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Central catheters complications

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https://www.readbyqxmd.com/read/29221340/sudden-hypotension-occurring-after-4-days-of-left-sided-central-catheter-placement
#1
Youn-Jung Kim, Won Young Kim
Central venous catheters (CVCs) have an important role in the management of critically ill patients. In contrast to the immediate complications after CVC insertion, the late complications were difficult to be noticed without high suspicion despite their life-threatening outcome. We report a rare but fatal delayed vascular perforation occurring after 4 days of left-sided hemodialysis catheter insertion. A 74-year-old male with septic shock was treated with continuous renal replacement therapy (CRRT) and recovered smoothly during hospitalization...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29203044/-new-international-guidelines-for-curative-treatment-and-prophylaxis-for-venous-thromboembolism-vte-in-cancer-patients-and-the-dedicated-smartphone-application
#2
I Benzidia, J Connault, A Solanilla, U Michon-Pasturel, M Jamelot, M K Nguessan, A Hij, C Le Maignan, D Farge, C Frère
Venous thromboembolism (VTE) is a frequent and serious complication in cancer patients, and the second leading cause of death in this setting. Cancer patients are also more likely to present recurrent VTE and major bleeding while taking anticoagulants. Management of VTE in these patients is always challenging and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME) released international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis, based on a systematic review of the literature ranked according to the Grading of Recommendations Assessment, Development, and Evaluation scale...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29201211/effects-of-freshwater-clam-extract-on-fracture-induced-inflammation-at-early-stage
#3
Kuang-Ting Yeh, Wen-Tien Wu, Yi-Maun Subeq, Chi-Chien Niu, Kuang-Wen Liao, Ing-Ho Chen, Ru-Ping Lee
The inflammatory process after traumatic fracture and soft tissue injury includes release of inflammatory cytokines and activated polymorph nuclear cells (PMN) that can cause subsequent affected limbs delayed healing and vital organ complications. Analgesics have good effect on relief of the symptom but may cause further burden for hepatic and renal metabolism. Freshwater clam extract (FCE) has been demonstrated to suppress the release of the pro-inflammatory cytokine tumor necrosis factor-α production after hemorrhagic shock, and decrease the level of liver injury marker in rats...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29200325/incidence-and-risk-factors-of-bacterial-and-fungal-infection-during-induction-chemotherapy-for-high-risk-neuroblastoma
#4
Sarah B Whittle, Kaitlin C Williamson, Heidi V Russell
High-risk neuroblastoma is an aggressive childhood cancer with poor outcomes. Treatment begins with an induction phase comprised of intense multi-agent chemotherapy with the goal of maximally reducing tumor bulk. Given the high intensity of induction chemotherapy, neutropenic fever and infectious complications are common; however, the actual incidence is difficult to determine from clinical trial reports. We performed a retrospective review of infection-related complications in 76 children treated for high-risk neuroblastoma at Texas Children's Hospital...
December 4, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29200147/pediatric-deep-venous-thrombosis-associated-with-staphylococcal-infections-single-institutional-experience
#5
Divyaswathi Citla Sridhar, Ossama M Maher, Nidra I Rodriguez
Deep venous thrombosis (DVT) has been previously reported in children with methicillin-resistant Staphylococcus aureus (MRSA). This study reviews our institutional experience by evaluating characteristics and outcomes of children with DVT and staphylococcal infections. Retrospective clinical data from 16 pediatric patients with DVT and staphylococcal infections over a 5-year period was obtained via medical record abstraction. Sixteen patients with a median age at diagnosis of 8 years were included. The most common infection encountered was osteomyelitis (56%)...
December 1, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29196794/ultrasound-guided-or-landmark-techniques-for-central-venous-catheter-placement-in-critically-ill-children
#6
Ignacio Oulego-Erroz, Rafael González-Cortes, Patricia García-Soler, Mónica Balaguer-Gargallo, Manuel Frías-Pérez, Juan Mayordomo-Colunga, Ana Llorente-de-la-Fuente, Paula Santos-Herraiz, Juan José Menéndez-Suso, María Sánchez-Porras, Daniel Palanca-Arias, Carmen Clavero-Rubio, Mª Soledad Holanda-Peña, Luis Renter-Valdovinos, Sira Fernández-De-Miguel, Antonio Rodríguez-Núñez
PURPOSE: To assess whether ultrasound guidance improves central venous catheter placement outcomes compared to the landmark technique in critically ill children. METHODS: A prospective multicentre observational study was carried out in 26 paediatric intensive care units over 6 months. Children 0-18 years old who received a temporary central venous catheter, inserted using either ultrasound or landmark techniques, were eligible. The primary outcome was the first-attempt success rate...
December 1, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29187653/-investigation-of-status-for-vascular-access-in-hemodialysis-patients-at-xiangya-hospital-of-central-south-university
#7
Yong Zhong, Jiaxi Pu, Xiang Ao, Weisheng Peng, Zhangzhe Peng, Xiaozhao Li, Xiangcheng Xiao, Qiaoling Zhou, Ping Xiao
To investigate the status of vascular access in hemodialysis patients in our center.
 Methods: The general information of hemodialysis patients and types and complications of vascular access at Xiangya Hospital of Central South University from April 2015 to April 2016, were retrospectively analyzed.
 Results: Among 258 prevalent patients, 87.60% of them had arteriovenous fistula (AVF), while 12.40% showed tunneled cuffed catheter. Of the 61 incident patients, 80.33% of them initiated dialysis with a non-tunneled and non-cuffed catheter, 8...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29167220/iatrogenic-injury-of-vertebral-artery-resulting-in-stroke-after-central-venous-line-insertion
#8
Vindya Abeysinghe, Jie Hua Xu, Kishore Sieunarine
There are many complications of central venous catheter insertion. Iatrogenic injury of the vertebral artery is a rare complication that can result in severe morbidity and mortality. The case presented describes the complication of an acute ischaemic stroke after cannulation of the vertebral artery. There are various techniques when obtaining central access, however the best practice as described by the evidence based guidelines produced by the American Society of Anesthesiologists utilises real-time ultrasound guidance to minimise adverse events...
November 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29160643/antithrombotic-treatment-in-neonates-and-children
#9
Cornelia H van Ommen
Despite the increasing incidence of venous thromboembolic disease in pediatric patients, it remains a rare complication in childhood. Particularly neonates and adolescents are at risk for development of venous thrombosis. Spontaneous thrombotic events are sporadic, the majority of children have multiple co-existing risk factors, including central venous catheter, asphyxia, congenital heart disease, infection, malignancy, surgery and hypovolemia. Most thrombi are diagnosed by ultrasonography. Recommendations for management of pediatric thrombosis are typically extrapolated from adult studies, despite many differences between adults and children, including developmental hemostasis...
November 21, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29153532/the-blind-pushing-technique-for-peripherally-inserted-central-catheter-placement-through-brachial-vein-puncture
#10
Jae Myeong Lee, Young Kwon Cho, Han Myun Kim, Myung Gyu Song, Soon-Young Song, Jae Woo Yeon, Dae Young Yoon, Sam Yeol Lee
OBJECTIVE: The objective of this study was to conduct a prospective clinical trial evaluating the technical feasibility and short-term clinical outcome of the blind pushing technique for placement of pretrimmed peripherally inserted central catheters (PICCs) through brachial vein access. METHODS: Patients requiring PICC placement at any of the three participating institutions were prospectively enrolled between January and December 2016. The review boards of all participating institutions approved this study, and informed consent was obtained from all patients...
November 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29151421/-disposable-nursing-applicator-pocket-of-indwelling-central-venous-catheter
#11
Congli Wei, Chunyuan Ma
Catheter related infection is the most common complication of central venous catheter, which pathogen mainly originate from the pipe joint and the skin around puncture site. How to prevent catheter infection is an important issue in clinical nursing. The utility model disclosed a "disposable nursing applicator-pocket of indwelling central venous catheter", which is mainly used for the fixation and the protection. The main structure consists of two parts, one is medical applicator to protect the skin around puncture site, and the other is gauze pocket to protect the catheter external connector...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#12
Abdelaali Bahadi, Mohammed Reda El Farouki, Yassir Zajjari, Driss El Kabbaj
INTRODUCTION: End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR). METHODS: This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29148007/how-to-treat-arteriovenous-graft-infection-total-versus-partial-graft-excision
#13
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
November 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#14
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148000/the-feasibility-and-safety-of-piccs-accessed-via-the-superficial-femoral-vein-in-patients-with-superior-vena-cava-syndrome
#15
Yonghui Wan, Yuxin Chu, Yanru Qiu, Qian Chen, Wei Zhou, Qibin Song
OBJECTIVE: To investigate the feasibility and safety of the peripherally inserted central catheters (PICCs) accessed via the superficial femoral vein in patients with superior vena cava syndrome (SVCS). METHODS: From October 2010 to December 2014, 221 cancer patients with SVCS in our center received real-time ultrasound-guidance of the superficial femoral vein inserted central catheters (FICCs) at the mid-thigh. PICC insertion via upper extremity veins had also been investigated in 2604 cancer patients without SVCS as control...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29135819/prophylactic-rtpa-in-the-prevention-of-line-associated-thrombosis-and-infection-in-short-bowel-syndrome
#16
Lynn M Malec, James Cooper, Jeffrey Rudolph, Marian G Michaels, Margaret V Ragni
BACKGROUND: Central venous access devices (CVADs) are essential for total parenteral nutrition administration in patients with short bowel syndrome (SBS). However, they are fraught with complications including infection and venous thromboembolism (VTE), which increases associated morbidity and mortality in this population. There is evidence linking the development of CVAD-associated thrombosis and line-related infection. Thus, it has been postulated that prevention of catheter-related clot formation could minimize the risk of infection originating from the catheter...
November 10, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29133462/improving-picc-use-and-outcomes-in-hospitalised-patients-an-interrupted-time-series-study-using-magic-criteria
#17
Lakshmi Swaminathan, Scott Flanders, Mary Rogers, Yvonne Calleja, Ashley Snyder, Rama Thyagarajan, Priscila Bercea, Vineet Chopra
BACKGROUND: Although important in clinical care, reports of inappropriate peripherally inserted central catheter (PICC) use are growing. OBJECTIVE: To test whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve PICC use and patient outcomes. DESIGN: Quasi-experimental, interrupted time series design at one study site with nine contemporaneous external controls. SETTING: Ten hospitals participating in a state-wide quality collaborative from 1 August 2014 to 31 July 2016...
November 13, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29133157/microbiological-and-clinical-characteristics-of-biofilm-forming-candida-parapsilosis-isolates-associated-with-fungaemia-and-their-impact-on-mortality
#18
Silvia Soldini, Brunella Posteraro, Antonietta Vella, Elena De Carolis, Elisa Borghi, Monica Falleni, Angela Raffaella Losito, Giuseppe Maiuro, Enrico Maria Trecarichi, Maurizio Sanguinetti, Mario Tumbarello
OBJECTIVES: Biofilm formation (BF) by fungal isolates may dramatically complicate infection. We determined the ability of C. parapsilosis isolates from single fungaemia episodes to form biofilms and we analysed biofilm subgroups for antifungal susceptibility and pathogenic potential. We then correlated BF with clinical characteristics and outcomes of the episodes. METHODS: BF was measured using the crystal-violet biomass assay, antifungal susceptibility of preformed biofilms was assessed, and virulence was studied using the Galleria mellonella model...
November 10, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29120892/ce-original-research-does-certification-in-vascular-access-matter-an-analysis-of-the-picc1-survey
#19
Vineet Chopra, Latoya Kuhn, Valerie Vaughn, David Ratz, Suzanne Winter, Nancy Moureau, Britt Meyer, Sarah Krein
Study reveals differences in practices and views between certified and noncertified inserters. ABSTRACT: Background: Although certification by an accredited agency is often a practice prerequisite in health care, it is not required of vascular access specialists who insert peripherally inserted central catheters (PICCs). Whether certification is associated with differences in practice among inserters is unknown. PURPOSE: The purpose of this study was to gather information regarding whether certified and noncertified PICC inserters differ with respect to their practices and views about PICC use...
November 8, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/29117059/vascular-access-in-critically-ill-pediatric-patients-with-obesity
#20
Elizabeth E Halvorson, Doug Case, Joseph A Skelton, Michael C McCrory
OBJECTIVES: Pediatric obesity is highly prevalent and has been associated with poor outcomes for hospitalized children. Vascular access is essential in critically ill patients. The aim of this study was to evaluate whether critically ill children with obesity are more likely to undergo vascular device insertion (excluding peripheral IV catheters) and develop related complications. DESIGN: Multi-institutional retrospective observational cohort study. SETTING: Ninety-four U...
November 7, 2017: Pediatric Critical Care Medicine
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