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Vascular access in haematology

Valya Weston, Adele Nightingale, Chris O'Loughlin, Roy Ventura
Vascular access is an important component of health care but is not without associated risks, some of which can be life-threatening. The Vessel Health and Preservation (VHP) framework was developed with the intention of providing frontline staff with a resource to assist in assessing and selecting the best vascular access device to meet individual patient needs and to preserve veins for future use. This article examines the impact of the introduction of the framework into a haematology ward in an acute hospital in the North West of England during a 3-month pilot study...
April 27, 2017: British Journal of Nursing: BJN
Ioana Cotlarciuc, Thomas Marjot, Muhammad S Khan, Sini Hiltunen, Elena Haapaniemi, Tiina M Metso, Jukka Putaala, Susanna M Zuurbier, Matthijs C Brouwer, Serena M Passamonti, Paolo Bucciarelli, Emanuela Pappalardo, Tasmin Patel, Paolo Costa, Marina Colombi, Patrícia Canhão, Aleksander Tkach, Rosa Santacroce, Maurizio Margaglione, Giovanni Favuzzi, Elvira Grandone, Donatella Colaizzo, Kostas Spengos, Antonio Arauz, Amanda Hodge, Reina Ditta, Stephanie Debette, Marialuisa Zedde, Guillaume Pare, José M Ferro, Vincent Thijs, Alessandro Pezzini, Jennifer J Majersik, Ida Martinelli, Jonathan M Coutinho, Turgut Tatlisumak, Pankaj Sharma
INTRODUCTION: Cerebral venous thrombosis (CVT) is a rare cerebrovascular condition accounting for <1% of all stroke cases and mainly affects young adults. Its genetic aetiology is not clearly elucidated. METHODS AND ANALYSIS: To better understand the genetic basis of CVT, we have established an international biobank of CVT cases, Biorepository to Establish the Aetiology of Sinovenous Thrombosis (BEAST) which aims to recruit highly phenotyped cases initially of European descent and later from other populations...
November 22, 2016: BMJ Open
Jan Hitchcock
Peripherally inserted central catheters (PICCs) are used in a variety of specialties. Infective and thrombotic complications are widely reported but little has been written about the complications of persistent withdrawal occlusion (PWO) or complete luminal occlusion in PICCs. An audit was conducted of all patients who had a PICC in situ for a 6-week period, using a combination of reviewing clinical documentation and local departmental databases, physical review of inpatients and discussion with the relevant clinical nurse specialists in haematology, oncology, outpatient antibiotic therapy and the vascular access team, to determine the degree of PWO or occlusion but also to review possible financial implications in the introduction of a more expensive product...
October 27, 2016: British Journal of Nursing: BJN
Khalid Bashar, Adeel Zafar, Sawsan Elsheikh, Donagh A Healy, Mary Clarke-Moloney, Liam Casserly, Paul E Burke, Eamon G Kavanagh, Stewart R Walsh
INTRODUCTION: With increasing numbers of patients diagnosed with ESRD, arteriovenous fistula (AVF) maturation has become a major factor in improving both dialysis related outcomes and quality of life of those patients. Compared to other types of access it has been established that a functional AVF access is the least likely to be associated with thrombosis, infection, hospital admissions, secondary interventions to maintain patency and death. AIM: Study of demographic factors implicated in the functional maturation of arteriovenous fistulas...
2015: PloS One
Leonardo Lorente, María M Martín, Pablo Vidal, Sergio Rebollo, María I Ostabal, Jordi Solé-Violán
INTRODUCTION: Best clinical practice for patients with suspected catheter-related infection (CRI) remains unclear according to the latest Infectious Diseases Society of America (IDSA) guidelines. Thus, the objective of this study was to analyze clinical practice concerning the central venous catheter (CVC) and its impact on prognosis in patients with suspected CRI. METHODS: We performed a prospective, multicenter, observational study in 18 Spanish Intensive Care Units (ICUs)...
October 17, 2014: Critical Care: the Official Journal of the Critical Care Forum
Karin Coady, Mohammed Ali, David Sidloff, Richard R Kenningham, Samreen Ahmed
AIM: The aim of this study is to compare the complication rates of three vascular access devices in patients with solid tumours having infusion chemotherapy. MATERIALS AND METHODS: An observational study of 58 central venous catheter (CVC) lines inserted in 55 patients with solid tumours requiring infusional chemotherapy was performed. The study was conducted between January 2011 and August 2013, looking at complication and infection rates as primary outcomes. Data were recorded from patients with 19 tunnelled cuffed silicone catheters, nine with peripherally inserted central catheters (PICCs) and 30 central venous ports...
January 2015: Journal of Vascular Access
Wendy J Dunn, Shyamala Sriram
OBJECTIVE: To examine the effects of patient and treatment-related variables on filter lifespan in critically ill adults receiving continuous renal replacement therapy (CRRT). DESIGN AND SETTING: This was a single-centre, retrospective, observational study conducted in a tertiary referral centre in metropolitan Melbourne, Australia. All CRRT filters used over a 44-month period from 1 January 2008 to 31 August 2011 were assessed for their hours of function before being stopped non-electively (due to clotting) or electively...
September 2014: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Emine Ince, Pelin Oğuzkurt, Abdulkerim Temiz, Semire Serin Ezer, Hasan Özkan Gezer, Nalan Yazici, Akgün Hiçsönmez
BACKGROUND: Totally, implantable access ports (TIAPs) are used for long standing venous catheterization. This study was designed to present our experiences of the TIAPs applications and efficacy of Taurolidine-citrate lock solution (TCLS) against catheter-related infections. MATERIALS AND METHODS: We evaluated records of the 108 patients implanted with 112 TIAPs, which had been performed using heparin solution or TCLS between 2005 and 2013. RESULTS: Duration of exposure to TIAPs was 17-2051 days (median: 411 days)...
April 2014: African Journal of Paediatric Surgery: AJPS
S K Ghosh, V Chaturvedi, P Chakraborty
Long-term venous access catheters are very useful for administration of chemotherapy and other drug infusions in patients with haematological malignancies. But their use in government hospitals is still restricted. This study aimed to audit the surgical and infective complications of the vascular access devices which we have used for last three years in patients of haematological malignancies. We also tried to identify risk factors associated with higher infective and other complications.
June 2013: Nepal Medical College Journal: NMCJ
E Chu, D Haller, T Cartwright, C Twelves, J Cassidy, W Sun, M W Saif, E McKenna, S Lee, H-J Schmoll
BACKGROUND: Central venous access devices in fluoropyrimidine therapy are associated with complications; however, reliable data are lacking regarding their natural history, associated complications and infusion pump performance in patients with metastatic colorectal cancer. METHODS: We assessed device placement, use during treatment, associated clinical outcomes and infusion pump performance in the NO16966 trial. RESULTS: Device replacement was more common with FOLFOX-4 (5-fluorouracil (5-FU)+oxaliplatin) than XELOX (capecitabine+oxaliplatin) (14...
March 18, 2014: British Journal of Cancer
G S Patel, K Jain, R Kumar, A H Strickland, L Pellegrini, J Slavotinek, M Eaton, W McLeay, T Price, M Ly, S Ullah, B Koczwara, G Kichenadasse, C S Karapetis
PURPOSE: Indwelling central venous catheters (CVCs) have been increasingly used to enable delivery of intravenous chemotherapy. We aimed to compare the safety and cost of two commonly used CVCs, peripherally inserted central venous catheter (PICCs) and ports, in the delivery of chemotherapy in patients with non-haematological malignancies. METHODS: Seventy patients were randomly assigned to receive either a PICC or a port. The primary endpoint was occurrence of major complications, which required removal of the CVC and secondary endpoints included occurrence of any complications...
January 2014: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Jean Brière
An increased platelet number in blood depends on a limited spectrum of causes, which aren't always simple to identify. Secondary thrombocytosis is a reactive process in relation with acute or chronic inflammatory diseases, or asplenia. The infrequent inherited thrombocytoses disorders are suspected when similar cases are observed in the same family. However, the most frequent causes of chronic thrombocytosis in adults are the so-called chronic myeloproliferative syndromes (chronic myelocytic leukaemia, polycythemia vera, primary myelofibrosis, essential thrombocytemia), and to a lesser extent, myelodysplastic syndromes...
March 2007: Bulletin de L'Académie Nationale de Médecine
S Johnson, P Byrne
The Renal Anaemia Management (RAM) Programme is a unique service available in 18 major renal centres around Australia. Since its inception some 6 years ago, the software package has been modified to accommodate the needs of the renal team and the renal patient population. In addition, with the support of nephrologists, the RAM software has created a specialised role, that of the Renal Anaemia Coordinator (RAC). The RAM software collects clinical data and patient characteristics from patients with anaemia associated with renal disease...
July 2006: Journal of Renal Care
D A Hughes, L Ginsberg, R Baker, S Goodwin, A Milligan, L Richfield, A B Mehta
We report here the results of 24 months' treatment with oral miglustat of a patient with mild-to-moderate Gaucher's disease (GD) and Parkinsonism. The patient's progressive Parkinsonian tremor, in addition to restricted vascular access, necessitated switching treatment for GD from intravenously infused enzyme replacement therapy (ERT) that had been administered for the previous 7 years. With control of haematological parameters and markers of GD activity improved or maintained and no notable adverse effects, miglustat treatment proved an effective and well-tolerated therapeutic alternative to ERT...
August 2007: Parkinsonism & related Disorders
D Jeyaratnam, J D Edgeworth, G L French
In 2001, the UK Department of Health introduced mandatory surveillance of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemias (blood-culture-positive episodes) in English hospitals. We performed enhanced surveillance in their hospital between April 2001 and March 2003 to determine the epidemiology of MRSA bacteraemia across different specialities. There were 267 MRSA-blood-culture-positive episodes, giving a rate of 0.37 per 1000 occupied bed-days (OBD). Thirty-three (12.4%) episodes were false positives due to contaminants and 15 (5...
August 2006: Journal of Hospital Infection
J-M Korach, D Petitpas, B Paris, F Bourgeade, V Passerat, Ph Berger, P Chillet et al.
The French plasma exchange registry created in 1985 lists the indications, techniques and complications of the French therapeutic haemapheresis. In 2001 it contains the data of more than 16,700 patients for a total of 153,641 sessions. The indications concern five groups of pathologies (neurology, haematology, nephrology, vasculitis, and endocrinology). Until 2000, the neurology represented the most important group but the use of the high dose IgIV for Guillain-Barre and myasthenia gravis decreased the indications...
October 2003: Transfusion and Apheresis Science
R Babu, R D Spicer
Implanted vascular access devices (ports) play a major role in the management of children with cystic fibrosis (CF) and many haematological conditions. With the expanding use of ports, new and more frequent complications are being encountered. To retrospectively review the complications associated with ports, the case notes of all patients who underwent insertion of a port between 1997 and 2000 were analysed. Details of the underlying disorder, type of vascular device, nature of use, and complications were recorded; 55 ports were inserted in 41 patients (a second port was required in 12, a third port in 2) during this period...
January 2002: Pediatric Surgery International
S Vucic, L Davies
BACKGROUND: Plasmapheresis is used as a treatment modality in several neurological disorders. Adverse reactions relating to vascular access, replacement fluid and anticoagulant use have been reported. AIMS: To establish the incidence of complications of therapeutic plasmapheresis in the treatment of neurological diseases. METHODS: A retrospective study was performed, in which case records of patients undergoing plasmapheresis for neurological indications between 1 April 1992 and 1 September 1996 were reviewed for fatalities and adverse reactions related to vascular access, transmission of Hepatitis B or C or Human Immunodeficiency Virus (HIV), fluid imbalance, allergic or febrile reactions, haematological complications, machine failure and citrate toxicity...
June 1998: Australian and New Zealand Journal of Medicine
J J Duron, K Keilani, N G Elian
OBJECTIVE: To compare the efficacy of double gloving with an inner coloured pair of gloves and double gloving with classic gloves, for prompt detection of perforation during a single standard operation. DESIGN: Prospective, randomised study. SETTING: Teaching hospital, France. SUBJECTS: 100 Consecutive patients with haematological malignancy or AIDS, who were referred for implantation of a vascular access port. INTERVENTIONS: Insertion of a central line with an implantable chamber under local anaesthesia...
December 1996: European Journal of Surgery, Acta Chirurgica
I Cheong, L M Samsudin, G H Law
Between July and December 1994, 25 patients with MRSA bacteraemia were treated at the Hospital Kuala Lumpur, a tertiary hospital in Malaysia with 3000 beds. The patients included 15 males and 10 females whose mean age was 46.7 years (range 13-75). The sources of their MRSA were: Urology/Nephrology, 11; General ICU, six; Orthopaedic, four; Medicine, three; Surgery, one. Their underlying diseases were: end-stage and chronic renal failure, 11; burns, three; acute necrotising pancreatitis, two; haematological malignancies, two; and one each of fracture of the neck of the femur, pustular psoriasis, alcoholic cirrhosis, liver abscess, peptic ulcer (antrectomy), choledochol cyst, and abdominal aneurysm with gangrene of the legs...
July 1996: British Journal of Clinical Practice
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