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Central venous catheters hemodialysis

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https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#1
Mariana Murea, W Mark Brown, Jasmin Divers, Shahriar Moossavi, Todd W Robinson, Benjamin Bagwell, John M Burkart, Barry I Freedman
BACKGROUND: Arteriovenous accesses (AVA) in patients performing hemodialysis (HD) are labeled "permanent" for AV fistulas (AVF) or grafts (AVG) and "temporary" for tunneled central venous catheters (TCVC). Durability and outcomes of permanent vascular accesses based on the sequence in which they were placed or used receives little attention. This study analyzed longitudinal transitions between TCVC-based and AVA-based HD outcomes according to the order of placement. METHODS: All 391 patients initiating chronic HD via a TCVC between 2012 and 2013 at 12 outpatient academic dialysis units were included in this study...
September 21, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#2
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28874131/a-chronic-hemodialysis-patient-with-isolated-pulmonary-valve-infective-endocarditis-caused-by-non-albicans-candida-a-rare-case-and-literature-review
#3
Chih-Hao Chang, Myo-Ming Huang, Dong-Feng Yeih, Kuo-Cheng Lu, Yi-Chou Hou
BACKGROUND: Isolated pulmonary valve infective endocarditis caused by Candida is rare in chronic hemodialysis patients. The 2009 Infectious Diseases Society of America guidelines suggest the combined use of surgery and antibiotics to treat candidiasis; however, successful nonsurgical treatment of Candida endocarditis has been reported. CASE PRESENTATION: A 63-year-old woman with end-stage kidney disease was admitted to our hospital after experiencing disorientation for 5 days...
September 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28857418/an-unusual-case-of-an-irretrievable-hemodialysis-catheter-in-a-patient-with-end-stage-renal-disease
#4
Mehrdad Ghahremani-Ghajar, Anna Jin, Peyman Borghei, Joline L T Chen
Hemodialysis catheters are associated with higher risks of complications compared to arteriovenous fistulas and grafts. Some common complications of dialysis catheters include infection, thrombus formation, central venous stenosis, and mechanical dysfunction. Rarely, catheters can become firmly adhered to a vessel wall. Catheter adhesion is a serious complication that can impact the delivery of safe and effective dialysis to affected patients. Adherent catheters commonly present insidiously with no overt diagnostic signs and symptoms or antecedent catheter malfunction...
August 30, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28835974/-hypercalcemic-crisis-and-hypocalcemic-tetany
#5
REVIEW
C Kasperk
A serum calcium level >3.5 mmol/l together with clinical symptoms such as muscle weakness, fatigue, nausea, vomiting, pancreatitis or even coma are characteristic for a hypercalcemic crisis (HC). Primary hyperparathyroidism (1HPT) and malignancy-associated hypercalcemia are the most frequent causal diseases for a HC. The analysis of serum levels for calcium, phosphorous, intact parathyroid hormone, electrophoresis and renal function parameters indicate which further radiological, scintigraphic or serum diagnostic steps are adequate to identify the cause of the patient's acute situation (i...
August 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28822609/transient-vocal-cord-paralysis-following-central-venous-hemodialysis-catheter-insertion
#6
Gül Pamukçu Günaydın, Selahattin Gürü, Elif Aslan Taş, Fatih Tanrıverdi, Gülhan Kurtoğlu Çelik
In this article, we present a case of recurrent laryngeal nerve palsy not caused by nerve injury but due to local anesthetic infiltration that was applied prior to central venous catheterization. A 47-year-old female patient was admitted to emergency room with fatigue and nausea and was diagnosed with acute renal failure. Right jugular venous catheterization was performed for emergency hemodialysis with Seldinger technique using middle approach. Within minutes and immediately after the procedure the patient complained of hoarseness and shortness of breath, and she had stridor in her physical exam...
August 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28819317/intradialytic-central-venous-oxygen-saturation-is-associated-with-clinical-outcomes-in-hemodialysis-patients
#7
Lili Chan, Hanjie Zhang, Anna Meyring-Wösten, Israel Campos, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Central venous oxygen saturation (ScvO2) in the superior vena cava is predominantly determined by cardiac output, arterial oxygen content, and oxygen consumption by the upper body. While abnormal ScvO2 levels are associated with morbidity and mortality in non-uremic populations, ScvO2 has received little attention in hemodialysis patients. From 1/2012 to 8/2015, 232 chronic hemodialysis patients with central venous catheters as vascular access had their ScvO2 monitored during a 6-month baseline period and followed for up to 36 months...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28798220/vascular-access-type-and-clinical-outcomes-among-elderly-patients-on-hemodialysis
#8
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/28779785/symptomatic-superior-vena-cava-syndrome-in-hemodialysis-patients-mid-term-results-of-primary-stenting
#9
MULTICENTER STUDY
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/28777422/the-use-of-streptokinase-for-restoration-of-patency-to-hemodialysis-central-venous-catheters-a-low-cost-safe-and-effective-option
#10
Bahman Bashardoust, Shahram Habibzadeh, Afshan Sharghi, Raheleh Eskandari, Nasrollah Maleki
No abstract text is available yet for this article.
July 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28739575/fda-regulatory-perspectives-for-studies-on-hemodialysis-vascular-access
#11
Frank P Hurst, Robert E Lee, Aliza M Thompson, Brian D Pullin, Douglas M Silverstein
In an effort to foster innovation and new product development, the American Society of Nephrology and the US Food and Drug Administration partnered to form the Kidney Health Initiative in 2012. Part of the Kidney Health Initiative's mission is to foster development of therapies by creating a collaborative environment where the US Food and Drug Administration and the greater nephrology community can interact to optimize product evaluation. This particular Kidney Health Initiative project focused on products related to hemodialysis vascular access, with the goal of clarifying appropriate trial end points that could subsequently inform clinical, regulatory, and coverage decisions...
July 24, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#12
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28710090/the-clinical-and-economic-effect-of-vascular-access-selection-in-patients-initiating-hemodialysis-with-a-catheter
#13
Alian Al-Balas, Timmy Lee, Carlton J Young, Jeffrey A Kepes, Jill Barker-Finkel, Michael Allon
Patients in the United States frequently initiate hemodialysis with a central venous catheter (CVC) and subsequently undergo placement of a new arteriovenous fistula (AVF) or arteriovenous graft (AVG). Little is known about the clinical and economic effects of initial vascular access choice. We identified 479 patients starting hemodialysis with a CVC at a large medical center (during 2004-2012) who subsequently had an AVF (n=295) or AVG (n=105) placed or no arteriovenous access (CVC group, n=71). Compared with patients receiving an AVG, those receiving an AVF had more frequent surgical access procedures per year (1...
July 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28700180/-superior-cava-vein-stenosis-in-a-hemodialysis-patient-with-long-term-central-venous-catheter-and-vascular-graft-a-case-report
#14
Carlo Jovane, Piera Farfaglia, Anna Maria Ierardi, Laura Rimoldi, Elisabetta Sogni, Carmela Figliola, Daniela Pogliani, Matteo Tozzi, Elena Caramella, Pasquale Esposito, Alessandro Castiglioni
Recently, the use of central venous catheters (CVC) as a vascular access in patients undergoing hemodialysis is significantly increased, mainly because of the aging of this population and the presence of several comorbidities. However, the implantation and the long stay of CVC are associated with many complications. Among them, central venous stenosis represents one of the most common problems that, if not properly diagnosed, could lead to vascular thrombosis and consequent vascular access malfunction. Here, we report a case of a 38-year-old patient, who underwent hemodialysis firstly by a CVC long-term into right jugular vein and then by a prosthetic fistula in the ipsilateral limb...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#15
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
July 10, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28685192/venous-thrombosis-and-stenosis-after-peripherally-inserted-central-catheter-placement-in-children
#16
H Stella Shin, Alexander J Towbin, Bin Zhang, Neil D Johnson, Stuart L Goldstein
BACKGROUND: Peripherally inserted central catheters (PICCs) can lead to development of venous thrombosis and/or stenosis. The presence of venous thrombosis and/or stenosis may preclude children with chronic medical conditions from receiving lifesaving therapies, from hemodialysis in end-stage renal disease to total parenteral nutrition in short bowel syndrome. Several adult studies have found an association between PICCs and venous thrombosis and/or stenosis, but none has evaluated for this association in children...
July 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28684919/point-prevalence-of-complications-between-the-y-connection-technique-and-the-usual-care-technique-for-blood-restitution-in-patients-of-an-outpatient-hemodialysis-unit-a-comparison
#17
Nadine Tacchini-Jacquier, Henk Verloo
BACKGROUND: Central venous catheter-related infections (CVCIs) in patients on maintenance hemodialysis (HD) have been documented due to unsafe/unsterile manipulations by nurses during HD machine deconnection and reconnection. Given the gravity of CVCIs in HD patients using catheter access, precise, safe installation of the device, and good nursing technique are crucial. AIM: To assess and compare safety performance and complications of a Y-connection (n=133) versus the usual tunneled central venous catheter (CVC) technique (n=73) among HD patients and then explore preferences between techniques among patients and frontline HD nurses...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28666501/spontaneous-rupture-and-dissection-of-aspergillus-infected-arteriovenous-fistula
#18
Syed Nayer Mahmud, Behzad Kaleem Baloch, Muhammed Safdar, Muhammed Saeed
Patients with end stage renal disease need a vascular access like arteriovenous (AV) fistula, AV graft or central venous catheter for hemodialysis. However, AV fistula can be complicated due to infection, stenosis, ulceration etc. Among these, spontaneous rupture of AV fistula is rare and can be due to stenosis or infection. Fungal infection of AV fistula is very rare and the most common organism involved is Candida. Infection of native AV fistula with Aspergillusis not reported in the literature. This case discusses the spontaneous rupture and dissection of an Aspergillusinfected arteriovenous fistula, requiring urgent closure and repairing of vessel...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28666490/an-unusual-cause-of-asystole-insertion-of-a-central-venous-catheter
#19
Harun Gunes, Elif Nisa Unlu, Ozlem Suzer, Abdullah Ibrahim, Ahmet Afacan, Ayhan Saritas, Hayati Kandis
Central venous catheters are a commonly used medical device which may sometimes cause complications. We present first case who had an asystolic cardiac arrest during insertion of a central venous catheter, needed cardiopulmonary resuscitation (CPR), and was resuscitated successfully. A46-year lady presented to the emergency department due to mushroom poisoning. Acentral venous catheter was inserted through the internal jugular vein. However, the patient suddenly lost consciousness and asystole was seen on the monitor immediately after the insertion of the catheter...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28663227/national-healthcare-safety-network-nhsn-dialysis-event-surveillance-report-for-2014
#20
Duc B Nguyen, Alicia Shugart, Christi Lines, Ami B Shah, Jonathan Edwards, Daniel Pollock, Dawn Sievert, Priti R Patel
BACKGROUND AND OBJECTIVES: Persons receiving outpatient hemodialysis are at risk for bloodstream and vascular access infections. The Centers for Disease Control and Prevention conducts surveillance for these infections through the National Healthcare Safety Network. We summarize 2014 data submitted to National Healthcare Safety Network Dialysis Event Surveillance. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Dialysis facilities report three types of dialysis events (bloodstream infections; intravenous antimicrobial starts; and pus, redness, or increased swelling at the hemodialysis vascular access site)...
July 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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