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Venous access

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https://www.readbyqxmd.com/read/29349919/analysis-of-follow-up-methods-of-vascular-access-and-patient-outcomes-in-hemodialysis-at-a-tertiary-care-hospital-in-china
#1
Ying Zhang, Xianglei Kong, Lijun Tang, Yong Wei, Dongmei Xu
Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center in China. A cohort of 124 patients with stage 3 chronic kidney disease was recruited and double-blind randomly assigned into two groups. Patients in Group A received phone calls to schedule their next consultation a week in advance. Patients in Group B scheduled their next appointment at the end of each visit...
January 19, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29345717/vasoconstrictive-responses-of-the-cephalic-vein-during-first-time-cardiac-implantable-electronic-device-placement
#2
Roman Steckiewicz, Elżbieta Barbara Świętoń, Magdalena Bogdańska, Przemysław Stolarz
BACKGROUND: During cardiac implantable electronic device (CIED) implantation procedures cardiac leads have been mostly introduced transvenously. The associated injury to the selected vessel and adjacent tissues may induce reflex vasoconstriction. PURPOSE: To assess the incidence of cephalic vein (CV) vasoconstriction during first-time CIED implantation. METHODS: Of the 146 evaluated first-time CIED implantation procedures conducted in our center in 2016, we selected those during which CV vasoconstriction was recorded...
January 18, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29344711/adult-picc-device-may-be-used-as-a-tunnelled-central-venous-catheter-in-children
#3
Brooke T Lawson, Ian A Zealley
PURPOSE: Central venous access in children, in particular small children and infants, is challenging. We have developed a technique employing adult peripherally inserted central venous catheters (PICCs) as tunnelled central venous catheters (TCVCs) in children. The principal advantage of this novel technique is that the removal technique is less complex than that of conventional cuffed TCVCs. The catheter can be removed simply by being pulled out and does not require general anaesthesia...
January 17, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29340455/central-venous-catheter-related-infections-in-patients-receiving-short-term-hemodialysis-therapy-incidence-associated-factors-and-microbiological-aspects
#4
Mayra Gonçalves Menegueti, Natália Cristina Betoni, Fernando Bellissimo-Rodrigues, Elen Almeida Romão
INTRODUCTION: Bloodstream infections are the second most common cause of death among patients on hemodialysis. This study aimed to evaluate the incidence of and risk factors associated with central venous catheter-related infections in patients undergoing hemodialysis, and to identify and characterize the type and antimicrobial susceptibility profiles of the primary microorganisms isolated during one year of follow-up. METHODS: A prospective cohort study was conducted in 2014 in a hemodialysis referral center...
November 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/29337042/endovascular-recanalization-for-nonmalignant-obstruction-of-the-inferior-vena-cava
#5
Young Erben, Haraldur Bjarnason, Gudrun L Oladottir, Robert D McBane, Peter Gloviczki
OBJECTIVE: The aim of this study was to evaluate outcomes of endovascular recanalization of the inferior vena cava (IVC) and iliac veins with long-standing chronic venous obstruction caused by nonmalignant disease. METHODS: Medical records for 66 patients who underwent endovascular recanalization of the IVC with or without iliac veins from January 2001 to December 2014 at our medical center were retrospectively reviewed. Primary outcomes included morbidity and mortality; secondary outcomes included primary, primary assisted, and secondary patency and resolution of symptoms...
January 11, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29336750/percutaneous-versus-cut-down-technique-for-indwelling-port-placement
#6
Mario Matiotti-Neto, Mariam F Eskander, Omidreza Tabatabaie, Gyulnara Kasumova, Lindsay A Bliss, Sing Chau Ng, Nicholas E Tawa, Blanche Murphy, Jonathan F Critchlow, Jennifer F Tseng
The superiority of surgical cut-down of the cephalic vein versus percutaneous catheterization of the subclavian vein for the insertion of totally implantable venous access devices (TIVADs) is debated. To compare the safety and efficacy of surgical cut-down versus percutaneous placement of TIVADs. This is a single-institution retrospective cohort study of oncologic patients who had TIVADs implanted by 14 surgeons. Primary outcomes were inability to place TIVAD by the primary approach and postoperative complications within 30 days...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29335840/efficacy-of-ultrasound-guided-axillary-subclavian-venous-approaches-for-pacemaker-and-defibrillator-lead-implantation-a-randomized-study
#7
Mattia Liccardo, Pasquale Nocerino, Salzano Gaia, Carmine Ciardiello
PURPOSE: Subclavian access is a reliable technique for lead insertion in pacemaker and defibrillator (ICD) implantation, but it is often accompanied by complications. The aim of this study was to compare the efficacy of the ultrasound-guided axillary approach to the subclavian method. METHODS: This randomized comparative study was performed on 174 patients: as a first attempt, 116 patients underwent the ultrasound-guided axillary access and 58 patients underwent the subclavian approach...
January 15, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29331162/unnecessary-removal-of-central-venous-catheters-in-cancer-patients-with-bloodstream-infections
#8
Anne Marie Chaftari, Ray Hachem, Sammy Raad, Ying Jiang, Elizabeth Natividad, Patrick Chaftari, Issam Raad
We evaluated the rate of central venous catheter (CVC) removal in 283 cancer patients with bloodstream infections (BSIs). Removal of CVCs occurred unnecessarily in 57% of patients with non-central-line-associated BSI (non-CLABSI), which was equivalent to the rate of CVC removal in patients with CLABSIs. Physician education and safe interventions to salvage the vascular access are warranted. Infect Control Hosp Epidemiol 2018;1-4.
January 14, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29324560/contrast-media-extravasations-in-patients-undergoing-computerized-tomography-scanning-a-systematic-review-and-meta-analysis-of-risk-factors-and-interventions
#9
Sandrine Ding, Nicole Richli Meystre, Cosmin Campeanu, Giuseppe Gullo
OBJECTIVE: To identify risk factors and interventions preventing or reducing contrast medium extravasation. INTRODUCTION: Computed tomography (CT) is a radiological examination essential for the diagnosis and monitoring of many diseases. It is often performed with the intravenous (IV) injection of contrast agents. Use of these products can result in a significant complication, extravasation, which is the accidental leakage of IV material into the surrounding tissue...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29319771/peritoneal-dialysis-as-the-first-dialysis-treatment-option-initially-unplanned
#10
Marcela Lara Mendes, Camila Albuquerque Alves, Edwa Maria Bucuvic, Dayana Bitencourt Dias, Daniela Ponce
Most patients with stage 5 CKD start RRT of unplanned manner. Unplanned dialysis, also known as urgent start, may be defined as hemodialysis (HD) started without permanent vascular access, i.e., using a central venous catheter (CVC), or as peritoneal dialysis (PD) started within seven days after implantation of the catheter, without family training. Although few studies have evaluated the PD as an immediate treatment option for patients starting urgent RRT, theirs results suggest that it is a feasible and safe alternative, with infectious complications and survival similar to patients treated with unplanned HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29317914/a-high-impact-intervention-for-a-high-impact-intervention-improving-documentation-of-peripheral-venous-access-insertion-in-theatre
#11
Kavita Upadhyaya, Heidy Hendra, Nick Wilson
The Department of Health's 'High Impact Intervention (HII) - Peripheral intravenous cannula care bundle' lists six actions to be performed at the time of peripheral intravenous cannulation. Audit of compliance to these requires documentation. We assessed documentation on the anaesthetic charts of 50 surgical patients. Purpose-made stickers were then placed on all anaesthetic charts. Re-assessment of a further 50 patients' charts demonstrated a significant improvement in documentation of the bundle post intervention (Fisher's exact test P < 0...
January 2018: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29314642/venous-access-closure-from-a-to-z
#12
EDITORIAL
Ashok Seth, Ranjan Modi
Points to increasing need for achieving safe and secure closure of femoral venous access site after large caliber venous sheath for after structural interventions. Emphasizes the role of a simple, easy to learn "Z-stitch" for achieving femoral vein hemostasis leading to early ambulation. Cautions and advocates the use of multiple complimentary techniques for venous access closure after extreme large bore devices.
January 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29310557/a-medium-term-venous-access-alternative-for-infants-undergoing-congenital-heart-surgery
#13
Muhammad Aanish Raees, Paul V Dubar, David P Bichell
We describe a strategy aimed at maximizing the safety and minimizing the thrombogenicity of central venous lines for neonates with congenital heart defects. Our method involves the use of a tunneled technique to place a 4.2 Fr single-lumen (Broviac) catheter in the subpericardial space, with minimal intravascular course and a tip placed in the lower right atrium. Using this technique, we potentially eliminated the requirement for percutaneous placement of central venous lines postoperatively as well as potentially decreased the risk of intrapericardial bleeding associated with transthoracic lines...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29306122/exploration-of-adherence-and-patient-experiences-with-doacs-one-year-after-switching-from-vitamin-k-antagonists-insights-from-the-switching-study
#14
John K Bartoli-Abdou, Jignesh P Patel, Jacob Crawshaw, Bipin Vadher, Alison Brown, Lara N Roberts, Raj K Patel, Roopen Arya, Vivian Auyeung
BACKGROUND: Current UK and European guidelines recommend anticoagulated patients prescribed warfarin with time in therapeutic range (TTR) <65% be considered for DOAC therapy. There has been considerable concern that adherence with DOACs may be poor compared with warfarin. Little is known about the patient experience of switching from warfarin to DOAC and how patients manage their DOAC long term. Our aim was to conduct focus groups exploring patient's previous experiences with warfarin, their current experience with DOACs, their adherence to DOACs and the long-term service provision they envisage...
January 2, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29302141/use-of-an-intra-arterial-catheter-as-a-provisional-conduit-for-regulated-outflow-management-in-the-setting-of-artery-only-digital-replantation
#15
Michael V DeFazio, Kevin D Han, Ebrahim Paryavi
Successful replantation of distal digital segments necessitates the establishment of sufficient outflow to minimize congestion and progressive tissue necrosis. In cases where only arterial anastomosis is feasible, an artificial outlet must be provided to maintain physiological requirements until microvenous circulation regenerates. This can be accomplished using any number of "exsanguination techniques" designed to facilitate egress through ongoing passive blood loss. Although reportedly effective, these measures are imprecise and carry a substantial risk of infection, scarring, and/or uncontrolled hemorrhage...
December 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/29301288/use-of-pleuroperitoneal-shunt-in-chylothorax-related-to-central-line-associated-thrombosis-in-sickle-cell-disease
#16
Elizabeth Spiwak, Chad Wiesenauer, Arun Panigrahi, Ashok Raj
Central vein thrombosis as a cause of chylothorax is uncommon, and in a few cases in the literature was related to thrombotic complications of central venous access devices (CVAD). Superior vena cava (SVC) occlusion-induced chylothorax has been described in adult sickle cell disease (SCD) in a setting of chronic indwelling CVAD. There are limited reports on chylothorax induced by central venous thrombosis secondary to chronic CVAD in children with SCD. We describe an 8-year-old male patient, with a history of SCD, maintained on long term erythrocytapheresis for primary prevention of stroke, and whose clinical course was complicated by chylothorax which was successfully treated with a pleuroperitoneal shunt...
January 2, 2018: Children
https://www.readbyqxmd.com/read/29300281/the-ios-have-it-a-prospective-observational-study-of-vascular-access-success-rates-in-patients-in-extremis-using-video-review
#17
Kristen M Chreiman, Ryan P Dumas, Mark J Seamon, Patrick K Kim, Patrick M Reilly, Lewis J Kaplan, Jason D Christie, Daniel N Holena
BACKGROUND: Quick and successful vascular access in injured patients arriving in extremis is crucial to enable early resuscitation and rapid OR transport for definitive repair. We hypothesized that intraosseous (IO) access would be faster and have higher success rates than peripheral IVs (PIVs) or central venous catheters (CVCs). METHODS: High-definition video recordings of resuscitations for all patients undergoing Emergency Department Thoracotomy (EDT) from 4/2016-7/2017 were reviewed as part of a quality improvement initiative...
January 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29295872/fibrotic-venous-remodeling-and-nonmaturation-of-arteriovenous-fistulas
#18
Laisel Martinez, Juan C Duque, Marwan Tabbara, Angela Paez, Guillermo Selman, Diana R Hernandez, Chad A Sundberg, Jason Chieh Sheng Tey, Yan-Ting Shiu, Alfred K Cheung, Michael Allon, Omaida C Velazquez, Loay H Salman, Roberto I Vazquez-Padron
The frequency of primary failure in arteriovenous fistulas (AVFs) remains unacceptably high. This lack of improvement is due in part to a poor understanding of the pathobiology underlying AVF nonmaturation. This observational study quantified the progression of three vascular features, medial fibrosis, intimal hyperplasia (IH), and collagen fiber organization, during early AVF remodeling and evaluated the associations thereof with AVF nonmaturation. We obtained venous samples from patients undergoing two-stage upper-arm AVF surgeries at a single center, including intraoperative veins at the first-stage access creation surgery and AVFs at the second-stage transposition procedure...
January 2, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#19
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29280905/ultrasound-guided-peripheral-intravenous-catheters-to-reduce-central-venous-catheter-use-on-the-inpatient-medical-ward
#20
Benjamin T Galen, William N Southern
PURPOSE: The traditional technique of placing a peripheral intravenous (IV) catheter is successful in most cases on inpatient wards. However, when the traditional method fails, a central venous catheter may be placed to maintain IV access. These catheters are associated with risks including central line-associated bloodstream infection. METHODS: We evaluated the effectiveness and acceptability of an ultrasound-guided peripheral IV service to reduce the number of newly placed central venous catheters on an inpatient ward...
January 2018: Quality Management in Health Care
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