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Cvc removal

Max B van Gent, Wendeline J van der Made, Perla J Marang-van de Mheen, Koen E van der Bogt
OBJECTIVE: To analyze the rate of infections and complications after surgeon-performed, largely ultrasound-guided, central venous catheter (CVC) placement in a pediatric population and to identify patients at high risk of complications. METHODS: All children aged between 4 months and 19 years with a percutaneous CVC inserted between January 1, 2000, and July 31, 2013, were included. Patient records were reviewed retrospectively for the occurrence of infection and other complications until CVC removal or the last outpatient clinic visit and compared between patient groups and with the recent literature...
October 14, 2016: Surgical Infections
Silvia Calviño Günther, Carole Schwebel, Rebecca Hamidfar-Roy, Agnès Bonadona, Maxime Lugosi, Claire Ara-Somohano, Clémence Minet, Leïla Potton, Jean-Charles Cartier, Aurelien Vésin, Magalie Chautemps, Lenka Styfalova, Stephane Ruckly, Jean-François Timsit
PURPOSE: To describe all post-insertion complications involving most used intravascular access, and to determine whether the use of a new-generation transparent dressing (3M™ IV Advanced) might reduce their number and impact on ICU patient outcomes. METHODS: Patients older than 18, with an expected length of stay ≥48 h and requiring at least one central venous catheter (CVC), arterial catheter (AC), haemodialysis catheter (HDC), pulmonary arterial catheters (PAC) or peripheral venous catheter (PVC) were randomized into two groups: a new-generation transparent dressing, or the hospital's classical transparent dressing, and were followed daily for any infectious and non-infectious complications...
October 12, 2016: Intensive Care Medicine
Massimo Lodi, Reza Far Ebrahimi, Piera Pezzotti, Luciano Carbonari
The use of the tunneled central venous catheter (CVC) is steadily increasing worldwide as a means of vascular access for hemodialysis. The increased use of these devices, which often outlive the patients, and the extended time they are used are associated with more frequent complications. Among these, one of the emerging complications is that of the "embedded" or stuck catheter. This term refers to when the catheter cannot be removed after detaching the retention cuff. In medical literature, experiences with the removal of stuck catheters are described with the use of several different methods...
September 27, 2016: Journal of Vascular Access
Sara C Keller, Deborah Williams, Mitra Gavgani, David Hirsch, John Adamovich, Dawn Hohl, Amanda Krosche, Sara Cosgrove, Trish M Perl
BACKGROUND Patients are frequently discharged with central venous catheters (CVCs) for home infusion therapy. OBJECTIVE To study a prospective cohort of patients receiving home infusion therapy to identify environmental and other risk factors for complications. DESIGN Prospective cohort study between March and December 2015. SETTING Home infusion therapy after discharge from academic medical centers. PARTICIPANTS Of 368 eligible patients discharged from 2 academic hospitals to home with peripherally inserted central catheters and tunneled CVCs, 222 consented...
October 4, 2016: Infection Control and Hospital Epidemiology
Jeffrey Forris Beecham Chick, Shilpa N Reddy, Ruchika D Bhatt, Benjamin J Shin, James N Kirkpatrick, Scott O Trerotola
PURPOSE: To explore significance, management, and outcomes of central venous catheter (CVC) tip-associated thrombi incidentally detected on echocardiography. MATERIALS AND METHODS: Echocardiogram data from all patients with CVCs from October 2009 to June 2011 were reviewed (N = 170). Patients with CVC tip-associated thrombi were selected (n = 49). Echocardiograms were reviewed for ejection fraction, presence of patent foramen ovale (PFO), presence of other intracardiac shunts, and mean thrombus size...
September 19, 2016: Journal of Vascular and Interventional Radiology: JVIR
İlker Devrim, Rana İşgüder, Hasan Ağın, Gökhan Ceylan, Yüce Ayhan, Özlem Sara Sandal, Ferhat Sarı, Ahu Kara, Mine Düzgöl, Gamze Gülfidan, Nuri Bayram
BACKGROUND: We aimed to evaluate the correlation of caspofungin E-tests with the prognosis and response to caspofungin therapy of Candida parapsilosis complex bloodstream infections in children hospitalized in a pediatric intensive care unit. METHODS: All children who had C. parapsilosis complex bloodstream infections and who were treated with caspofungin were included in this retrospective study. For each patient, the following parameters, including all consecutive blood and central venous catheter (CVC) cultures, the duration between diagnosis and CVC removal, mortality rate, relapses of the C...
2016: Mediterranean Journal of Hematology and Infectious Diseases
Munehiro Furuichi, Isao Miyairi
BACKGROUND: Coagulase-negative Staphylococcus (CoNS) is the predominant cause of catheter-related bloodstream infections (CRBSI). Infants in neonatal intensive care units (NICU) often suffer from CoNS CRBSI, which are often refractory to treatment. OBJECTIVES: We sought to evaluate risk factors for developing persistent bacteremia due to CoNS CRBSI in infants, in order to identify those who require early aggressive management. METHODS: We conducted a retrospective case-control study of infants in the NICU who developed CRBSI due to CoNS...
September 16, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Stefano Avanzini, Leila Mameli, Nicola Disma, Clelia Zanaboni, Andrea Dato, Giovanni Montobbio, Luigi Montagnini, Michela Bevilacqua, Filomena Pierri, Massimo Conte, Loredana Amoroso, Giovanna Pala, Sara Pestarino, Elio Castagnola, Angelo Claudio Molinari, Concetta Micalizzi, Giuseppe Morreale, Girolamo Mattioli, A Pini Prato
BACKGROUND: Ultrasound-guided (USG) cannulation of the brachiocephalic vein (BCV) is gaining worldwide consensus for central venous access in children. This study reports a 20-month experience with this approach in children. METHODS: All patients who underwent percutaneous USG central venous catheter (CVC) positioning in the BCV between August 2013 and March 2015 have been included. Devices inserted during this period were open-ended, either single or double-lumen tunneled CVC...
August 31, 2016: Pediatric Blood & Cancer
Francesco Barchiesi, Elena Orsetti, Patrizia Osimani, Carlo Catassi, Fabio Santelli, Esther Manso
BACKGROUND: Although Candida albicans is the most common cause of fungal blood stream infections (BSIs), infections due to Candida species other than C. albicans are rising. Candida parapsilosis complex has emerged as an important fungal pathogen and became one of the main causes of fungemia in specific geographical areas. We analyzed the factors related to outcome of candidemia due to C. parapsilosis in a single tertiary referral hospital over a five-year period. METHODS: A retrospective observational study of all cases of candidemia was carried out at a 980-bedded University Hospital in Italy...
2016: BMC Infectious Diseases
Parul A Patel, Susan Boehm, Ying Zhou, Catherine Zhu, Kari E Peterson, Althea Grayes, Lance R Peterson
BACKGROUND: Major complications of central venous catheter (CVC) use include bloodstream infection and occlusion. We performed a prospective, observational study to determine the rate of central line-associated bloodstream infection (CLABSI) and CVC occlusion using a negative displacement connector with an alcohol disinfecting cap. METHODS: Patients were followed from the time of CVC insertion through 2 days after removal, at the time of hospital discharge if there was no documentation of removal, or 90 days after the insertion of the CVC if it was not removed...
August 4, 2016: American Journal of Infection Control
Yong Duk Jeon, Woo Yong Jeong, Moo Hyun Kim, In Young Jung, Mi Young Ahn, Hea Won Ann, Jin Young Ahn, Sang Hoon Han, Jun Yong Choi, Young Goo Song, June Myung Kim, Nam Su Ku
Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients. In this study, we investigated the risk factors for mortality in patients with S. maltophilia bacteremia.Retrospectively, medical records from all patients with S. maltophilia bacteremia between December 2005 and 2014 at Severance Hospital, a 2000-bed tertiary care hospital in Seoul, Korea, were reviewed. Analysis was performed to identify factors associated with 28-day mortality...
August 2016: Medicine (Baltimore)
Wee Ming Peh, Wann Jia Loh, Ghee Chee Phua, Chian Min Loo
Guidewire retention is a severe but preventable complication from central venous catheter (CVC) insertion. There were three cases of guidewire retention during CVC insertion in the medical intensive care unit (MICU) in Singapore General Hospital, in the period between December 2011 and February 2012. The primary objective of this quality improvement project was to eliminate future incidences of guidewire retention during CVC insertion in the MICU and medical intermediate care area (MICA) via a structured educational program and a cost effective modified CVC set...
2016: BMJ Quality Improvement Reports
Roberto Luzzati, Maria Merelli, Filippo Ansaldi, Chiara Rosin, Annamaria Azzini, Silvia Cavinato, Pierluigi Brugnaro, Claudio Vedovelli, Annamaria Cattelan, Busetti Marina, Giuseppe Gatti, Ercole Concia, Matteo Bassetti
PURPOSE: Risk factors for nosocomial candidemia, severity of sepsis, treatment, and outcome were compared between patients admitted to medicine wards and those to surgical and intensive care units (ICUs). METHODS: Data were retrospectively collected from patients belonging to six referral hospitals in Italy between January 2011 and December 2013. Risk factors for 30-day mortality were evaluated in the whole patient population. RESULTS: A total of 686 patients (mean age 70 ± 15 years) with candidemia were included...
July 11, 2016: Infection
Susanne Janum, Arash Afshari
BACKGROUND: Candida bloodstream infections most often affect those already suffering serious, potentially life-threatening conditions and often cause significant morbidity and mortality. Most affected persons have a central venous catheter (CVC) in place. The best CVC management in these cases has been widely debated in recent years, while the incidence of candidaemia has markedly increased. OBJECTIVES: The main purpose of this review is to examine the impact of removing versus retaining a CVC on mortality in adults and children with candidaemia who have a CVC in place...
2016: Cochrane Database of Systematic Reviews
Rabia Topan, Tim Ambrose, Mia Small, Elewys Lightman, Jeremy Nightingale, Simon M Gabe
Spinal infections are a rare yet serious metastatic complication of bacteremia among patients with long-term central venous catheters (CVCs) for which clinicians must remain vigilant. We performed a retrospective review of all cases of spinal infection occurring in the context of a CVC for long-term parenteral nutrition (PN) managed in our department between January 2010 and October 2013, a cohort of 310 patients over this time period. Six patients were identified (mean age, 65 years; 5 male). One hundred percent of patients presented with spinal pain (5/6 cervical, 1/6 thoracic)...
July 6, 2016: Nutrition in Clinical Practice
B Balakrishnan, Z Noor, C L Curran
INTRODUCTION: Venous air embolism (VAE) due to central venous catheter (CVC) placement is a rare but preventable complication which is potentially fatal. We describe a case highlighting unique patient characteristics which increase the risk of developing VAE. CASE DESCRIPTION: A sixty-year-old gentleman was admitted to the hospital with dyspnea and altered mental status. His comorbidities include cancer of the neck and tongue, currently in remission, and schizophrenia...
2016: Respiratory Medicine Case Reports
Rina R Rus, Vladimir Premru, Gregor Novljan, Mojca Grošelj-Grenc, Rafael Ponikvar
Renal replacement treatment (RRT) is required in severe acute kidney injury, and a functioning central venous catheter (CVC) is crucial. Twenty-eight children younger than 16 years have been treated at the University Medical Centre Ljubljana between 2003 and 2012 with either acute hemodialysis (HD) and/or plasma exchange (PE), and were included in our study. The age of the patients ranged from 2 days to 14.1 years. Sixty-six CVCs were inserted (52% de novo, 48% guide wire). The sites of insertion were the jugular vein in 20% and the femoral vein in 80%...
June 2016: Therapeutic Apheresis and Dialysis
Daniela Lanza, Rossella Paolini, Elisabetta Rodella, Tommaso Hinna Danesi, Giandomenico Cresce, Loris Salvador, Loris Roncon
Central venous catheters (CVC) are commonly used in clinical practice. Although long-term complications are uncommon, catheter-related right atrial thrombosis is a rare but potentially life-threatening one. The optimal management is still controversial. We report the case of a young woman affected by Hodgkin lymphoma with CVC-related right atrial thrombosis diagnosed during routine echocardiography. After initial anticoagulation treatment, she complicated with pulmonary embolism, and the mass was surgically removed via a minimally invasive approach with right minithoracotomy access...
May 2016: Giornale Italiano di Cardiologia
María Jesús Pérez-Granda, María Guembe, Raquel Cruces, Emilio Bouza
BACKGROUND: Superficial culture has a high negative predictive value in the assessment of catheter tip colonization (CC) and catheter-related bloodstream infection (C-RBSI). However, the process of hub culture requires the hubs to be swabbed, and this carries a risk of dislodging the biofilm. At present, most catheter hubs are closed by needleless connectors (NCs) that are periodically replaced. Our objective was to compare the yield of SC (skin + hub culture) with that of skin + NC culture in the assessment of CC and C-RBSI...
2016: Critical Care: the Official Journal of the Critical Care Forum
Hiroaki Tanaka, Satoshi Ambiru, Takeharu Kawaguchi, Yasumasa Sugita, Chika Kawajiri, Yuhei Nagao, Takenori Shimura
Objective The use of intravenous in-line filters is effective for the mechanical removal of large particles, precipitates, bacteria, fungi, large lipid globules, and air. However, the routine use of in-line filters remains controversial. Many patients with hematological diseases frequently suffer from bloodstream infections (BSIs) with fatal outcomes. Methods The year before cessation of an in-line filter was defined as the "filter period" and the year after its cessation was defined as the "non-filter period...
2016: Internal Medicine
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