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https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#1
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/28306627/novel-microspheres-reduce-the-formation-of-deep-venous-thrombosis-and-repair-the-vascular-wall-in-a-rat-model
#2
Bingyang Dai, Lan Li, Qiangqiang Li, Xiaoxiao Song, Dongyang Chen, Jin Dai, Yao Yao, Wenjin Yan, Huajian Teng, Fang Yang, Zhihong Xu, Qing Jiang
L-Arginine (L-arg), widely known as a substrate for endogenous nitric oxide synthesis, can improve endothelial function associated with the vasculature, inhibit platelet aggregation, and alter the activity of vascular smooth muscle cells. P-selectin is a membrane component of the platelet alpha-granule and the endothelial cell-specific Wiebel-Palade body that plays a central role in mediating interactions between platelets and both leukocytes and the endothelium. The experiment was designed to evaluate the effect of novel microspheres with L-arg targeting P-selectin on the formation of deep vein thrombosis and repair of vascular wall in a rat model...
March 16, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28297066/cerebral-hyperperfusion-and-other-consequences-of-hemodialysis-central-vein-catheters
#3
Haimanot Wasse
While central venous stenosis is a common consequence of protracted central venous catheter use, intracardiac device transvenous leads, and central venous instrumentation, the majority of patients who develop symptomatic central venous stenosis present with characteristic venous hypertension. However, some patients may develop an abnormal intracranial venous circulation and present with neurologic symptoms. This paper will summarize findings from case reports that describe the neurologic sequelae that can develop as a result of central venous stenosis/occlusion in end-stage renal disease patients with a functional arteriovenous access...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297051/endovascular-treatment-to-boost-av-fistula-maturation
#4
Lars Kamper, Patrick Haage
Impaired fistula maturation is associated with puncture-related complications, insufficient dialysis and potential permanent access failure. Non-maturation is frequently initiated by stenotic vascular access vessels comprising the outflow veins, the arteriovenous anastomosis and infrequently the inflow artery. Further findings in maturation protraction are central venous stenoses or accessory outflow veins. Depending on the underlying pathology, several endovascular approaches to boost fistula maturation are possible...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28286186/placement-of-upper-extremity-arteriovenous-access-in-patients-with-central-venous-occlusions-a-novel-technique
#5
Allen G Murga, Jason T Chiriano, Christian Bianchi, Neha Sheng, Sheela Patel, Ahmed M Abou-Zamzam, Theodore H Teruya
OBJECTIVE: Central venous occlusion is a common occurrence in patients with end stage renal disease. Placement of upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins is often not an option. Avoidance of lower extremity vascular access can decrease morbidity and infection. TECHNIQUE: The central venous lesions were crossed centrally via femoral access. The wire was retrieved in the neck extravascular. A HeRo catheter was then placed in the right atrium and completed with an arterial anastomosis...
March 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28255132/extra-anatomical-veno-venous-surgical-bypass-for-central-vein-occlusion-in-patients-with-ipsilateral-arterio-venous-fistula-avf-for-haemodialysis-a-single-centre-experience
#6
K S Saravana, A A Zainal
OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face. MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28238926/clinical-utility-of-a-new-predicting-score-for-radiocephalic-arteriovenous-fistula-survival
#7
Lucia I Martinez, Vicent Esteve, Montserrat Yeste, Vicent Artigas, Secundino Llagostera
INTRODUCTION: Radio-cephalic arteriovenous fistula (RC-AVF) is the recommended first choice for vascular access (VA). The CAVeA2T2 scoring system was recently published (ipsilateral central venous catheter access, age >73 years, vein <2.2 mm, lower limb angioplasty and absent intra-operative thrill). The aim of the present study was to assess the clinical utility of the CAVeA2T2 scoring system for predicting RC-AVFs survival in our centre and its subsequent application in VA management...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28218363/sex-race-and-hemodialysis-vascular-access-processes
#8
Rita L McGill, Eduardo Lacson
PURPOSE: Hemodialysis (HD) patients who are female or black receive fewer arteriovenous fistulas (AVF) and more grafts (AVG). We evaluated race- and sex-based differences for three process exposures: access surgery, peripherally-inserted central catheters (PICCs), and vascular imaging. METHODS: US Renal Data System with linked Medicare claims for patients initiating HD between April 2010 - December 2011 were used to identify PICC placement, imaging, AVF and AVG surgeries, and the vascular accesses in use at individual HD treatments...
February 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28188038/tunneled-central-venous-catheters-in-children-with-malignant-and-chronic-diseases-a-comparison-of-open-vs-percutaneous-implantation
#9
Lea-Valeska Blum, Ulf Abdel-Rahman, Thomas Klingebiel, Henning Fiegel, Stefan Gfroerer, Udo Rolle
PURPOSE: Tunneled central venous catheters (tCVCs) are routinely used for long-term venous access in children with cancer and chronic diseases. They may be inserted by surgical venous cut-down or percutaneously. The aim of this study was to compare the operative times and intraoperative complications of both techniques. METHODS: This study compared group A (surgical venous cut-down, years 2002-2006) with group B (percutaneous, years 2008-2012). Patient characteristics, operative times, and intraoperative complications were obtained from surgical reports...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28165577/surgical-reconstruction-of-central-venous-obstruction-in-salvaging-upper-extremity-dialysis-accesses
#10
Jurabek Babadjanov, Rick Bernstein, Lee Kirksey
BACKGROUND: Central vein thrombosis or obstruction is a common complication associated with central venous catheters placed for intermittent hemodialysis. The reported outcomes of percutaneous catheter-based interventions reveal high rates of lesion recurrence with varying and frequently limited patency intervals. We present the case of open venous bypass in the treatment of catheter-associated chronic central vein occlusion. METHODS: We report a case of symptomatic arm swelling secondary to central vein stenosis and failed endovascular venous intervention treated by central vein bypass with prosthetic graft through median sternotomy...
February 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28157793/ultrasound-guided-subclavian-vein-cannulation-in-low-birth-weight-neonates
#11
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/28151838/retinal-blood-flow-after-intravitreal-bevacizumab-is-a-predictive-factor-for-outcomes-of-macular-edema-associated-with-central-retinal-vein-occlusion
#12
Makiko Matsumoto, Kiyoshi Suzuma, Yoshihisa Yamada, Eiko Tsuiki, Azusa Fujikawa, Takashi Kitaoka
PURPOSE: To investigate whether retinal blood flow levels after intravitreal bevacizumab (IVB) treatment are correlated with the outcomes of patients with macular edema secondary to central retinal vein occlusion. METHODS: This retrospective observational case study enrolled 44 cases nonischemic central retinal vein occlusion. In each patient, visual acuity, central retinal thickness, and mean blur rate, which was measured by laser speckle flowgraphy and represents retinal blood flow velocity, were examined...
February 1, 2017: Retina
https://www.readbyqxmd.com/read/28144088/outcomes-cost-comparison-and-patient-satisfaction-during-long-term-central-venous-access-in-cancer-patients-experience-from-a-tertiary-care-cancer-institute-in-south-india
#13
K Govind Babu, M C Suresh Babu, D Lokanatha, Gita R Bhat
INTRODUCTION: Prolonged treatment, frequent administration of chemotherapy, antibiotics and blood products in cancer patients requires long term venous access. Central venous catheters (CVC) inserted into the subclavian vein or internal jugular vein, peripherally inserted central venous catheters (PICC) and chemoport (CP) are the commonly used central venous access devices (CVAD). AIM: This study was envisaged to review our experience of CVADs over a one year period and analyze the outcome with regard to catheter life, reasons for removal, complications, patient satisfaction and cost comparison between the CVAD types in the Indian setting...
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28132552/service-development-of-a-nurse-led-community-based-picc-insertion-service
#14
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
#15
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.
January 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28114193/the-homburg-lung-efficacy-and-safety-of-a-minimal-invasive-pump-driven-device-for-veno-venous-extracorporeal-carbon-dioxide-removal
#16
Frederik Seiler, Franziska Trudzinski, Kai Hennemann, Tom Niermeyer, Christian Schmoll, Annegret Kamp, Robert Bals, Ralf Muellenbach, Hendrik Haake, Philipp M Lepper
Extracorporeal carbon dioxide removal (ECCO2R) is increasingly considered a viable therapeutic approach in the management of hypercapnic lung failure in order to avoid intubation or to allow lung-protective ventilator settings. This study aimed to analyze efficacy and safety of a minimal-invasive ECCO2R device, the Homburg lung. The Homburg lung is a pump-driven system for veno-venous ECCO2R with ¼" tubing and a 0.8 m surface oxygenator. Vascular access is usually established via a 19F/21cm bilumen cannula in the right internal jugular vein...
January 19, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28111198/institution-of-a-hospital-based-central-venous-access-policy-for-peripheral-vein-preservation-in-patients-with-chronic-kidney-disease-a-12-year-experience
#17
Jeffrey Forris Beecham Chick, Shilpa N Reddy, Benjamin L Yam, Sidney Kobrin, Scott O Trerotola
PURPOSE: To describe the implementation of nursing-based venous access team (VAT) and standardized interventional radiology (IR) protocols in accordance with Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines to provide central venous access while preserving peripheral veins in patients with chronic kidney disease (CKD). MATERIALS AND METHODS: Review of peripherally inserted central catheter (PICC) and small-bore central catheter (SBCC) referral and placement data from VAT and IR databases was conducted over a 12-year period...
March 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#18
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28042558/long-term-outcomes-of-arteriovenous-grafts-for-hemodialysis-in-lower-extremities
#19
Seok Han, Dan Song, Sangchul Yun
PURPOSE: The lower extremity has received its fair share of attention as a vascular access site in patients who have exhausted their upper arm vessels. However, experiences with lower extremity arteriovenous grafts (AVGs) have so far been disappointing because of high infection rates and severe limb ischemia. We report our experience with hemodialysis access from the lower extremity. MATERIALS AND METHODS: A retrospective review of 60 lower extremity AVGs created between January 2003 and December 2011 was performed...
December 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/27997162/carbohydrate-neuroactive-hybrid-strategy-for-metabolic-glycan-engineering-of-the-central-nervous-system-in-vivo
#20
Asif Shajahan, Shubham Parashar, Surbhi Goswami, Syed Meheboob Ahmed, Perumal Nagarajan, Srinivasa-Gopalan Sampathkumar
Sialic acids are abundant in the central nervous system (CNS) and are essential for brain development, learning, and memory. Dysregulation in biosynthesis of sialo-glycoconjugates is known to be associated with neurological disorders, CNS injury, and brain cancer. Metabolic glycan engineering (MGE) and bioorthogonal ligation have enabled study of biological roles of glycans in vivo; however, direct investigations of sialoglycans in brain have been intractable. We report a simple strategy utilizing carbohydrate-neuroactive hybrid (CNH) molecules, which exploit carrier-mediated transport systems available at the blood-brain barrier, to access brain via tail vein injection in mice...
January 18, 2017: Journal of the American Chemical Society
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