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Ultrasound guided central venous catheter

Fabrizio Poletti, Claudio Coccino, Davide Monolo, Paolo Crespi, Giorgio Ciccioli, Giuseppe Cordio, Giovanni Seveso, Stefano De Servi
PURPOSE: Patients admitted to cardiac intensive care unit need administration of drugs intravenously often in concomitance of therapeutic techniques such as non-invasive ventilation, continuous renal replacement therapy and intra-aortic balloon counterpulsation. Therefore, the insertion of central venous catheters provides a reliable access for delivering medications, laboratory testing and hemodynamic monitoring, but it is associated with the risk of important complications. In our study, we tested the efficacy and safety of peripherally inserted central catheters to manage cardiac intensive care...
March 1, 2018: Journal of Vascular Access
Folkert Steinhagen, Maximilian Kanthak, Guido Kukuk, Christian Bode, Andreas Hoeft, Stefan Weber, Se-Chan Kim
INTRODUCTION: A significant increase of the p-wave of a real-time intracavitary electrocardiography is a reliable and safe method to confirm the central venous catheter tip position close to the atrium. However, conflicting data about the feasibility of electrocardiography exist in patients with atrial fibrillation. METHODS: An observational prospective case-control cohort study was set up to study the feasibility and accuracy of the electrocardiography-controlled central venous catheter tip placement in 13 patients with atrial fibrillation versus 10 patients with sinus rhythm scheduled for elective surgery...
February 1, 2018: Journal of Vascular Access
Jason Chui, Rasha Saeed, Luke Jakobowski, Wanyu Wang, Basem Eldeyasty, Angel Zhu, LeeAnne Fochesato, Ronit Lavi, Daniel Bainbridge
BACKGROUND: A routine chest X-ray (CXR) is recommended as a screening test after central venous catheter (CVC) insertion. We sought to assess the value of a routine post-procedural CXR in the era of ultrasound-guided CVC insertion. METHODS: We performed a population-based retrospective cohort study to review the records of all adult patients who had a CVC inserted in the operating room in a tertiary institution between July 1, 2008 and December 31, 2015. We determined the incidence of pneumothorax and catheter misplacement after ultrasound-guided CVC insertion...
February 28, 2018: Chest
Emma K van de Weerdt, Bart J Biemond, Sacha S Zeerleder, Krijn P van Lienden, Jan M Binnekade, Alexander P J Vlaar
BACKGROUND: Severe thrombocytopenia should be corrected by prophylactic platelet transfusion prior to central venous catheter (CVC) insertion, according to national and international guidelines. Even though correction is thought to prevent bleeding complications, evidence supporting the routine administration of prophylactic platelets is absent. Furthermore, platelet transfusion bears inherent risk. Since the introduction of ultrasound-guided CVC placement, bleeding complication rates have decreased...
February 20, 2018: Trials
Shuichi Takano, Norio Shimizu, Naruo Tokuyasu, Teruhisa Sakamoto, Soichiro Honjo, Keigo Ashida, Hiroaki Saito, Yoshiyuki Fujiwara
Background: Tunneled central venous catheters (CVC), called Broviac/Hickman catheter, are widely used in the long-term treatment of pediatric patients. Recently, the percutaneous approach for CVC insertion has become dominant as a less invasive intervention. In this study, we reviewed the mechanical and delayed complications according to different procedures of CVC insertion and assessed the risk factors for complications in CVC insertions for pediatric patients. Methods: A total of 159 pediatric patients (85 males and 74 females) were included in this study...
December 2017: Yonago Acta Medica
Bing Liu, Wenyan Sun, Kai Wang
INTRODUCTION: Primary cardiac angiosarcoma is a rare tumor and the common treatment is surgical resection followed by chemotherapy. Peripherally inserted central venous catheters (PICCs) are widely used in cancer patients and ultrasound-guided PICC insertion could improve success rate especially in patient with abnormal anatomy structure. Reports about PICCs being placed in patient who had suffered from the cardiac angiosarcoma and neoplasty of right atrium with an ipsilateral cardiac permanent pacemaker are rarely...
December 2017: Medicine (Baltimore)
Kai Wang, Wenyan Sun, Xiaodong Shi
INTRODUCTION: Peripherally inserted central venous catheters (PICC) are widely used in cancer patients and ultrasound-guided PICC insertion could improve success rate. The tip position of the catheter should be located at the border of lower one-third of the superior vena cava (SVC) and cavo-atrial junction. The migration is malposition at the late stage after PICCs were inserted, and catheter malposition was associated with thrombosis and other complications.After patient's informed consent, we report a case of a 66-year-old male with twice catheter migrations resulting in thrombosis after being diagnosed with cardiac cancer...
December 2017: Medicine (Baltimore)
Brian P Lucas, David M Tierney, Trevor P Jensen, Ria Dancel, Joel Cho, Mahmoud El-Barbary, Ricardo Franco-Sadud, Nilam J Soni
Ultrasound guidance is used increasingly to perform the following 6 bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis. Yet most hospitalists have not been certified to perform these procedures, whether using ultrasound guidance or not, by specialty boards or other institutions extramural to their own hospitals. Instead, hospital privileging committees often ask hospitalist group leaders to make ad hoc intramural certification assessments as part of credentialing...
January 18, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie
Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015)...
March 2018: European Journal of Pediatrics
Lori A Gurien, Martin L Blakely, Marie C Crandall, Cameron Schlegel, Mallikarjuna R Rettiganti, Marie E Saylors, Daniel J France, Shilo Anders, Sheila L Thomas, Melvin S Dassinger
BACKGROUND: Major health care agencies recommend real-time ultrasound (RTUS) guidance during insertion of percutaneous central venous catheters (CVC) based on studies in which CVCs were placed by non-surgeons. We conducted a meta-analysis to compare outcomes for surgeon-performed RTUS-guided CVC insertion versus traditional landmark technique. METHODS: A systematic review of the literature was performed identifying randomized controlled trials (RCT) and prospective "safety studies" of surgeon-performed CVC insertions comparing landmark to RTUS techniques...
January 4, 2018: Journal of Trauma and Acute Care Surgery
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
Ignacio Oulego-Erroz, Rafael González-Cortes, Patricia García-Soler, Mónica Balaguer-Gargallo, Manuel Frías-Pérez, Juan Mayordomo-Colunga, Ana Llorente-de-la-Fuente, Paula Santos-Herraiz, Juan José Menéndez-Suso, María Sánchez-Porras, Daniel Palanca-Arias, Carmen Clavero-Rubio, Mª Soledad Holanda-Peña, Luis Renter-Valdovinos, Sira Fernández-De-Miguel, Antonio Rodríguez-Núñez
PURPOSE: To assess whether ultrasound guidance improves central venous catheter placement outcomes compared to the landmark technique in critically ill children. METHODS: A prospective multicentre observational study was carried out in 26 paediatric intensive care units over 6 months. Children 0-18 years old who received a temporary central venous catheter, inserted using either ultrasound or landmark techniques, were eligible. The primary outcome was the first-attempt success rate...
January 2018: Intensive Care Medicine
Yonghui Wan, Yuxin Chu, Yanru Qiu, Qian Chen, Wei Zhou, Qibin Song
OBJECTIVE: To investigate the feasibility and safety of the peripherally inserted central catheters (PICCs) accessed via the superficial femoral vein in patients with superior vena cava syndrome (SVCS). METHODS: From October 2010 to December 2014, 221 cancer patients with SVCS in our center received real-time ultrasound-guidance of the superficial femoral vein inserted central catheters (FICCs) at the mid-thigh. PICC insertion via upper extremity veins had also been investigated in 2604 cancer patients without SVCS as control...
November 10, 2017: Journal of Vascular Access
Mary Yovanoff, David Pepley, Katelin Mirkin, Jason Moore, David Han, Scarlett Miller
While Virtual Reality (VR) has emerged as a viable method for training new medical residents, it has not yet reached all areas of training. One area lacking such development is surgical residency programs where there are large learning curves associated with skill development. In order to address this gap, a Dynamic Haptic Robotic Trainer (DHRT) was developed to help train surgical residents in the placement of ultrasound guided Internal Jugular Central Venous Catheters and to incorporate personalized learning...
September 2017: Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting
Sylvain Boet, Calvin Thompson, Michael Y Woo, Debra Pugh, Rakesh Patel, Pavithra Pasupathy, Asad Siddiqui, Ashlee-Ann Pigford, Viren N Naik
Evidence has demonstrated that the use of dynamic ultrasound guidance (USG) for central venous catheter (CVC) significantly decreases attempts, failures, and complication rates. Despite national organizations recommending the use of USG and its increasing availability, USG is used inconsistently and non-uniformly. We sought to determine if an online training module for CVC insertion with ultrasound guidance will improve acquisition and long-term retention of knowledge and skills for attending physicians. Participants were tested for declarative knowledge and skills on a simulator (pre-test) for ultrasound-guided CVC insertion at baseline...
August 22, 2017: Curēus
Zied Merchaoui, Ulrik Lausten-Thomsen, Florence Pierre, Maher Ben Laiba, Nolwenn Le Saché, Pierre Tissieres
The correct choice of intra vascular access in critically ill neonates should be individualized depending on the type and duration of therapy, gestational and chronological age, weight and/or size, diagnosis, clinical status, and venous system patency. Accordingly, there is an ongoing demand for optimization of catheterization. Recently, the use of ultrasound (US)-guided cannulation of the subclavian vein (SCV) has been described in children and neonates. This article gives an overview of the current use of US for achieving central venous catheter placement in the SCV or the brachiocephalic vein (BCV) in neonates...
2017: Frontiers in Pediatrics
Darko Sazdov, Marija Jovanovski Srceva, Zorka Nikolova Todorova
INTRODUCTION: Central venous catheterization is performed by the landmark method and ultrasound guided method. The purpose of the study was to compare the success, average number of attempts, average time to return of blood, and complication rate between the two methods. MATERIAL AND METHODS: This was a prospective study done in the Intensive Care Unit of the Acibadem Sistina Clinical Hospital, in Skopje. There were 400 patients in need of central venous catheter and they were prospectively randomized in two groups...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Tonya Jagneaux, Terrell S Caffery, Mandi Wilkes Musso, Ann C Long, Lauren Zatarain, Erik Stopa, Nathan Freeman, Cara Cantelli Quin, Glenn N Jones
OBJECTIVE: We describe the effect of simulation-based education on residents' adherence to protocols for and performance of central venous access. METHODS: Internal medicine and emergency medicine residents underwent a central venous access course that included a lecture, video presentation, readings, and simulation demonstrations presented by faculty. Baseline data were collected before the course was initiated. After a skills session where they rehearsed their ultrasound-guided central venous access skills, residents were evaluated using a procedural checklist and written knowledge exam...
October 4, 2017: Journal of Patient Safety
R Abdelfattah, S Al-Jumaah, A Al-Qahtani, S Al-Thawadi, I Barron, S Al-Mofada
BACKGROUND: Burkholderia cepacia is an important opportunistic organism in hospitalized and immunocompromised patients, particularly in cystic fibrosis. AIMS: To describe the epidemiological investigation of an outbreak of B. cepacia bacteraemia. METHODS: The study examined 14 patients during their admission to three intensive care units in a tertiary care hospital between January and June 2016. The outbreak involved nine (57%) female and six (43%) male patients...
March 2018: Journal of Hospital Infection
Christian Breschan, Gudrun Graf, Robert Jost, Haro Stettner, Georg Feigl, Stefan Neuwersch, Christian Stadik, Markus Koestenberger, Rudolf Likar
BACKGROUND: The aim of this retrospective analysis was to evaluate the clinical effectiveness of the supraclavicular ultrasound-guided cannulation of the brachiocephalic vein in preterm infants. METHODS: The ultrasound probe was placed in the supraclavicular region so as to obtain the optimum sonographic long-axis view of the brachiocephalic vein. By using a strict in-plane approach the brachiocephalic vein was cannulated by advancing a 22- or 24-gauge iv cannula from lateral to medial under the long axis of the ultrasound probe under real-time ultrasound guidance into the vein...
January 2018: Anesthesiology
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