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Venous access ultrasound

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https://www.readbyqxmd.com/read/28439999/cost-effectiveness-of-introducing-a-nursing-based-programme-of-ultrasound-guided-peripheral-venous-access-in-a-regional-teaching-hospital
#1
Émilie Gosselin, Johanne Lapré, Stéphan Lavoie, Stéphane Rhein
AIM: To analyse the cost-effectiveness of care provided to patients in need of peripheral venous access by comparing the traditional approach with a nurse-based ultrasound-guided programme. BACKGROUND: Letting nurses insert ultrasound-guided catheters is a promising cost-saving approach, but there are few data available to document the efficiency of this type of programme. METHOD: A cost-efficiency evaluative research design was used. Data were collected over a 6-year timeframe, before and after the implementation of the nurse-based programme...
April 25, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28430315/adding-access-blood-flow-surveillance-reduces-thrombosis-and-improves-arteriovenous-fistula-patency-a-randomized-controlled-trial
#2
Inés Aragoncillo, Soraya Abad, Silvia Caldés, Yésika Amézquita, Almudena Vega, Antonio Cirugeda, Cristina Moratilla, José Ibeas, Ramón Roca-Tey, Cristina Fernández, Nicolás Macías, Borja Quiroga, Ana Blanco, Maite Villaverde, Caridad Ruiz, Belén Martín, Asunción M Ruiz, Jara Ampuero, Fernando de Alvaro, Juan M López-Gómez
PURPOSE: Stenosis is the main cause of arteriovenous fistula (AVF) failure. It is still unclear whether surveillance based on vascular access blood flow (QA) enhances AVF function and longevity. METHODS: We conducted a three-year follow-up randomized, controlled, multicenter, open-label trial to compare QA-based surveillance and pre-emptive repair of subclinical stenosis with standard monitoring/surveillance techniques in prevalent mature AVFs. AVFs were randomized to either the control group (surveillance based on classic alarm criteria; n = 104) or to the QA group (QA measured quarterly using Doppler ultrasound [M-Turbo®] and ultrasound dilution [Transonic®] added to classic surveillance; n = 103)...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28415162/value-of-doppler-evaluation-of-physically-abnormal-fistula-hemodynamic-guidelines-and-access-outcomes
#3
Seong Cho, Yu-Ji Lee, Sung-Rok Kim
Background/Aims: The strategy of access care at out center involves the use of ultrasound (USG) in case of physical examination (PE) abnormality. USG determines the need of angiography. This study investigated the possible association between the need for percutaneous transluminal angioplasty (PTA) and hemodynamic parameters of USG. The study also assessed the effects of this monitoring strategy on outcomes in comparison with a historical control. Methods: A retrospective study of the medical records of 127 patients (65 PTA, 62 non-PTA) was conducted...
April 18, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28393000/clinical-experience-with-ultrasound-guided-angioplasty-for-vascular-access
#4
Seong Cho, Yu-Ji Lee, Sung-Rok Kim
BACKGROUND: The use of ultrasound guided percutaneous transluminal angioplasty (UG-PTA), which use ultrasound as an imaging modality, is an evolving strategy. But, in Korea, this method is rarely used. We report our experiences with UG-PTA with respect to technical success rates and complication rates compared to conventional PTA (C-PTA), performed between 2010 and 2015 at Samsung Changwon Hospital, Korea. METHODS: In our series, 53 cases of UG-PTA and 90 cases of C-PTA were reviewed, respectively...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28341509/dialysis-access-hemorrhage-access-rescue-from-a-surgical-emergency
#5
Tazo Inui, Valy Boulom, Dennis Bandyk, John S Lane, Erik Owens, Andrew Barleben
OBJECTIVE: Hemorrhage from a dialysis access can be a life-threatening condition. This study details our experience using access rescue strategies, including in situ graft replacement, primary repair, or conversion to an autogenous fistula; coupled with treatment of central vein occlusion to maintain access usage in patients presenting with conduit hemorrhage. METHODS: During a 3-yr period (2012-2014), 26 patients (14 women, 12 men) on chronic hemodialysis were treated for access conduit bleeding (n=18) or life-threatening hemorrhage (n=8); located in the upper extremity (n=23) or thigh (n=3)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341502/significance-of-blunted-venous-waveforms-seen-on-upper-extremity-ultrasound
#6
Xuan-Binh D Pham, Ezinne J Ihenachor, Hoover Wu, Jerry J Kim, Amy H Kaji, Matthew C Koopmann, Timothy J Ryan, Christian de Virgilio
INTRODUCTION: Current guidelines recommend vascular mapping ultrasound (US) prior to arteriovenous fistula creation. Blunted venous waveforms (BVW) suggest central venous stenosis; however, this relationship and one between BVW and the presence of a central venous catheter (CVC) remain unclear. MATERIAL AND METHODS: All patients who received upper-extremity vascular mapping US between January 2013 and October 2014 at a single institution were retrospectively reviewed...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#7
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
March 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319286/a-successful-model-to-learn-and-implement-ultrasound-guided-venous-catheterization-in-apheresis
#8
Nigopan Gopalasingam, Anna-Marie Eller Thomsen, Lars Folkersen, Peter Juhl-Olsen, Erik Sloth
BACKGROUND: Apheresis treatments can be performed with peripheral venous catheters (PVC), although central venous catheters (CVC) are inserted when PVCs fail or patient with history of difficult vascular access prior to the apheresis. Ultrasound guidance for PVC has shown promising results in other settings. PURPOSE: To investigate if ultrasound guidance for PVC could be implemented among apheresis nurses. Second, how implementation of ultrasound guidance affected the number of CVCs used for apheresis per patient...
March 20, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28297059/preoperative-ultrasound-still-valuable-for-radio-cephalic-arteriovenous-fistula-creation
#9
Jernej Pajek, Marko Malovrh
Radio-cephalic arteriovenous fistula is a prototype hemodialysis access with small incidences of infection and distal ischemia, it spares proximal veins for future access use and it helps in the maturation of veins that may be used for more proximal access creations. This access type is prone to higher early failure rates compared to more proximal fistulas and there are unsolved uncertainties regarding exact ultrasound parameters predictive of fistula outcome. Evolution of ultrasound use has yielded several functional parameters that can be measured in addition to anatomical lumen sizes, which remain core parameters on which the decision to construct fistula in radio-cephalic forearm position is based...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28293489/a-novel-strategy-to-supercharge-a-deep-inferior-epigastric-artery-perforator-flap-after-port-a-cath-removal
#10
Chad M Teven, Adrian S H Ooi, David W Chang, David H Song
Autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEP) flap has become increasingly popular because of its unique advantages. However, compared with some other forms of abdominal-based autologous reconstruction, DIEP flaps are associated with an increased risk of venous congestion. Many techniques-or lifeboats-have been introduced to diagnose and treat this potentially devastating complication. In this case report, we describe a novel strategy to augment venous drainage when venous congestion is encountered...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#11
Bradley S Jackson, Mykel Sepula, Jared T Marx, Chad M Cannon
BACKGROUND: Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. CASE REPORT: A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279407/nonmaturing-fistulae-epidemiology-possible-interventions-and-outcomes
#12
Rahul A Sheth, Robert Freed, Sidhartha Tavri, Tam T T Huynh, Zubin Irani
Autogenous arteriovenous fistulae are the best method for prolonged, successful dialysis access. However, a substantial limitation of dialysis fistulae is their high primary failure rate, estimated to be as high as 70% for radiocephalic fistulae. Fistula maturation is influenced by demographic risk factors as well as anatomical barriers, the latter of which can be readily identified by noninvasive ultrasound imaging and physical examination. These barriers can be categorized as inflow problems (native arterial disease, arteriovenous anastomotic stenosis, and juxta-anastomotic stenosis) or outflow problems (proximal venous stenosis or collateral veins)...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28278194/spectral-tissue-sensing-to-identify-intra-and-extravascular-needle-placement-a-randomized-single-blind-controlled-trial
#13
Andrea J R Balthasar, Geert-Jan van Geffen, Marjolein van der Voort, Gerald W Lucassen, Stefan Roggeveen, Ivar J Bruaset, Joergen Bruhn
Safe vascular access is a prerequisite for intravenous drug admission. Discrimination between intra- and extravascular needle position is essential for procedure safety. Spectral tissue sensing (STS), based on optical spectroscopy, can provide tissue information directly from the needle tip. The primary objective of the trial was to investigate if STS can reliably discriminate intra-vascular (venous) from non-vascular punctures. In 20 healthy volunteers, a needle with an STS stylet was inserted, and measurements were performed for two intended locations: the first was subcutaneous, while the second location was randomly selected as either subcutaneous or intravenous...
2017: PloS One
https://www.readbyqxmd.com/read/28236379/cruciform-position-for-trauma-resuscitation
#14
Biswadev Mitra, Mark C Fitzgerald, Alexander Olaussen, Prasanthan Thaveenthiran, Jordan Bade-Boon, Katherine Martin, De Villiers Smit, Peter A Cameron
Multiply injured patients represent a particularly demanding subgroup of trauma patients as they require urgent simultaneous clinical assessments using physical examination, ultrasound and invasive monitoring together with critical management, including tracheal intubation, thoracostomies and central venous access. Concurrent access to multiple body regions is essential to facilitate the concept of 'horizontal' resuscitation. The current positioning of trauma patient, with arms adducted, restricts this approach...
February 25, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28168447/how-to-achieve-ultrasound-guided-femoral-venous-access-the-new-standard-of-care-in-the-electrophysiology-laboratory
#15
REVIEW
Benedict M Wiles, Nicholas Child, Paul R Roberts
PURPOSE: Bedside vascular ultrasound machines are increasingly available. They are used to facilitate safer vascular access across a number of different specialties. In the electrophysiology laboratory however, where patients are frequently anticoagulated and require the insertion of multiple venous sheaths, anatomical landmark techniques predominate. Despite the high number of vascular complications associated with electrophysiological procedures and the increasing evidence to support its use in electrophysiology, ultrasound remains underutilised...
February 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28165578/a-randomized-study-of-training-with-large-versus-small-vessel-size-on-successful-ultrasound-guided-peripheral-venous-access
#16
Joshua Davis, Timothy Faust, Azeem Tajani, Amanda Bates, Jenna Jarriel, Arthur Au, Jason Matthew Fields
PURPOSE: Our objective was to investigate whether training on phantoms with smaller or larger vessels would improve success rate in novice medical students learning this skill. METHODS: Medical students who participated in a voluntary, extracurricular ultrasound training day were asked to participate in the study as part of their procedural training. They were given a standardized education and demonstration of how to use ultrasound to place a peripheral intravenous (IV) catheter...
January 31, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28157793/ultrasound-guided-subclavian-vein-cannulation-in-low-birth-weight-neonates
#17
Ulrik Lausten-Thomsen, Zied Merchaoui, Cécile Dubois, Sergio Eleni Dit Trolli, Nolwenn Le Saché, Mostafa Mokhtari, Pierre Tissières
OBJECTIVES: Central venous access in critically ill, small infants remains technically challenging even in experienced hands. Several vascular accesses exist, but the subclavian vein is often preferred for central venous catheter insertion in infants where abdominal malformation and/or closure of the vein preclude the use of umbilical venous catheters, as catheterization of the subclavian vein is easier in very short necks than the internal jugular vein for age-related anatomical reasons...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28149825/correlations-between-pulmonary-artery-pressures-and-inferior-vena-cava-collapsibility-in-critically-ill-surgical-patients-an-exploratory-study
#18
Stanislaw P Stawicki, Thomas J Papadimos, David P Bahner, David C Evans, Christian Jones
INTRODUCTION: As pulmonary artery catheter (PAC) use declines, search continues for reliable and readily accessible minimally invasive hemodynamic monitoring alternatives. Although the correlation between inferior vena cava collapsibility index (IVC-CI) and central venous pressures (CVP) has been described previously, little information exists regarding the relationship between IVC-CI and pulmonary artery pressures (PAPs). The goal of this study is to bridge this important knowledge gap...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28132552/service-development-of-a-nurse-led-community-based-picc-insertion-service
#19
Eva Bedford, Dee Waterhouse
Patients receiving intravenous therapy require reliable venous access. Typically patients with poor peripheral access or requiring long-term treatment from an outpatient antibiotic therapy (OPAT) service need to receive secondary care input for safe central line placement, and radiological confirmation of the correct line tip placement where necessary, if treatment is to proceed as planned. Technological developments that enable accurate ultrasound-guided vein selection and electrocardiograph (ECG)-guided central line tip placement have eliminated the need for radiological or fluoroscopic confirmation of correct tip placement for peripherally placed central catheters (PICCs)...
January 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28118211/perioperative-surface-ultrasound-for-placement-and-confirmation-of-central-venous-access-a-case-report
#20
Jeffrey Bortman, Ziyad Knio, Rabia Amir, Khadija Hamid, Feroze Mahmood, Robina Matyal
We present a case highlighting that the real-time visualization of the guidewire in the internal jugular vein with ultrasound, and confirmation of correct position of the guidewire tip at the superior vena cava to right atrial junction with surface ultrasound, is possibly the safest method of central venous catheter insertion.
April 15, 2017: A & A Case Reports
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