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Intravenous vascular access

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https://www.readbyqxmd.com/read/29677389/population-pharmacokinetics-of-intramuscular-and-intravenous-ketamine-in-children
#1
Christoph P Hornik, Daniel Gonzalez, John van den Anker, Andrew M Atz, Ram Yogev, Brenda B Poindexter, Kee Chong Ng, Paula Delmore, Barrie L Harper, Chiara Melloni, Andrew Lewandowski, Casey Gelber, Michael Cohen-Wolkowiez, Jan Hau Lee
Ketamine is an N-methyl D-aspartate receptor antagonist used off-label to facilitate dissociative anesthesia in children undergoing invasive procedures. Available for both intravenous and intramuscular administration, ketamine is commonly used when vascular access is limited. Pharmacokinetic (PK) data in children are sparse, and the bioavailability of intramuscular ketamine in children is unknown. We performed 2 prospective PK studies of ketamine in children receiving either intramuscular or intravenous ketamine and combined the data to develop a pediatric population PK model using nonlinear mixed-effects methods...
April 20, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29675625/multidetector-ct-of-iatrogenic-and-self-inflicted-vascular-lesions-and-infections-at-the-groin
#2
REVIEW
Massimo Tonolini, Anna Maria Ierardi, Gianpaolo Carrafiello, Domenico Laganà
The number and complexity of endovascular procedures performed via either arterial or venous access are steadily increasing. Albeit associated with higher morbidity compared to the radial approach, the traditional common femoral artery remains the preferred access site in a variety of cardiac, aortic, oncologic and peripheral vascular procedures. Both transarterial and venous cannulation (for electrophysiology, intravenous laser ablation and central catheterisation) at the groin may result in potentially severe vascular access site complications (VASC)...
April 19, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29617940/intraosseous-versus-intravenous-access-in-pediatric-septic-shock-patients-admitted-to-alexandria-university-pediatric-intensive-care-unit
#3
Ahmed A El-Nawawy, Omneya M Omar, Mona Khalil
The cornerstone of emergency management of sepsis is early, goal-directed therapy. The purpose of this study was to evaluate the effect of intraosseous (IO) vs. intravenous (IV) access for resuscitation of patients with septic shock admitted to pediatric intensive care unit. This prospective interventional randomized clinical trial study was conducted on 60 patients with septic shock who need rapid administration of fluids and drugs; 30 cases were randomly chosen for IO vascular access, while the other 30 were selected for IV access...
April 1, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29571620/regional-variation-in-patient-outcomes-in-carotid-artery-disease-treatment-in-the-vascular-quality-initiative
#4
Katie E Shean, Thomas F X O'Donnell, Sarah E Deery, Alexander B Pothof, Joseph R Schneider, Caron B Rockman, Brian W Nolan, Marc L Schermerhorn
OBJECTIVE: Quality metrics were developed to improve outcomes after carotid artery revascularization; however, few studies have evaluated regional differences in perioperative outcomes. This study aimed to evaluate regional variation in mortality and perioperative outcomes after carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: We identified all patients who underwent CEA or CAS from 2009 to 2016 in the Vascular Quality Initiative. Patients were analyzed on the basis of their symptom status...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29562830/the-impact-of-the-difficult-vascular-access-fear-and-anxiety-level-in-children-on-the-success-of-first-time-phlebotomy
#5
Gülçin Özalp Gerçeker, Dijle Ayar, Emine Zahide Özdemir, Murat Bektaş
PURPOSE: This study aimed to investigate the success of first-time phlebotomy and the affecting factors in children between 4 and 10 years of age. METHODS: This descriptive, comparative, and cross-sectional study was conducted on 155 children who underwent phlebotomy. The Sociodemographic Data Form, the Children's Anxiety Meter-State, the Children's Fear Scale, and the Difficult Intravenous Access score were used to collect the data for the study. The relationship between the success of first-time phlebotomy, mean pre-phlebotomy fear and anxiety score, and Difficult Intravenous Access score were examined...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29558570/vascular-access-specialist-teams-for-device-insertion-and-prevention-of-failure
#6
REVIEW
Peter J Carr, Niall S Higgins, Marie L Cooke, Gabor Mihala, Claire M Rickard
BACKGROUND: Most people admitted to hospitals worldwide require a vascular access device (VAD). Hundreds of millions of VADs are inserted annually in the USA with reports of over a billion peripheral intravenous catheters used annually worldwide. Numerous reports suggest that a team approach for the assessment, insertion, and maintenance of VADs improves clinical outcomes, the patient experience, and healthcare processes. OBJECTIVES: To compare the use of the vascular access specialist team (VAST) for VAD insertion and care to a generalist model approach for hospital or community participants requiring a VAD in terms of insertion success, device failure, and cost-effectiveness...
March 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29529917/ultrasound-guided-intravenous-access-in-adults-using-sonostik-%C3%A2-a-novel-encapsulated-sterile-guidewire-a-prospective-cohort-trial
#7
Keith S Boniface, Maxine A LeSaux, Sohaib Mandoorah, Amit Patel, Kai L Neander, Hamid Shokoohi
PURPOSE: We evaluated the performance of an encapsulated guidewire designed for single-handed use with ultrasound-guided vascular access (SonoStik) with Seldinger technique, as compared with conventional intravenous catheters placed under ultrasound guidance in healthy subjects. METHODS: This is a prospective cohort trial in healthy subjects in which each subject served as his/her own control by having a SonoStik ultrasound intravenous cannulation placed in one arm and a conventionally placed, standard ultrasound intravenous cannulation placed in the other arm...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29525210/pediatric-vascular-access-peripheral-iv-algorithm-success-rate
#8
Jane H Hartman, John Baker, James F Bena, Shannon L Morrison, Nancy M Albert
PURPOSE: Determine if the pediatric peripheral vascular access algorithm (PPVAA) led to differences in first-attempt and overall peripheral intravenous (PIV) success, staff attempting PIV access per episode and overall attempts and first PIV attempt success by provider. DESIGN/METHODS: A two-cohort pre-/post-implementation comparative design involved pediatric nurses and patients. The PPVAA included four components: a patient comfort plan, PIV grading score, nurses' self-assessed IV access capability and nurse decision to stop-the-line...
March 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29514546/efficacy-and-safety-of-peripherally-inserted-central-venous-catheters-in-acute-cardiac-care-management
#9
Fabrizio Poletti, Claudio Coccino, Davide Monolo, Paolo Crespi, Giorgio Ciccioli, Giuseppe Cordio, Giovanni Seveso, Stefano De Servi
PURPOSE: Patients admitted to cardiac intensive care unit need administration of drugs intravenously often in concomitance of therapeutic techniques such as non-invasive ventilation, continuous renal replacement therapy and intra-aortic balloon counterpulsation. Therefore, the insertion of central venous catheters provides a reliable access for delivering medications, laboratory testing and hemodynamic monitoring, but it is associated with the risk of important complications. In our study, we tested the efficacy and safety of peripherally inserted central catheters to manage cardiac intensive care...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29512430/infection-of-totally-implantable-venous-access-devices-a-review-of-the-literature
#10
Fulvio Pinelli, Elena Cecero, Dario Degl'Innocenti, Valentina Selmi, Rosa Giua, Gianluca Villa, Cosimo Chelazzi, Stefano Romagnoli, Mauro Pittiruti
Totally implantable venous access devices, or ports, are essential in the therapeutic management of patients who require long-term intermittent intravenous therapy. Totally implantable venous access devices guarantee safe infusion of chemotherapy, blood transfusion, parenteral nutrition, as well as repeated blood samples. Minimizing the need for frequent vascular access, totally implantable venous access devices also improve the patient's quality of life. Nonetheless, totally implantable venous access devices are not free from complications...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29506860/-anesthesia-for-cesarean-delivery-in-a-patient-with-klippel-trenaunay-syndrome
#11
Clara Elisa Frare de Avelar Teixeira, Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho, Rafael Miranda da Costa, Giselle Ioná Teixeira Brighenti
INTRODUCTION: Klippel-Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetric risk. CASE REPORT: Female patient, 29 years old, 99kg, 167cm, BMI 35.4kg.m-2 , physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel-Trenaunay syndrome...
March 2, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29480851/validation-of-the-peripheral-ultrasound-guided-vascular-access-rating-scale
#12
Stine C Primdahl, Jesper Weile, Louise Clemmesen, Kristian R Madsen, Yousif Subhi, Poul Petersen, Ole Graumann
Evidence-based standards in proficiency are needed for ultrasound-guided peripheral intravenous access. In this study, we explored the validity of the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale.We recruited 3 groups of physicians (5 novices, 5 intermediates, and 5 experts) of increasing proficiency in peripheral ultrasound-guided intravenous access. All participants performed 3 peripheral ultrasound-guided intravenous accesses on three different patients. Performance was video-recorded by 3 cameras and the ultrasound image...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29473717/interventions-for-paracetamol-acetaminophen-overdose
#13
REVIEW
Angela L Chiew, Christian Gluud, Jesper Brok, Nick A Buckley
BACKGROUND: Paracetamol (acetaminophen) is the most widely used non-prescription analgesic in the world. Paracetamol is commonly taken in overdose either deliberately or unintentionally. In high-income countries, paracetamol toxicity is a common cause of acute liver injury. There are various interventions to treat paracetamol poisoning, depending on the clinical status of the person. These interventions include inhibiting the absorption of paracetamol from the gastrointestinal tract (decontamination), removal of paracetamol from the vascular system, and antidotes to prevent the formation of, or to detoxify, metabolites...
February 23, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29472414/laminin-521-protein-therapy-for-glomerular-basement-membrane-and-podocyte-abnormalities-in-a-model-of-pierson-syndrome
#14
Meei-Hua Lin, Joseph B Miller, Yamato Kikkawa, Hani Y Suleiman, Karl Tryggvason, Bradley L Hodges, Jeffrey H Miner
Background Laminin α 5 β 2 γ 1 (LM-521) is a major component of the GBM. Mutations in LAMB2 that prevent LM-521 synthesis and/or secretion cause Pierson syndrome, a rare congenital nephrotic syndrome with diffuse mesangial sclerosis and ocular and neurologic defects. Because the GBM is uniquely accessible to plasma, which permeates endothelial cell fenestrae, we hypothesized that intravenous delivery of LM-521 could replace the missing LM-521 in the GBM of Lamb2 mutant mice and restore glomerular permselectivity...
February 22, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29462086/emergency-sternal-intraosseous-access-for-warm-fresh-whole-blood-transfusion-in-damage-control-resuscitation-sternal-intraosseous-access-in-dcr
#15
Christopher Kalhagen Bjerkvig, Theodor Fosse, Torunn Oveland Apelseth, Joar Sivertsen, Hanne Braathen, Håkon Skogrand Eliassen, Anne Berit Guttormsen, Andrew P Cap, Geir Strandenes
BACKGROUND: Intraosseous (IO) vascular access is increasingly used as an emergency tool for achieving access to the systemic circulation in critically ill patients. The role of IO transfusion of blood in Damage Control Resuscitation is however questionable due to possible inadequate flow rate and hemolysis. Some experts claim that IO transfusion is contraindicated. In this study we have challenged this statement by looking at flow rates of autologous fresh whole blood reinfusion and hemolysis using two of the commonly used FDA-approved and CE-marked sternal needles...
February 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29427533/utilization-of-a-biomedical-device-veinviewer-%C3%A2-to-assist-with-peripheral-intravenous-catheter-piv-insertion-for-pediatric-nurses
#16
Heidi L McNeely, Theresa L Ream, Jodi M Thrasher, Oliwier Dziadkowiec, Tiffany J Callahan
PURPOSE: Vascular access in pediatric patients can be challenging even with the currently available technological resources. This nurse-driven research study explored time, cost, and resources for intravenous access to determine if a biomedical device, VeinViewer® Vision, would facilitate improvements in pediatric access. In addition, this study looked at nurse perceptions of skills and confidence around intravenous insertion and if the use of the VeinViewer® impacted these perceptions...
February 10, 2018: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/29385901/opat-proof-of-concept-in-a-peripheral-belgian-hospital-after-review-of-the-literature
#17
Annick Smismans, Astrid Vantrappen, Freija Verbiest, Christophe Indevuyst, Bea Van den Poel, Sandrina von Winckelmann, Annelore Peeters, Sara Ombelet, Peter Lybeert, Andre Heremans, Eric Frans, Erwin Ho, Johan Frans
Since its introduction in the 1970s in the United States, outpatient parenteral antibiotic/antimicrobial therapy (OPAT) has been adopted internationally for long-term intravenous (IV) treatment of stable infectious diseases. The aim is to provide a safe and successful completion of IV antimicrobial treatment at the ambulatory care center or at home without complications and costs associated with hospitalization. OPAT implementation has been accelerated by progress in vascular access devices, newly available antibiotics, the emphasis on cost-savings, as well as an improved patient comfort and a reduced incidence of health care associated infections with a similar outcome...
January 31, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29366423/therapeutic-approach-to-patients-with-heart-failure-with-reduced-ejection-fraction-and-end-stage-renal-disease
#18
Chakradhari Inampudi, Paulino Alvarez, Rabea Asleh, Alexandros Briasoulis
BACKGROUND: Several risk factors including Ischemic heart disease, uncontrolled hypertension, high output Heart Failure (HF) from shunting through vascular hemodialysis access, and anemia, contribute to development of HF in patients with End-Stage Renal Disease (ESRD). Guidelinedirected medical and device therapy for Heart Failure with Reduced Ejection Fraction (HFrEF) has not been extensively studied and may have limited safety and efficacy in patients with ESRD. RESULTS: Maintenance of interdialytic and intradialytic euvolemia is a key component of HF management in these patients but often difficult to achieve...
March 14, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29333494/ensuring-adequate-vascular-access-in-patients-with-major-trauma-a-quality-improvement-initiative
#19
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ open quality
https://www.readbyqxmd.com/read/29310869/intraosseous-vascular-access-is-associated-with-lower-survival-and-neurologic-recovery-among-patients-with-out-of-hospital-cardiac-arrest
#20
Takahisa Kawano, Brian Grunau, Frank X Scheuermeyer, Koichiro Gibo, Christopher B Fordyce, Steve Lin, Robert Stenstrom, Robert Schlamp, Sandra Jenneson, Jim Christenson
STUDY OBJECTIVE: We seek to determine the effect of intraosseous over intravenous vascular access on outcomes after out-of-hospital cardiac arrest. METHODS: This secondary analysis of the Resuscitation Outcomes Consortium Prehospital Resuscitation Using an Impedance Valve and Early Versus Delayed (PRIMED) study included adult patients with nontraumatic out-of-hospital cardiac arrests treated during 2007 to 2009, excluding those with any unsuccessful attempt or more than one access site...
January 6, 2018: Annals of Emergency Medicine
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