinical practice. Static and real-time US can be used to visualize the anatomy and patency of the target vein in a short-axis and a long-axis view...
August 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28843837/how-useful-is-ultrasound-guidance-for-internal-jugular-venous-access-in-children
#12
Gabriela Ruschel Zanolla, Matteo Baldisserotto, Jefferson Piva
PURPOSE: The aim of this study was to determine whether US reduces number of puncture attempts, procedure time, and complication rate during IJV access in children. METHODS: A prospective study was performed in children (age ≤18years) admitted to our institution, from September 2013 to July 2014, with indications for central venous access. Patients meeting the inclusion criteria were randomized to the US-guided or control groups. The same physician performed all IJV cannulations in both groups...
August 17, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28839904/uk-practice-in-the-prevention-of-central-venous-catheter-associated-thrombosis-in-adults-on-home-parenteral-nutrition
#13
L Macdougall, J Hanley, C Mountford, N P Thompson
BACKGROUND: Maintaining central access is imperative for the delivery of home parenteral nutrition (HPN) in those with intestinal failure. Methods to reduce central venous catheter infection are well recognised; however, the prevention of line thrombosis is less well studied. METHODS: This paper reviews the current evidence and reports a survey of current practice within the UK. Using an electronic survey, respondents were asked to detail their use of anticoagulation in different patient groups and the type of anticoagulation used...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28837291/-prehospital-misconceptions
#14
Eduardo Alcouce, Vincent Darioli, Pierre-Nicolas Carron, Mathieu Pasquier
We confronted some of the most prevalent prehospital misconceptions with the available literature. We found that: the diminution of a retrosternal pain following nitrate administration is not predictive of a cardiac origin of the pain ; survival of traumatic cardiac arrest may not be as bad as usually believed ; peripheral venous administration of vasopressors through proximal catheters during short times may be considered as a safe temporary alternative to central venous access ; using the pulse palpation usually lead to an under-estimation of the systolic blood pressure ; applying a pelvic belt at the level of the iliac crests doesn't aggravate an open-book fracture; there is no 90 mmHg threshold values below which mortality increases in traumatic brain injuries...
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28827013/unmasking-of-previously-asymptomatic-central-venous-stenosis-following-percutaneous-transluminal-angioplasty-of-hemodialysis-access
#15
Jarrod E Ehrie, Therese E Sammarco, Jesse L Chittams, Scott O Trerotola
PURPOSE: To determine the frequency of new-onset symptoms of central venous stenosis (CVS) after percutaneous transluminal angioplasty (PTA) of a hemodialysis access-related stenosis in patients with previously asymptomatic CVS and to identify risk factors for this phenomenon. MATERIALS AND METHODS: Retrospective review was performed of patients treated with PTA for an access-related stenosis (excluding central vein interventions) between 2001 and 2016 who returned within 3 months with symptoms of CVS (ie, "unmasking"): 39 patients met these criteria...
August 18, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28822403/inpatient-peripherally-inserted-central-venous-catheter-complications-should-peripherally-inserted-central-catheter-lines-be-placed-in-the-intensive-care-unit-setting
#16
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
https://www.readbyqxmd.com/read/28819317/intradialytic-central-venous-oxygen-saturation-is-associated-with-clinical-outcomes-in-hemodialysis-patients
#17
Lili Chan, Hanjie Zhang, Anna Meyring-Wösten, Israel Campos, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Central venous oxygen saturation (ScvO2) in the superior vena cava is predominantly determined by cardiac output, arterial oxygen content, and oxygen consumption by the upper body. While abnormal ScvO2 levels are associated with morbidity and mortality in non-uremic populations, ScvO2 has received little attention in hemodialysis patients. From 1/2012 to 8/2015, 232 chronic hemodialysis patients with central venous catheters as vascular access had their ScvO2 monitored during a 6-month baseline period and followed for up to 36 months...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28815975/urea-based-recirculation-validation-of-the-symmetrical-palindrome-catheter
#18
Martin Jonczyk, Christian Althoff, Torsten Slowinski, Ina Lieker, Marcel Naik, Jonas Auer, Raúl García Marcos, Ejona Duka, Bernd Hamm, Maximilian de Bucourt
BACKGROUND: High blood flow and low recirculation rates are central for adequate haemodialysis. A new symmetrical tip has been invented promising efficient haemodialysis even if the ports are reversed. OBJECTIVE: To evaluate access recirculation of the 'palindrome' catheter and to report initial experiences in a clinical setting. MATERIAL AND METHODS: After implantation of the new catheter in 20 patients (male: 14; female: 6; mean age 72 ± 12...
August 16, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28806225/preventing-retained-central-venous-catheter-guidewires-a-randomized-controlled-simulation-study-using-a-human-factors-approach
#19
Maryanne Z A Mariyaselvam, Ken R Catchpole, David K Menon, Arun K Gupta, Peter J Young
BACKGROUND: Retained central venous catheter guidewires are never events. Currently, preventative techniques rely on clinicians remembering to remove the guidewire. However, solutions solely relying upon humans to prevent error inevitably fail. A novel locked procedure pack was designed to contain the equipment required for completing the procedure after the guidewire should have been removed: suture, suture holder, and antimicrobial dressings. The guidewire is used as a key to unlock the pack and to access the contents; thereby, the clinician must remove the guidewire from the patient to complete the procedure...
October 2017: Anesthesiology
https://www.readbyqxmd.com/read/28798220/vascular-access-type-and-clinical-outcomes-among-elderly-patients-on-hemodialysis
#20
Timmy Lee, Mae Thamer, Qian Zhang, Yi Zhang, Michael Allon
BACKGROUND AND OBJECTIVES: The optimal type of initial permanent access for hemodialysis among the elderly is controversial. Duration of central venous catheter dependence, patient comorbidities, and life expectancy are important considerations in whether to place an arteriovenous fistula or graft. We used an observational study design to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed...
August 10, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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