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Venous access

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https://www.readbyqxmd.com/read/28812224/risk-factors-for-totally-implantable-venous-access-device-associated-complications-in-cystic-fibrosis
#1
C McCarthy, O O'Carroll, M E O'Brien, T McEnery, A Franciosi, C Gunaratnam, N G McElvaney
BACKGROUND: Candidaemia is an important nosocomial infection, seen frequently in immunocompromised and critically ill patients and increasingly recognised in cystic fibrosis (CF) patients with totally implantable venous access devices (TIVADs). This study aims to investigate the incidence and risk factors for the development of TIVAD-associated candidaemia and to assess the rate of TIVAD-related complications in CF patients. METHODS: A 10-year retrospective study was carried out on adult CF patients attending a single centre...
August 15, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28811808/prevention-of-anesthesia-induced-injection-pain-of-propofol-in-pediatric-anesthesia
#2
Dabin Cheng, Lu Liu, Zheng Hu
OBJECTIVE: Propofol is a new anesthetic agent in clinical practice, but randomized double-blinded prospective studies on its role in pediatric anesthesia remain limited. We aimed to compare the preventive effects of pre-injected lidocaine or ketamine and its pre-mixture on the anesthesia-induced injection pain of propofol using a randomized double-blinded prospective method, and to compare the outcomes with those of medium-/long-chain propofol (M/LCT). METHODS: A total of 360 pediatric patients (aged 5-12 years old) who received elective surgery were randomly divided into six groups (n= 60) as follows...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28806225/preventing-retained-central-venous-catheter-guidewires-a-randomized-controlled-simulation-study-using-a-human-factors-approach
#3
Maryanne Z A Mariyaselvam, Ken R Catchpole, David K Menon, Arun K Gupta, Peter J Young
BACKGROUND: Retained central venous catheter guidewires are never events. Currently, preventative techniques rely on clinicians remembering to remove the guidewire. However, solutions solely relying upon humans to prevent error inevitably fail. A novel locked procedure pack was designed to contain the equipment required for completing the procedure after the guidewire should have been removed: suture, suture holder, and antimicrobial dressings. The guidewire is used as a key to unlock the pack and to access the contents; thereby, the clinician must remove the guidewire from the patient to complete the procedure...
August 11, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28798220/vascular-access-type-and-clinical-outcomes-among-elderly-patients-on-hemodialysis
#4
Timmy Lee, Mae Thamer, Qian Zhang, Yi Zhang, Michael Allon
BACKGROUND AND OBJECTIVES: The optimal type of initial permanent access for hemodialysis among the elderly is controversial. Duration of central venous catheter dependence, patient comorbidities, and life expectancy are important considerations in whether to place an arteriovenous fistula or graft. We used an observational study design to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed...
August 10, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28797661/patency-and-clinical-outcome-after-stent-placement-for-chronic-obstruction-of-the-inferior-vena-cava
#5
O Grøtta, T Enden, G Sandbæk, G F Gjerdalen, C-E Slagsvold, D Bay, N-E Kløw, A Rosales
OBJECTIVE/BACKGROUND: The objective was to assess the technical success, patency, and clinical outcome after stent placement for chronic obstruction of the inferior vena cava (IVC). METHODS: A retrospective analysis was carried out of patients with chronic IVC obstruction verified with computed tomography and/or magnetic resonance venography, accepted for stent placement at the Norwegian National Unit for Reconstructive Deep Venous Surgery from March 2010 to September 2015...
August 7, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28796429/comparison-of-time-to-obtain-intraosseous-versus-jugular-venous-catheterization-on-canine-cadavers
#6
Alison R Allukian, Amanda L Abelson, Jonathan Babyak, Elizabeth A Rozanski
OBJECTIVE: To compare the time required and the success rate of personnel with 4 different levels of experience to place a humeral intraosseous (IO) catheter versus a jugular venous catheter (IV) in cadaver dogs. DESIGN: Prospective study. SETTING: Veterinary university teaching hospital. INTERVENTIONS: Canine cadavers from recently euthanized dogs were obtained from the cadaver donation program between May and December 2014...
August 10, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28794870/cost-and-morbidity-analysis-of-chest-port-insertion-in-adults-outpatient-clinic-versus-operating-room-placement
#7
Claudio F Feo, Giorgio C Ginesu, Alessandro Bellini, Giuseppe Cherchi, Antonio M Scanu, Maria Laura Cossu, Alessandro Fancellu, Alberto Porcu
BACKGROUND: Totally implantable venous access devices (TIVADs) represent a convenient way for the administration of medications or nutrients. Traditionally, chest ports have been positioned by surgeons in the operating room, however there has been a transition over the years to port insertion by interventional radiologists in the radiology suite. The optimal method for chest port placement is still under debate. MATERIALS AND METHODS: Data on all adult patients undergoing isolated chest port placement at our institution in a 12-year period were retrospectively reviewed...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28794652/stent-tunnel-technique-to-save-thrombosed-native-hemodialysis-fistula-with-extensive-venous-aneurysm
#8
Martin Rabellino, Guillermo J Rosa-Diez, Sergio A Shinzato, Pablo Rodriguez, Oscar A Peralta, Maria S Crucelegui, Rosario Luxardo, Agustina Heredia-Martinez, Mariela I Bedini-Rocca, Ricardo D García-Mónaco
INTRODUCTION AND PURPOSE: The increasing number of patients undergoing hemodialysis and the limited number of access sites have resulted in an increasing number of techniques to maintain vascular access for hemodialysis. Thrombosed arteriovenous (AV) fistulas with large venous aneurysms have poor treatment results, with both endovascular and surgical techniques, leading to a high rate of definitive AV access loss. The purpose of this study was to review the feasibility and initial results of this novel endovascular treatment of thrombosed AV fistulas with large venous aneurysms...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28790839/isolated-thoracic-perfusion-with-chemofiltration-for-progressive-malignant-pleural-mesothelioma
#9
Karl Reinhard Aigner, Emir Selak, Sabine Gailhofer
INTRODUCTION: Therapy of malignant pleural mesothelioma and especially the adequate role of surgery in this context remain the subject of controversial discussions. Radical surgery in particular, which is associated with substantial morbidity, failed to translate into a definite survival advantage. We report on interim results of an ongoing Phase II study of regional chemotherapy in terms of isolated thoracic perfusion with chemofiltration (ITP-F). PATIENTS AND METHODS: Twenty-eight patients (25 male, 3 female, mean age 63...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28782257/how-to-perform-extracorporeal-photopheresis-via-port-catheter
#10
Katharina Schwede, Stephanie Nagel, Jan-Christoph Simon, Mirjana Ziemer
BACKGROUND: Extracorporeal photopheresis (ECP) is commonly performed via peripheral venous access catheter. If this is not possible, a tunneled central venous catheter may be considered. However, this access mode may be associated with high complication rates. Port catheters and permanent arteriovenous fistulas in principle could serve as alternative options; however, treatment opinions are limited. STUDY DESIGN AND METHODS: We report on four adult patients with poor peripheral vein conditions in whom we performed ECP via port catheter...
August 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28782178/staphylococcal-biofilm-gene-expression-on-biomaterials-a-methodological-study
#11
Annika Juhlin, Sara Svensson, Peter Thomsen, Margarita Trobos
The combination of increased healthcare access, universal aging, and infallible therapy demands, synergistically drive the need for the development of biomaterial technologies that mitigate the challenge of biomaterial-associated infections (BAI). Staphylococcus epidermidis and Staphylococcus aureus account for the majority of BAI due to their ability to accumulate in adherent multilayered biofilm. This investigation details the development of gene expression assays to evaluate the genetic processes of attachment, accumulation, maturation, and dispersal phases on biomaterials in vitro, while abiding by the Minimum Information for Publication of Quantitative Real-Time PCR Experiments (MIQE) guidelines...
August 7, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28779788/transjugular-venous-approach-for-endovascular-intervention-in-upper-extremity-dialysis-access-fistulae-and-grafts
#12
REVIEW
Hector Ferral, Marc J Alonzo
A transjugular venous access is an alternative approach for endovascular intervention in upper-extremity dialysis arteriovenous fistulae and grafts. The transjugular access is recommended for patients who have an unfavorable anatomy for the direct arm access approach. Ultrasound evaluation of the arteriovenous access is essential before intervention and includes evaluation of the inflow artery and outflow vein diameters, arteriovenous anastomosis, and the entire outflow vein, specifically looking into potential problem areas...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28779785/symptomatic-superior-vena-cava-syndrome-in-hemodialysis-patients-mid-term-results-of-primary-stenting
#13
Mafalda Massara, Giovanni De Caridi, Antonino Alberti, Pietro Volpe, Francesco Spinelli
This clinical report details the results of endovascular treatment of symptomatic superior vena cava syndrome due to central vein stenosis or obstruction (CVSO) by stent angioplasty in patients with dialysis-dependent end-stage renal disease. A 3-year retrospective review of two institutional registries identified 25 chronic hemodialysis patients (17 men, 8 women) affected by CVSO who received endovascular treatment. The majority of the patients (n = 19) presented with symptomatic arm, breast, and facial swelling; and 6 patients presented with dialysis-access dysfunction and venous-line hypertension...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28777415/repositioning-of-central-venous-access-devices-using-a-high-flow-flush-technique-a-clinical-practice-and-cost-review
#14
Timothy R Spencer
BACKGROUND: Malpositioned central venous access device (CVAD) tip locations can cause significant mechanical and chemical vessel-related injuries and complications if left in inappropriate positions.The aim of this study is to determine the use of a high-flow flush technique (HFFT) in successful correction of malpositioned catheters into the lower superior vena cava or cavoatrial junction and provide a cost comparison to interventional/fluoroscopic-based repositioning. METHODS: This is a Retrospective chart and radiographic review of all inserted CVADs found malpositioned between 1996-2014 in a multi-specialty 1000-bed tertiary trauma center in Sydney, Australia...
August 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28777405/bursting-pressure-of-triple-lumen-central-venous-catheters-under-static-and-dynamic-loads
#15
Tim Beckingham, Andy Roberts, Alana St John, Gerry O'Callaghan
INTRODUCTION: Central venous catheter (CVC) access is commonplace in intensive care units. Patients undergoing computed tomographic angiography require injection of contrast at high flow rates (4.5 mL/s), often CVC access is not used due to safety concerns. The CVC might rupture at high flow rates, resulting in CVC fragmentation and embolization or contrast extravasation.The objective of this study is to determine the pressure required to burst a CVC under static load and compare this to the pressure generated by injection of contrast at high flow rates (dynamic load) through the distal (16-g) lumen of a triple-lumen CVC...
August 3, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28777402/long-term-outcomes-of-staged-basilic-vein-transposition-for-hemodialysis-access-in-children
#16
Elias Kfoury, Christopher J Demaree, Mun J Poi, Jesus M Matos, Carlos F Bechara, Peter H Lin
INTRODUCTION: Children requiring long-term hemodialysis often face significant challenges due to their young age and small-vessel caliber for arteriovenous (AV) access creation. In this study, we report our experience of staged basilic vein transposition (BVT) in pediatric patients. METHODS: All patients undergoing staged BVT at a tertiary care pediatric hospital from 2003 to 2015 were reviewed. Indications for staged BVT included inadequate cephalic conduit or failed AV fistula using cephalic vein...
July 29, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28777397/thrombosis-of-the-superior-vena-cava-due-to-a-hickman-catheter-successful-management-by-rt-pa-thrombolysis
#17
Giuseppe Zaccone, Paolo D Pafundi, Augusto Veneziani, Alessandro Verbo, Rosa Colli
INTRODUCTION: Venous thrombosis is a frequent complication of long-term venous access. Its management is well defined in most cases, but some specific clinical situations have not yet been definitively standardized.Thrombosis may occur at the catheter tip and involve the superior vena cava (SVC) and/or the right atrium (RA). In such cases, while the need for a rapid intervention to relieve the venous obstruction and avoid embolism is obvious, the best management is still to be established...
July 29, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28767319/systematic-review-and-meta-analysis-of-the-utilization-of-ethanol-locks-in-pediatric-patients-with-intestinal-failure
#18
Riad Rahhal, Maisam A Abu-El-Haija, Lin Fei, Dawn Ebach, Sarah Orkin, Elizabeth Kiscaden, Conrad R Cole
BACKGROUND: Intestinal failure is a chronic condition related to loss of bowel length and/or function, resulting in dependence on central venous catheters for fluids and nutrition. Catheter use can be associated with significant complications, including catheter-related bloodstream infections (CRBSIs), which can lead to loss of vascular access, advancing intestinal failure associated-liver disease and death. Our objective was to evaluate the effectiveness and safety of ethanol locks as compared with standard heparin locks in pediatric intestinal failure...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28765768/subacute-pneumothorax-contralateral-to-the-venous-access-site-associated-with-atrial-lead-perforation-in-a-patient-who-was-receiving-corticosteroid-therapy
#19
Naruya Ishizue, Jun Kishihara, Shinichi Niwano, Junya Ako
Pneumothorax contralateral to the venous access site due to the right atrial lead is an uncommon complication. Concomitant steroid use is known as a risk factor of pacemaker lead perforation. We report a rare case of subacute contralateral pneumothorax due to a screw-in atrial lead perforation that occurred after dual-chamber pacemaker implantation in a patient who was receiving steroid therapy. The pneumothorax disappeared, and no recurrence was observed during follow-up with close observation alone.
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765192/four-dimensional-ct-guided-transcatheter-removal-of-a-fractured-migrated-catheter-of-a-totally-implantable-venous-access-port
#20
Kazushi Fujimoto, Hajime Kasai, Toshihiko Sugiura, Koichiro Tatsumi
Patients undergoing chemotherapy usually undergo placement of a totally implantable venous access port (TIVAP), but TIVAP catheter fracture is rare. We encountered a case where flushing the TIVAP catheter became impossible because of resistance. A 61-year-old-woman underwent TIVAP placement. Although a chest X-ray revealed the fractured catheter had migrated into the right hilar area, the timing of the fracture was unclear. Four-dimensional computed tomography (4D-CT) showed that the tip of the fractured catheter was located at the anterior segmental artery of the right upper lobe and was immobile, with the remaining portion flapping with the blood flow...
August 1, 2017: BMJ Case Reports
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