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Informed consent central venous catheter

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https://www.readbyqxmd.com/read/27884849/access-hd-pilot-a-randomised-feasibility-trial-comparing-catheters-with-fistulas-in-elderly-patients-starting-haemodialysis
#1
Robert Quinn, Pietro Ravani
INTRODUCTION: The selection of the type of vascular access for haemodialysis is an important intervention question. However, only observational studies are available to inform decision-making in this area, and they are at high risk of selection bias. While a clinical trial comparing the effects of the 2 most frequently chosen strategies for haemodialysis access (fistulas and catheters) on patient important and 'hard' clinical end points is needed, the feasibility of such a trial is uncertain...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27229130/sonography-for-complete-evaluation-of-neonatal-intensive-care-unit-central-support-devices-a-pilot-study
#2
David Saul, Samuel Ajayi, David L Schutzman, Mindy M Horrow
OBJECTIVES: Neonates in the neonatal intensive care unit often require considerable support with endotracheal tubes, umbilical arterial and venous catheters, and peripherally inserted central venous catheters. Support device evaluation with radiography exposes neonates to ionizing radiation. This study evaluated the effectiveness of sonographic localization for endotracheal tubes, umbilical arterial and venous catheters, and peripherally inserted central venous catheters. METHODS: This blinded prospective Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant study with informed consent compared sonography to radiography for endotracheal tube, umbilical arterial and venous catheter, and peripherally inserted central venous catheter localization...
July 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27012271/ultrasound-guided-supraclavicular-central-venous-catheter-tip-positioning-via-the-right-subclavian-vein-using-a-microconvex-probe
#3
Se-Chan Kim, Ingo Gräff, Alexandra Sommer, Andreas Hoeft, Stefan Weber
PURPOSE: The ultrasound-guided central venous catheter (CVC) guidewire tip positioning has been demonstrated for catheterization of the right internal jugular vein. We explored the feasibility of an ultrasound-guided right subclavian vein (RScV) CVC tip positioning via a right supraclavicular approach using a microconvex probe. METHODS: Twenty patients scheduled for elective surgery were consecutively included in this observational feasibility study following written informed consent...
September 21, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/26935961/catheter-infections-in-children-catch-a-randomised-controlled-trial-and-economic-evaluation-comparing-impregnated-and-standard-central-venous-catheters-in-children
#4
Katie Harron, Quen Mok, Kerry Dwan, Colin H Ridyard, Tracy Moitt, Michael Millar, Padmanabhan Ramnarayan, Shane M Tibby, Berit Muller-Pebody, Dyfrig A Hughes, Carrol Gamble, Ruth E Gilbert
BACKGROUND: Impregnated central venous catheters (CVCs) are recommended for adults to reduce bloodstream infection (BSI) but not for children. OBJECTIVE: To determine the effectiveness of impregnated compared with standard CVCs for reducing BSI in children admitted for intensive care. DESIGN: Multicentre randomised controlled trial, cost-effectiveness analysis from a NHS perspective and a generalisability analysis and cost impact analysis...
March 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/26438711/deferred-consent-for-randomized-controlled-trials-in-emergency-care-settings
#5
Katie Harron, Kerry Woolfall, Kerry Dwan, Carrol Gamble, Quen Mok, Padmanabhan Ramnarayan, Ruth Gilbert
BACKGROUND: There is limited experience in using deferred consent for studies involving children, which was legalized in the United Kingdom in 2008. We aimed to inform future studies by evaluating consent rates and reasons for nonconsent in a large randomized controlled trial in pediatric intensive care. METHODS: In the CATCH trial, eligible children from 14 PICUs in England and Wales were randomly assigned to 3 types of central venous catheters. To avoid delay in treatment, children admitted on an emergency basis were first randomly assigned to a trial central venous catheter, and we deferred seeking consent to use already collected data and blood samples until after stabilization...
November 2015: Pediatrics
https://www.readbyqxmd.com/read/25885054/immediate-access-arteriovenous-grafts-versus-tunnelled-central-venous-catheters-study-protocol-for-a-randomised-controlled-trial
#6
RANDOMIZED CONTROLLED TRIAL
Emma Aitken, Colin Geddes, Pete Thomson, Ram Kasthuri, Mohan Chandramohan, Colin Berry, David Kingsmore
BACKGROUND: Autologous arteriovenous fistulae (AVF) are the optimal form of vascular access for haemodialysis. AVFs typically require 6 to 8 weeks to "mature" from the time of surgery before they can be cannulated. Patients with end-stage renal disease needing urgent vascular access therefore traditionally require insertion of a tunnelled central venous catheter (TCVC). TCVCs are associated with high infection rates and central venous stenosis. Early cannulation synthetic arteriovenous grafts (ecAVG) provide a novel alternative to TCVCs, permitting rapid access to the bloodstream and immediate needling for haemodialysis...
2015: Trials
https://www.readbyqxmd.com/read/25778560/immediate-access-arteriovenous-grafts-versus-tunnelled-central-venous-catheters-study-protocol-for-a-randomised-controlled-trial
#7
Emma Aitken, Colin Geddes, Pete Thomson, Ram Kasthuri, Mohan Chandramohan, Colin Berry, David Kingsmore
BACKGROUND: Autologous arteriovenous fistulae (AVF) are the optimal form of vascular access for haemodialysis. AVFs typically require 6 to 8 weeks to "mature" from the time of surgery before they can be cannulated. Patients with end-stage renal disease needing urgent vascular access therefore traditionally require insertion of a tunnelled central venous catheter (TCVC). TCVCs are associated with high infection rates and central venous stenosis. Early cannulation synthetic arteriovenous grafts (ecAVG) provide a novel alternative to TCVCs, permitting rapid access to the bloodstream and immediate needling for haemodialysis...
December 2015: Trials
https://www.readbyqxmd.com/read/24962946/the-comparison-between-stroke-volume-variation-and-filling-pressure-as-an-estimate-of-right-ventricular-preload-in-patients-undergoing-renal-transplantation
#8
Daisuke Toyoda, Mitsue Fukuda, Ririko Iwasaki, Takashi Terada, Nobukazu Sato, Ryoichi Ochiai, Yoshifumi Kotake
PURPOSE: The purpose of this prospective, observational study was to respiratory variation of stroke volume (stroke volume variation, SVV) against central venous pressure (CVP) and pulmonary artery diastolic pressure (PADP) as an estimate of right and left ventricular preload. METHODS: With IRB approval and informed consent, 31 patients undergoing living related renal transplantation were analyzed. Under general anesthesia with positive pressure ventilation, stroke volume index and SVV were continuously monitored with FloTrac/Vigileo monitor...
February 2015: Journal of Anesthesia
https://www.readbyqxmd.com/read/23997555/fibrin-sheath-angioplasty-a-technique-to-prevent-superior-vena-cava-stenosis-secondary-to-dialysis-catheters
#9
Robert I Hacker, Lorena De Marco Garcia, Ankur Chawla, Thomas F Panetta
Fibrin sheaths are a heterogeneous matrix of cells and debris that form around catheters and are a known cause of central venous stenosis and catheter failure. A total of 50 cases of central venous catheter fibrin sheath angioplasty (FSA) after catheter removal or exchange are presented. A retrospective review of an outpatient office database identified 70 eligible patients over a 19-month period. After informed consent was obtained, the dialysis catheter exiting the skin was clamped, amputated, and a wire was inserted...
September 2012: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/23748817/home-artificial-nutrition-in-advanced-cancer-patients
#10
Enrico Ruggeri, Federica Agostini, Luana Fettucciari, Marilena Giannantonio, Loris Pironi, Franco Pannuti
AIMS AND BACKGROUND: Malnutrition is over 50% in advanced cancer patients and is related to a decreased survival. Cachexia is the first reason for death in 4-23% of cases. The aim of the study was to estimate the appropriateness of the criteria to select patients for home artificial nutrition and its effectiveness to avoid death from cachexia and to improve quality of life in patients with advanced cancer assisted at home by the National Tumor Association (ANT) Foundation. METHODS AND STUDY DESIGN: The criteria for patient selection are: inadequate caloric intake ± malnutrition; life expectancy ≥6 weeks; suitable psycho-physical conditions; informed consent...
March 2013: Tumori
https://www.readbyqxmd.com/read/23162392/hemodynamic-changes-during-robotic-radical-prostatectomy
#11
Vanlal Darlong, Nishad Poolayullathil Kunhabdulla, Ravindra Pandey, Chandralekha, Jyotsna Punj, Rakesh Garg, Rajeev Kumar
BACKGROUND: Effect on hemodynamic changes and experience of robot-assisted laparoscopic radical prostatectomy (RALRP) in steep Trendelenburg position (45°) with high-pressure CO(2) pneumoperitoneum is very limited. Therefore, we planned this prospective clinical trial to study the effect of steep Tredelenburg position with high-pressure CO(2) pneumoperitoneum on hemodynamic parameters in a patient undergoing RALRP using FloTrac/Vigileo™1.10. METHODS: After ethical approval and informed consent, 15 patients scheduled for RALRP were included in the study...
July 2012: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/23059715/a-comparison-of-coagulation-study-results-between-heparinized-peripherally-inserted-central-catheters-and-venipunctures
#12
COMPARATIVE STUDY
Linda Humphries, Kathleen M Baldwin, Kirstena L Clark, Vivian Tenuta, Kimberly Brumley
PURPOSE/OBJECTIVE: The purpose of this study was to test an evidence-based procedure of drawing blood samples for coagulation testing from heparinized peripherally inserted central catheter (PICC) by comparing results with blood drawn from venipuncture (VP). DESIGN: A prospective, quasi-experimental design using purposive sampling was used. SETTING: The setting was a 230-bed community hospital located in the Southwest. The hospital is part of a 15-hospital system...
November 2012: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/23034121/efficacy-and-safety-of-venous-angioplasty-of-the-extracranial-veins-for-multiple-sclerosis-brave-dreams-study-brain-venous-drainage-exploited-against-multiple-sclerosis-study-protocol-for-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Paolo Zamboni, Antonio Bertolotto, Paolo Boldrini, Patrizia Cenni, Roberto D'Alessandro, Roberto D'Amico, Massimo Del Sette, Roberto Galeotti, Stefania Galimberti, Alessandro Liberati, Luca Massacesi, Donato Papini, Fabrizio Salvi, Silvana Simi, Andrea Stella, Luigi Tesio, Maria Grazia Valsecchi, Graziella Filippini
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system with a disabling progressive course. Chronic cerebrospinal venous insufficiency (CCSVI) has recently been described as a vascular condition characterized by restricted venous outflow from the brain, mainly due to blockages of the internal jugular and azygos veins. Despite a wide variability among studies, it has been found to be associated with MS. Data from a few small case series suggest possible improvement of the clinical course and quality of life by performing percutaneous balloon angioplasty (PTA) of the stenotic veins...
2012: Trials
https://www.readbyqxmd.com/read/22870249/making-co-enrolment-feasible-for-randomised-controlled-trials-in-paediatric-intensive-care
#14
REVIEW
Katie Harron, Twin Lee, Tracy Ball, Quen Mok, Carrol Gamble, Duncan Macrae, Ruth Gilbert
AIMS: Enrolling children into several trials could increase recruitment and lead to quicker delivery of optimal care in paediatric intensive care units (PICU). We evaluated decisions taken by clinicians and parents in PICU on co-enrolment for two large pragmatic trials: the CATCH trial (CATheters in CHildren) comparing impregnated with standard central venous catheters (CVCs) for reducing bloodstream infection in PICU and the CHIP trial comparing tight versus standard control of hyperglycaemia...
2012: PloS One
https://www.readbyqxmd.com/read/22856492/breakdown-of-the-consent-process-at-a-quaternary-medical-center-our-full-disclosure
#15
Lindsay M Fairfax, A Britton Christmas, H James Norton, David G Jacobs
Circumstances may arise in the intensive care unit (ICU) when the physician is unable to obtain informed consent. We undertook this study to determine the variations in the consent process. An anonymous survey was distributed to all critical care nurses (RN), resident physicians (RES), advanced practitioners (AP), and attending physicians (ATT). Participants were asked to describe the risks of nine common ICU procedures (central venous line, peripherally inserted central catheter, bronchoscopy, tube thoracostomy, tracheostomy, vena cava filter, angioembolization, image-guided drainage, and percutaneous endoscopic gastrostomy tube)...
August 2012: American Surgeon
https://www.readbyqxmd.com/read/22846944/insertion-of-central-venous-catheters-induces-a-hypercoagulable-state
#16
COMPARATIVE STUDY
Mark L Ryan, Chad M Thorson, David R King, Robert M Van Haren, Ronald J Manning, David M Andrews, Alan S Livingstone, Kenneth G Proctor
BACKGROUND: Central venous catheters (CVCs) increase the risk of venous thromboembolism. We have previously demonstrated that pulmonary artery catheters are associated with a hypercoagulable state in an animal model and in patients. The purpose of this study is to determine whether the insertion of a CVC is associated with a similar response. METHODS: HASH(0x3fb2778) ANIMAL: 7F femoral artery catheters were placed in healthy anesthetized swine (N = 16)...
August 2012: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/21534230/central-venous-catheters-legal-issues
#17
REVIEW
Maurizio Gallieni, Valentina Martina, Maria Antonietta Rizzo, Luciana Gravellone, Francesca Mobilia, Antonino Giordano, Daniele Cusi, Umberto Genovese
In dialysis patients, both central venous catheter (CVC) insertion and CVC use during the dialysis procedure pose important legal issues, because of potentially severe, even fatal, complications. The first issue is the decision of the kind of vascular access that should be proposed to patients: an arteriovenous (AV) fistula, a graft, or a CVC. The second issue, when choosing the CVC option, is the choice of CVC: nontunneled versus tunneled. Leaving a temporary nontunneled CVC for a prolonged time increases the risk of complications and could raise a liability issue...
October 2011: Journal of Vascular Access
https://www.readbyqxmd.com/read/20574104/triple-lumen-peripherally-inserted-central-catheter-in-patients-in-the-critical-care-unit-prospective-evaluation
#18
RANDOMIZED CONTROLLED TRIAL
Scott O Trerotola, S William Stavropoulos, Jeffrey I Mondschein, Aalpen A Patel, Neil Fishman, Barry Fuchs, Daniel M Kolansky, Scott Kasner, John Pryor, Jesse Chittams
PURPOSE: To prospectively evaluate outcomes associated with use of a triple-lumen (TL) peripherally inserted central catheter (PICC) in the intensive care unit (ICU) setting. MATERIALS AND METHODS: Patients were prospectively enrolled in this HIPAA-compliant, institutional review board-approved study. Informed consent was obtained. All patients were in one hospital's ICUs and needed intermediate-term central venous access requiring three lumina. A 6-F tapered TL PICC was placed by a bedside nursing-based team with backup from the Interventional Radiology department...
July 2010: Radiology
https://www.readbyqxmd.com/read/20308906/comparison-of-central-and-mixed-venous-saturation-during-liver-transplantation-in-cirrhotic-patients-a-pilot-study
#19
COMPARATIVE STUDY
Souhayl Dahmani, Catherine Paugam-Burtz, Tobias Gauss, Michael Alves, Eric Le Bihan, Scander Necib, Jacques Belghiti, Jean Mantz
BACKGROUND AND OBJECTIVE: Liver transplantation is associated with important haemodynamic variations requiring cardiac output and oximetric data monitoring. The mixed venous saturation (SvO2) integrates parameters combining information about oxygen consumption, cardiac output and haemoglobin concentration. Central venous saturation (ScvO2) can be directly measured from blood drawn in the superior venous system via a central venous catheter. ScvO2 has been proposed as an alternative to SvO2 for intraoperative haemodynamic monitoring...
August 2010: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/19935072/ultrasound-guided-external-jugular-vein-cannulation-for-central-venous-access-by-inexperienced-trainees
#20
RANDOMIZED CONTROLLED TRIAL
Călin I Mitre, Adela Golea, Iurie Acalovschi, Teodora Mocan, Ana-Maria Caea, Claudia Ruţă, Mureşan Mariana
BACKGROUND AND OBJECTIVE: The insertion of central venous catheters via the external jugular vein (EJV) is not always practical because of the relatively frequent failure rate; thus, the internal jugular approach is generally used. Data from the literature suggest that ultrasound-guided catheterization of the internal jugular vein is superior to the surface anatomy landmark technique and, therefore, should be the method of choice. We evaluated the value of ultrasound guidance in the learning process of central venous cannulation via EJV by similarly inexperienced trainees...
March 2010: European Journal of Anaesthesiology
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