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Arterial puncture central venous line

D Rivera-Tocancipá, E Díaz-Sánchez, C A Montalvo-Arce
INTRODUCTION: The insertion of a central venous line in children and adolescents is technically more difficult, due to the smaller size of the structures. This can lead to an increase in immediate complications, which can be reduced when using ultrasound. In our institution, the percentage of these complications and the use of ultrasound are unknown. OBJECTIVE: To describe the frequency of immediate complications of central venous catheterisation guided by the ultrasound in a general university hospital, compared to the anatomical landmarks technique in children less than 18years of age...
April 4, 2018: Revista Española de Anestesiología y Reanimación
Adrian Vk Wong, Nitin Arora, Olusegun Olusanya, Ben Sharif, Robert M Lundin, A Dhadda, S Clarke, R Siviter, M Argent, Gavin Denton, Anna Dennis, Angela Day, Tamas Szakmany
Background: Central venous catheters are inserted ubiquitously in critical care and have roles in drug administration, fluid management and renal replacement therapy. They are also associated with numerous complications. The true number of central venous catheters inserted per year and the proportion of them associated with complications are unknown in the UK. Methods: We performed a prospective audit at five hospitals, as a feasibility pilot for a larger, nationwide audit...
February 2018: Journal of the Intensive Care Society
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 nonsurgeons. 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...
April 2018: Journal of Trauma and Acute Care Surgery
Shrikanth Srinivasan, Deepak Govil, Sachin Gupta, Sweta Patel, K N Jagadeesh, Deeksha Singh Tomar
BACKGROUND AND AIMS: The true incidence of penetration of the posterior wall (through-and-through puncture) of the internal jugular vein (IJV) during cannulation is unknown. This may have implications if there is hematoma formation, penetration and/or inadvertent cannulation of an underlying carotid artery. This study compared the incidence of posterior wall puncture during IJV cannulation using ultrasound guidance versus traditional landmarks-guided technique. METHODS: One hundred and seventy adult patients admitted to a gastro-liver Intensive Care Unit who required central venous lines were randomly divided into Group A: IJV cannulation using anatomical landmark-guided technique and Group B: IJV cannulation using real-time ultrasound guidance...
March 2017: Indian Journal of Anaesthesia
A Y Molina Caballero, M Martínez Merino, A Pérez Martínez, L Ayuso González, S Hernández Martín, J Pisón Chacón
INTRODUCTION: Peripherally inserted central catheters are indicated when an intravenous treatment is expected for more than 6 days or less if phlebotoxic medication is used. We report our recent experience. METHODS: Retrospective study from 2014 to 2015 including patients to whom a catheter was placed either, in the operating room after surgery and before awakening the patient, or in the Pediatric ICU by direct or ultrasound guidance venipuncture. We reviewed patient characteristics, underlying disease, line catheterization procedure, type and duration of venous line, intravenous treatment and complications...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
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
Lauryn R Rochlen, Robert Levine, Alan R Tait
INTRODUCTION: The value of simulation in medical education and procedural skills training is well recognized. Despite this, many mannequin-based trainers are limited by the inability of the trainee to view the internal anatomical structures. This study evaluates the usability and feasibility of a first-person point-of-view-augmented reality (AR) trainer on needle insertion as a component of central venous catheter placement. METHODS: Forty subjects, including medical students and anesthesiology residents and faculty, participated...
February 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Aynur Camkiran Firat, Pinar Zeyneloglu, Murat Ozkan, Arash Pirat
OBJECTIVES: To compare internal jugular vein and subclavian vein access for central venous catheterization in terms of success rate and complications. DESIGN: A 1:1 randomized controlled trial. SETTING: Baskent University Medical Center. PATIENTS: Pediatric patients scheduled for cardiac surgery. INTERVENTIONS: Two hundred and eighty children undergoing central venous catheterization were randomly allocated to the internal jugular vein or subclavian vein group during a period of 18 months...
September 2016: Pediatric Critical Care Medicine
Robert P Richter, Mark A Law, Santiago Borasino, Jessica A Surd, Jeffrey A Alten
OBJECTIVE: To describe a novel real-time ultrasound (US)-guided distal superficial femoral vein (DSFV) cannulation technique for insertion of peripherally inserted central catheters (PICC) in critically ill infants with congenital heart disease. DESIGN: Descriptive retrospective cohort study SETTING: Pediatric cardiac intensive care unit in a pediatric tertiary hospital PATIENTS: First 28 critically ill infants that received DSFV PICCs via this new technique. RESULTS: Thirty-seven US-guided DSFV PICCs were attempted on 31 infants from September 2012 to November 2014; 34 PICCs were placed in 28 patients (success rate 92%)...
December 2016: Congenital Heart Disease
Justin Barr, Christopher S Graffeo
OBJECTIVE: Bedside procedures are a vital component of patient care-particularly for surgeons. Anecdotal evidence and previous studies from individual institutions reveal a lack of exposure to these interventions in medical school. Our objective was to ascertain medical students' experience and confidence in performing bedside procedures. DESIGN: Our study included a multi-institutional, anonymous, Health Insurance Portability and Accountability Act-compliant electronic survey...
May 2016: Journal of Surgical Education
H Glen, I Lang, L Christie
Central venous catheter (CVC) insertion is commonly undertaken in the ICU. The use of ultrasound (US) to facilitate CVC insertion is standard and is supported by guidelines. Because the subclavian vein cannot be insonated where it underlies the clavicle, its use as a CVC site is now less common. The axillary vein, however, can be seen on US just distal to the subclavian vein and placement of a CVC at this site gives a result which is functionally indistinguishable from a subclavian CVC. We evaluated placement of US-guided axillary CVCs in mechanically ventilated intensive care patients...
September 2015: Anaesthesia and Intensive Care
Jinguang Ruan, Cao Zhang, Zhiyou Peng, David Yue Tang, Zhiying Feng
BACKGROUND: Central venous catheter placement is an important aspect of patient care for the administration of fluids and medications and for monitoring purposes. However, it is still associated with significant morbidity and mortality. CASE PRESENTATION: We report a case of iatrogenic inferior thyroid artery pseudoaneurysm during the central line placement due to internal jugular vein puncture. This is a rare complication of central venous cannulation. Fortunately the pseudoaneurysm was monitored closely, diagnosed promptly and obliterated by using radiological intervention...
May 6, 2015: BMC Anesthesiology
Altaf Bukhari, Ashfaq Kitaba, Sherine Koudera
Over the last few years the role of ultrasound has steadily increased and has now an established role in anesthesia and critical care. The various applications of this technology in this field include ultrasound-guided insertion of central lines (internal jugular, subclavian, axillary, femoral) and peripheral venous catheters, arterial line insertion, regional blocks etc. The simple reason of using this technology is "You believe what you see". In this text we will mainly focus on central line, peripheral venous placement and arterial blood flow patterns under ultrasound guidance...
July 2010: Anesthesia, Essays and Researches
Patrick Brass, Martin Hellmich, Laurentius Kolodziej, Guido Schick, Andrew F Smith
BACKGROUND: Central venous catheters (CVCs) can help with diagnosis and treatment of the critically ill. The catheter may be placed in a large vein in the neck (internal jugular vein), upper chest (subclavian vein) or groin (femoral vein). Whilst this is beneficial overall, inserting the catheter risks arterial puncture and other complications and should be performed with as few attempts as possible. Traditionally, anatomical 'landmarks' on the body surface were used to find the correct place in which to insert catheters, but ultrasound imaging is now available...
January 9, 2015: Cochrane Database of Systematic Reviews
Abdulraouf M Z Jijeh, Ghassan Shaath, Mohamed S Kabbani, Mahmoud Elbarbary, Sameh Ismail
INTRODUCTION: Safely obtaining vascular access in the pediatric population is challenging. This report highlights our real-world experience in developing a safer approach to obtaining vascular access using ultrasound guidance in children and infants with congenital heart disease. METHODS: As part of a quality initiative, we prospectively monitored outcomes of all vascular access attempts guided by ultrasound from January 2010 to September 2010. Variables monitored included age, weight, the time from first needle puncture to wire insertion, site of insertion, number of attempts, type of line, and complications...
October 2014: Journal of the Saudi Heart Association
Robinson M Ferre, Mark Mercier
INTRODUCTION: Real-time ultrasound guidance is considered to be the standard of care for central venous access for non-emergent central lines. However, adoption has been slow, in part because of the technical challenges and time required to become proficient. The AxoTrack(®) system (Soma Access Systems, Greenville, SC) is a novel ultrasound guidance system recently cleared for human use by the United States Food and Drug Administration (FDA). METHODS: After FDA clearance, the AxoTrack(®) system was released to three hospitals in the United States...
July 2014: Western Journal of Emergency Medicine
John T Powell, Jennifer T Mink, Jason T Nomura, Brian J Levine, Neil Jasani, Wendy L Nichols, James Reed, Paul R Sierzenski
BACKGROUND: Ultrasound-guidance for internal jugular central venous cannulation (CVC) has become the recommended best practice and has been shown to improve placement success and reduce complications. There is a dearth of studies that evaluate emergency point-of-care ultrasound guidance of femoral CVC. OBJECTIVE: Our aim was to determine if point-of-care ultrasound guidance for femoral CVC decreases adverse events and increases the likelihood of successful placement when compared with the landmark technique...
April 2014: Journal of Emergency Medicine
Tarek F Tammam, Eid M El-Shafey, Hossam F Tammam
The use of real-time ultrasound (US) is advantageous in the insertion of central venous catheters (CVCs) in adults, especially in whom difficulties are anticipated for various reasons. The aim of the present study was to compare two different real-time 2-dimensional US-guided techniques [short axis view/out-of-plane approach (SAX OOP approach) versus long axis view/in-plane approach (LAX IP approach)] for internal jugular vein (IJV) cannulation. In this prospective study, 90 critical care and hemodialysis patients were assigned for insertion of CVCs using either the real-time US-guided (SAX OOP approach or LAX IP approach) or landmark technique (control group)...
July 2013: Saudi Journal of Kidney Diseases and Transplantation
M Nayeemuddin, A D Pherwani, J R Asquith
Central venous catheters (CVCs) provide valuable vascular access. Complications associated with the insertion and maintenance of CVCs includes pneumothorax, arterial puncture, arrhythmias, line fracture, malposition, migration, infection, thrombosis, and fibrin sheath formation. Image-guided CVC placement is now standard practice and reduces the risk of complications compared to the blind landmark insertion technique. This review demonstrates the imaging of a range of complications associated with CVCs and discusses their management with catheter salvage techniques...
May 2013: Clinical Radiology
T Kander, A Frigyesi, J Kjeldsen-Kragh, H Karlsson, F Rolander, U Schött
BACKGROUND: The aim of this study was to map pre-procedural variables for insertion of a central venous catheter, prophylactic blood component use and to investigate whether any independent variable could be identified as an independent risk factor for associated bleeding complications in patients outside the intensive care unit. METHODS: In this retrospective study, we investigated 1737 consecutive insertions of central venous catheters in 1444 patients in a large university hospital during 2009-2010...
May 2013: Acta Anaesthesiologica Scandinavica
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