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Xiao-Ju Zhu, Ling Zhao, Na Peng, Jia-Min Luo, Shui-Xia Liu
BACKGROUND: Peripherally inserted central catheters (PICCs) are an essential infusion route for oncology patients receiving intravenous treatments, but lower extremity venipuncture is the preferred technique for patients with superior vena cava syndrome (SVCS). We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein, to indicate and verify PICC catheterisation in the lower extremity is safe and feasible. And hope to provide different perspectives for clinical PICC venipuncture to get the attention of peers...
March 16, 2024: World Journal of Clinical Cases
#2
JOURNAL ARTICLE
Leila Naddi, Ola Borgquist, Maria Adrian, Björn P Bark, Thomas Kander
INTRODUCTION: Central venous catheters are indispensable in modern healthcare. Unfortunately, they are accompanied by minor as well as major complications, leading to increased morbidity, mortality and costs. Immediate insertion-related complications (mechanical complications) have decreased due to the implementation of real-time ultrasound guidance, but they still occur and additional efforts to enhance patient safety are warranted. This study aims to investigate whether the use of a needle guide mounted on the ultrasound probe in subclavian catheterisations may decrease the number of catheterisations with >1 skin puncture (primary outcome)...
December 19, 2023: BMJ Open
#3
JOURNAL ARTICLE
Adrian Ebner, Santiago Gallo, Juan Castellano, Maria Filartiga, Allie Haarstad, Cory Pries, Kate Gahlbeck, Mariah McMahon, Camila Herrera, Martha Avila, Kem Schankereli, Rick Murphy, Mark Stenoien, Zeeshan Syedain, Haimanot Wasse
INTRODUCTION: The long-term survival and low complication rate of autogenous fistulas for hemodialysis access is often offset by early thrombosis and slow or failed maturation leading to the use of central venous catheters. A regenerative material may have the potential to overcome these limitations. A completely biological acellular vascular conduit was investigated in this first-in-human clinical study. METHODS: With approval of the ethics board and patients' informed consent, five subjects were enrolled based on predetermined inclusion criteria...
March 9, 2023: Journal of Vascular Access
#4
JOURNAL ARTICLE
José Luis Cobo-Sánchez, Ian Blanco-Mavillard, Raquel Pelayo-Alonso, Noelia Mancebo-Salas, Ismael Fernandez-Fernandez, Joan Ernest De Pedro-Gomez
INTRODUCTION: Haemodialysis patients with central venous catheter (HD-CVC) are at increased risk of exit site infections (ESIs) and catheter-related bloodstream infections, causing an increase of hospitalisation, morbidity and mortality rates. The main aim of the EXITA Study is to develop and validate an instrument for the early detection of HD-CVC ESIs. METHODS AND ANALYSIS: EXITA is a multicentre prospective cohort study to validate the proposed instrument with a sample of 457 HD-CVCs: 92 in the ESI group and 365 in the non-ESI group...
September 6, 2022: BMJ Open
#5
RANDOMIZED CONTROLLED TRIAL
Makena Pook, Nasim Zamir, Ellen McDonald, Alison Fox-Robichaud
PURPOSE: Intensive care unit (ICU) patients are at risk for central line-associated bloodstream infection (CLABSI) with significant attributable mortality and increased hospital length of stay, readmissions, and costs. Chlorhexidine (di)gluconate (CHG) is used as a disinfectant for central line insertion; however, the feasibility and efficacy of using CHG as a locking solution is unknown. METHODS: Patients with a central venous access device (CVAD) in situ were randomized to standard care or a CHG lock solution (CHGLS) within 72 hours of ICU admission...
July 21, 2022: British Journal of Nursing: BJN
#6
JOURNAL ARTICLE
Christina Belza, Wendy J Ungar, Yaron Avitzur, Robyn Stremler, Darcy Fehlings, Paul W Wales
OBJECTIVE: To measure the time that caregivers spend on tasks related to providing care to their child with intestinal failure receiving home parenteral nutrition (PN). STUDY DESIGN: We conducted an exploratory cross-sectional study of caregivers of children with intestinal failure receiving long-term PN followed by our intestinal rehabilitation program. Caregivers completed a daily diary of care-related tasks. Data were analyzed using descriptive statistics. Exploratory models were completed to evaluate factors that influenced the amount of time that caregivers spent providing care...
November 2022: Journal of Pediatrics
#7
JOURNAL ARTICLE
Amanda J Ullman, Deanne August, Tricia Kleidon, Rachel Walker, Nicole M Marsh, Andrew Bulmer, Benjamin Pearch, Naomi Runnegar, Jessica A Schults, Joanne Leema, Paul Lee-Archer, Cathy Biles, Katrina Southam, Victoria Gibson, Joshua Byrnes, Robert S Ware, Vineet Chopra, Alan Coulthard, Peter Mollee, Claire M Rickard, Patrick N A Harris
INTRODUCTION: Peripherally inserted central catheters (PICCs) are vital for the delivery of medical therapies, but up to 30% of PICCs are associated with complications such as deep vein thrombosis or infection. The integration of antimicrobial and hydrophobic catheter materials, and pressure-activated valves, into polyurethane PICCs are innovations designed to prevent infective and/or thrombotic complications. METHODS AND ANALYSIS: A multicentre, parallel group, superiority randomised controlled trial with two experimental arms ((1) hydrophobic PICC (with pressure-activated valve); (2) chlorhexidine gluconate-impregnated PICC (with external clamp)) and one control group ((3) conventional polyurethane PICC (with external clamp))...
April 14, 2021: BMJ Open
#8
JOURNAL ARTICLE
Alix Marie Pouget, Elodie Civade, Philippe Cestac, Charlotte Rouzaud-Laborde
INTRODUCTION: Clinical pharmacy improves patient safety and secures drug management using information, education and good clinical practices. However, medical device management is still unexplored, and proof of effectiveness is needed. A PICC line (peripherally inserted central catheter) is a medical device for infusion. It accesses the central venous system after being implanted in a peripheral vein. However, complications after implantation often interfere with smooth execution of the treatment...
April 7, 2021: BMJ Open
#9
REVIEW
Kavitha C Raghavan, Manon Hache, Purva Bulsara, Zhaohua Lu, Michael G Rossi
BACKGROUND: Perianesthetic neurological adverse events are rare in children and have been studied in detail in the settings of cardiac surgery and regional anesthesia. Our study aims to characterize perianesthetic neurological adverse events in children in the setting of all types of surgery and diagnostic or interventional procedures, to evaluate anesthesia's role, and to identify factors amenable to prevention. METHODS: We conducted a retrospective study by reviewing all the anesthetic encounters reported in the Wake-Up Safe database between January 2010 and December 2017...
May 2021: Paediatric Anaesthesia
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JOURNAL ARTICLE
Yan-Bo Chen, Hao-Shi Bao, He-Ran Deng, Ting-Ting Hu, Biao-Lin Wen, Chun-Yan Yi, Xiu-Wan Chen, Li Yan, Jian-Nan Wu
BACKGROUND: Internal jugular vein (IJV) and axillary vein/subclavian vein (AxV/SCV) are commonly used for implantable venous access port (IVAP) implantation in breast cancer (BC) patients with chemotherapy. Previous studies focused on complications between these different approaches and ignored patient comfort. In this study, we aim to compare patient comfort between IJV and AxV/SCV approaches, as well as surgery duration and complications. METHODS: This is a single-center prospective randomized controlled clinical trial...
November 2020: Annals of Palliative Medicine
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JOURNAL ARTICLE
Jane O'Sullivan, Cathleen McCarrick, Paul Tierney, Donal B O'Connor, Jack Collins, Robert Franklin
BACKGROUND: The American Medical Association Code of Medical Ethics states that any clinical image taken for public education forms part of the patient's records. Hence, a patient's informed consent is required to collect, share, and distribute their image. Patients must be informed of the intended use of the clinical image and the intended audience as part of the informed consent. OBJECTIVE: This paper aimed to determine whether a random selection of instructional videos containing footage of central venous catheter insertion on real patients on YouTube (Google LLC) would mention the presence of informed consent to post the video on social media...
October 13, 2020: JMIR Medical Education
#12
REVIEW
Gloria Pelizzo, Pietro Bagolan, Francesco Morini, Mariagrazia Aceti, Daniele Alberti, Mario Andermarcher, Luigi Avolio, Fabio Bartoli, Vito Briganti, Sebastiano Cacciaguerra, Francesco S Camoglio, Pierluca Ceccarelli, Maurizio Cheli, Fabio Chiarenza, Enrico Ciardini, Marcello Cimador, Ennio Clemente, Denis A Cozzi, Luigi Dall' Oglio, Ugo De Luca, Carmine Del Rossi, Ciro Esposito, Diego Falchetti, Silvana Federici, Piergiorgio Gamba, Valerio Gentilino, Girolamo Mattioli, Ascanio Martino, Mario Messina, Bruno Noccioli, Alessandro Inserra, Pierluigi Lelli Chiesa, Ernesto Leva, Francesco Licciardi, Paola Midrio, Maria Nobili, Alfonso Papparella, Guglielmo Paradies, Giuseppe Piazza, Alessio Pini Prato, Fabio Rossi, Giovanna Riccipetitoni, Carmelo Romeo, Domenico Salerno, Alessandro Settimi, Jurgen Schleef, Mario Milazzo, Valeria Calcaterra, Mario Lima
INTRODUCTION: This is the report of the first official survey from the Italian Society of Pediatric Surgery (ISPS) to appraise the distribution and organization of bedside surgery in the neonatal intensive care units (NICU) in Italy. METHODS: A questionnaire requesting general data, staff data and workload data of the centers was developed and sent by means of an online cloud-based software instrument to all Italian pediatric surgery Units. RESULTS: The survey was answered by 34 (65%) out of 52 centers...
September 16, 2020: Italian Journal of Pediatrics
#13
JOURNAL ARTICLE
Christopher Gallo, Pezhman Foroughi, Elisabeth Meagher, Ranjith Vellody, Bhupender Yadav, Anthony Ho, Alican Demir, Dorothee Heisenberg, Kevin Cleary, Karun Sharma
INTRODUCTION: Vascular access for central venous catheter placement is technically challenging in children. Ultrasound guidance is recommended for pediatric central venous catheter placement, yet many practitioners rely on imprecise anatomic landmark techniques risking procedure failure due to difficulty mastering ultrasound guidance. A novel navigation system provides a visual overlay on real-time ultrasound images to depict needle trajectory and tip location during cannulation. We report the first pediatric study assessing feasibility and preliminary safety of using a computer-assisted needle navigation system to aid in central venous access...
November 2020: Journal of Vascular Access
#14
JOURNAL ARTICLE
Yoshifumi Noda, Satoshi Goshima, Shoma Nagata, Hiroshi Kawada, Yukichi Tanahashi, Takehiro Kato, Tetsuya Suwa, Nobuyuki Kawai, Daisuke Yabe, Masayuki Matsuo
OBJECTIVE: To evaluate the utility of microcatheter in adrenal venous sampling (AVS) for assessing aldosterone hypersecretion and the laterality in patients with primary aldosteronism. METHODS: This retrospective study was approved by the institutional review board of Gifu University Hospital, and written informed consent was waived. A total of 37 consecutive patients with primary aldosteronism underwent AVS by inserting a microcatheter into the right adrenal central vein (RCV), left adrenal central vein (LCV), and left adrenal common trunk (CT) followed by AVS with 5-French (5-Fr) catheter...
May 1, 2020: British Journal of Radiology
#15
JOURNAL ARTICLE
Nasim Zamir, Makena Pook, Ellen McDonald, Alison E Fox-Robichaud
BACKGROUND: Critically ill patients in the intensive care unit (ICU) are at risk for central line-associated bloodstream infection (CLABSI) with an incidence up to 6.9 per 1000 catheter days. CLABSI has a significant attributable mortality and increases in-hospital length of stay, readmissions, and costs. Chlorhexidine gluconate (CHG), a broad-spectrum biocide, has been shown to effectively reduce infections including CLABSI; however, few trials have utilized CHG for prevention of central line infections...
2020: Pilot and Feasibility Studies
#16
JOURNAL ARTICLE
Malik Nadeem Azam, Batool Butt, Taleah Tahir, Nudrat Jehangir Khan, Muhammad Khalid Rahman, Khalid Mehmood Raja, Abdul Rehman Arshad, Abdul Wahab Mir
BACKGROUND: Chronic kidney disease is a growing disease with high morbidity and mortality. Haemodialysis remains the most common option available for all those not planning for renal transplantation. Vascular access is the most important aspect of haemodialysis. Though not recommended but central venous catheters remain the most common vascular access in starters on haemodialysis. There is a growing trend towards placement of tunnelled cuffed catheters (TCC). Tunnelled cuffed catheters placement requires fluoroscopic guidance which is not available in all centres...
October 2019: Journal of Ayub Medical College, Abbottabad: JAMC
#17
REVIEW
Fulvio Fiorini, Antonio Granata
Central venous catheterization is a procedure frequently performed in daily clinical practice. The use of ultrasound during central venous catheter placement has significantly reduced the number of complications. However, while the outcome of the procedure has significantly improved, the number of legal disputes has increased. Despite the current legislation has repeatedly stressed the importance of adequately collecting informed consent, to date many legal cases show that this procedure is only superficially followed...
December 9, 2019: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
#18
JOURNAL ARTICLE
Junren Kang, Bing Liu, Wenyan Sun
RATIONALE: Peripherally inserted central catheters (PICC), normally located at the lower 1/3rd of the superior vena cava (SVC) and cavo-atrial junction, are commonly used in cancer patients. Persistent left superior vena cava (PLSVC) is a vascular anomaly, in patients with which seldom research was reported about PICC implanted. After obtaining written informed consent, we present a case where two successful insertions of PICC were performed in a 50-year-old female patient with PLSVC and right SVC...
September 2019: Medicine (Baltimore)
#19
JOURNAL ARTICLE
Keti Dalla, Odd Bech-Hanssen, Sven-Erik Ricksten
BACKGROUND: In this observational study, the effects of norepinephrine-induced changes in mean arterial pressure (MAP) on right ventricular (RV) systolic function, afterload and pulmonary haemodynamics were studied in septic shock patients. We hypothesised that RV systolic function improves at higher doses of norepinephrine/MAP levels. METHODS: Eleven patients with septic shock requiring norepinephrine after fluid resuscitation were included <24 hours after ICU arrival...
November 2019: Acta Anaesthesiologica Scandinavica
#20
JOURNAL ARTICLE
Chuanlin Zhang, Zeju Zhang, Jie Mi, Xueqin Wang, Yujun Zou, Xiaoya Chen, Zhi Nie, Xinyi Luo, Ruiying Gan
Few prospective studies have reported the cumulative incidence of venous thromboembolism (VTE) in the intensive care unit (ICU), especially for patients receiving guideline-recommended VTE prophylaxis. We aimed to design a prospective observational study to investigate the cumulative incidence and risk factors of ICU-acquired VTE for those populations.We prospectively studied 281 consecutively included patients in the ICU at a single center. All patients provided informed consent. Patients received ultrasound evaluation and were followed for VTE before ICU discharge or within 28 days of ICU stay...
June 2019: Medicine (Baltimore)
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