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Central venous access devices

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https://www.readbyqxmd.com/read/28297066/cerebral-hyperperfusion-and-other-consequences-of-hemodialysis-central-vein-catheters
#1
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/28259730/incidence-of-central-venous-catheter-hub-contamination
#2
Julie L Holroyd, Terrie Vasilopoulos, Mark J Rice, Kenneth H Rand, Brenda G Fahy
PURPOSE: To investigate microorganisms causing central venous catheter contamination and how this contamination differs across different catheter metrics. MATERIALS AND METHODS: After obtaining IRB approval and informed consent, 830 cultures were prospectively obtained from 45 ICU patients with central venous catheter or peripherally inserted central catheter. Bacterial colonies were identified by mass spectrometry. RESULTS: Bacterial contamination of central catheter hubs occurred 44% of the time in this study in the ICU setting...
February 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28239509/system-design-and-development-of-a-robotic-device-for-automated-venipuncture-and-diagnostic-blood-cell-analysis
#3
Max L Balter, Alvin I Chen, Alex Fromholtz, Alex Gorshkov, Tim J Maguire, Martin L Yarmush
Diagnostic blood testing is the most prevalent medical procedure performed in the world and forms the cornerstone of modern health care delivery. Yet blood tests are still predominantly carried out in centralized labs using large-volume samples acquired by manual venipuncture, and no end-to-end solution from blood draw to sample analysis exists today. Our group is developing a platform device that merges robotic phlebotomy with automated diagnostics to rapidly deliver patient information at the site of the blood draw...
October 2016: Proceedings of the ... IEEE/RSJ International Conference on Intelligent Robots and Systems
https://www.readbyqxmd.com/read/28238580/concurrent-central-venous-stent-and-central-venous-access-device-placement-does-not-compromise-stent-patency-or-catheter-function-in-patients-with-malignant-central-venous-obstruction
#4
Katherine Clark, Jeffrey Forris Beecham Chick, Shilpa N Reddy, Benjamin J Shin, Gregory J Nadolski, Timothy W Clark, Scott O Trerotola
PURPOSE: To determine if concurrent placement of a central venous stent (CVS) and central venous access device (CVAD) compromises stent patency or catheter function in patients with malignant central venous obstruction. MATERIALS AND METHODS: CVS placement for symptomatic stenosis resulting from malignant compression was performed in 33 consecutive patients who were identified retrospectively over a 10-year period; 28 (85%) patients had superior vena cava syndrome, and 5 (15%) had arm swelling...
February 23, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#5
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28224103/management-of-parenteral-nutrition-in-critically-ill-patients
#6
REVIEW
Paolo Cotogni
Artificial nutrition (AN) is necessary to meet the nutritional requirements of critically ill patients at nutrition risk because undernutrition determines a poorer prognosis in these patients. There is debate over which route of delivery of AN provides better outcomes and lesser complications. This review describes the management of parenteral nutrition (PN) in critically ill patients. The first aim is to discuss what should be done in order that the PN is safe. The second aim is to dispel "myths" about PN-related complications and show how prevention and monitoring are able to reach the goal of "near zero" PN complications...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28214161/human-factors-related-to-time-dependent-infection-control-measures-scrub-the-hub-for-venous-catheters-and-feeding-tubes
#7
Lindsay Caspari, Elizabeth Epstein, Amy Blackman, Li Jin, David A Kaufman
BACKGROUND: The use of catheter hub decontamination protocols is a common practice to reduce central line-associated bloodstream infections. However, few data exist on the most effective disinfection procedure prior to hub access accounting for human factors and time-dependent practices in real time in the clinical setting. METHODS: An observational design with a multimodal intervention was used in this study in a neonatal intensive care unit. Direct observations on nurse compliance of scrub times with decontamination when accessing of venous catheter and feeding tube hubs were conducted during 3 phases: (1) baseline period prior to any interventions; (2) during an educational intervention phase; and (3) during a timer intervention period when using a timing device, either an actual timer or music button...
February 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28165572/early-cannulation-graft-flixene%C3%A2-for-conventional-and-complex-hemodialysis-access-creation
#8
Carlos A Hinojosa, Saul Soto-Solis, Sandra Olivares-Cruz, Hugo Laparra-Escareno, Zeniff Gomez-Arcive, Javier E Anaya-Ayala
PURPOSE: The Flixene™ (Atrium™, Hudson, NH) is a trilaminate composite polytetrafluoroethylene (PTFE) graft that allows access within 72 hours. We evaluate our initial experience with this device for conventional and complex hemodialysis access creation. METHODS: Retrospective review in end-stage renal disease (ESRD) patients who underwent access creation with Flixene from January 2013 to July 2014. For our analysis, the patients were divided in two groups: those with complex access configurations tunneled in the chest and/or abdominal wall (thoraco-abdominal wall access [TAWA]), and those tunneled in conventional sites (extremity access [EA])...
February 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28163887/central-venous-access-related-adverse-events-after-trabectedin-infusions-in-soft-tissue-sarcoma-patients-experience-and-management-in-a-nationwide-multi-center-study
#9
Michiel C Verboom, Jan Ouwerkerk, Neeltje Steeghs, Jacob Lutjeboer, J Martijn Kerst, Winette T A van der Graaf, Anna K L Reyners, Stefan Sleijfer, Hans Gelderblom
BACKGROUND: Trabectedin has shown efficacy against soft tissue sarcomas (STS) and has manageable toxicity. Trabectedin is administered through central venous access devices (VAD), such as subcutaneous ports with tunneled catheters, Hickman catheters and PICC lines. Venous access related adverse events are common, but have not yet been reported in detail. METHODS: A retrospective analysis of patient files of STS patients receiving trabectedin monotherapy between 1999 and 2014 was performed in all five STS referral centers in the Netherlands...
2017: Clinical Sarcoma Research
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
#10
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/28132565/a-blended-learning-approach-to-teaching-cvad-care-and-maintenance
#11
Karen Hainey, Linda J Kelly, Audrey Green
Nurses working within both acute and primary care settings are required to care for and maintain central venous access devices (CVADs). To support these nurses in practice, a higher education institution and local health board developed and delivered CVAD workshops, which were supported by a workbook and competency portfolio. Following positive evaluation of the workshops, an electronic learning (e-learning) package was also introduced to further support this clinical skill in practice. To ascertain whether this blended learning approach to teaching CVAD care and maintenance prepared nurses for practice, the learning package was evaluated through the use of electronic questionnaires...
January 26, 2017: British Journal of Nursing: BJN
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
#12
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/28106685/totally-implantable-venous-access-devices-a-review-of-complications-and-management-strategies
#13
Omidreza Tabatabaie, Gyulnara G Kasumova, Mariam F Eskander, Jonathan F Critchlow, Nicholas E Tawa, Jennifer F Tseng
OBJECTIVE: Totally implantable venous access devices (portacaths, or "ports"), are widely used for intermittent central venous access especially for cancer patients. Although ports have a superior safety margin compared with other long-term venous access devices, there are a number of complications associated with their use. METHODS: This is a narrative review. We searched PubMed and Google Scholar for articles about complications related to the use of portacaths...
February 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27981565/a-multicentre-snapshot-study-of-the-incidence-of-serious-procedural-complications-secondary-to-central-venous-catheterisation
#14
R K Lathey, R E Jackson, A Bodenham, D Harper, V Patle
Despite the high number of central venous access devices inserted annually, there are limited data on the incidence of the associated procedural complications, many of which carry substantial clinical risk. This point was highlighted in the recently published Association of Anaesthetists of Great Britain and Ireland 'Safe vascular access 2016' guidelines. This trainee-led snapshot study aimed to identify the number of central venous catheter insertions and the incidence of serious complications across multiple hospital sites within a fixed two-week period...
December 16, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27957798/evaluation-of-the-need-for-chest-x-rays-in-the-management-of-asymptomatic-intraluminal-vascular-access-device-occlusion-in-childhood-cancer
#15
David Stammers, Bairbre Connolly, Leonardo R Brandão, Sue Zupanec, Sumit Gupta
BACKGROUND: Venous access device (VAD) occlusion from intraluminal thrombus is a common complication during childhood cancer treatment. Current practice at many institutions is to assess VAD position with a chest X-ray (CXR) prior to intraluminal administration of tissue plasminogen activator (tPA). We aimed to determine the utility of this practice. PROCEDURE: A retrospective chart review of children with newly diagnosed cancer with a VAD, treated at The Hospital for Sick Children between 2010 and 2011, was performed...
December 13, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27951558/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvements
#16
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27876561/tip-design-of-hemodialysis-catheters-influences-thrombotic-events-and-replacement-rate
#17
C Petridis, M Nitschke, W Lehne, E Smith, J P Goltz, H Lehnert, M Meier
OBJECTIVE/BACKGROUND: Central venous tunnelled hemodialysis catheters (CVTC) are used for initial vascular access in patients with renal failure. Tip design of the CVTC may play an important role in catheter function and complication rates, influencing adequate hemodialysis treatment of these patients. METHODS: This prospective, observational cohort study compared the function and complication rates of two CVTCs in patients with end stage renal disease (ESRD) within a follow-up period of 24 months...
November 19, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27872609/panitumumab-associated-encephalopathy-after-accidental-intra-arterial-application-through-dislocated-central-venous-access-device
#18
Slaven Pikija, Georg Pilz, Gerald Gschwandtner, Cornelia Rösler, Konstantin Schlick, Richard Greil, Johann Sellner
Acute central nervous system (CNS) toxicity and immune-related side effects are increasingly recognized with the use of monoclonal antibodies for cancer therapy. Here, we report a patient who developed of acute-onset encephalopathy and coma, which began shortly after administration of panitumumab for the treatment of metastatic colorectal cancer. Echocardiography revealed that the drug had been infused into the left cardiac ventricle via a dislocated central venous line. Diffusion-weighted magnetic resonance imaging disclosed multiple cortical hyperintensities, which were preferentially located in the frontal lobes...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27813214/complications-of-haemophilia-in-babies-first-two-years-of-life-a-report-from-the-centers-for-disease-control-and-prevention-universal-data-collection-system
#19
R Kulkarni, R J Presley, J M Lusher, A D Shapiro, J C Gill, M Manco-Johnson, M A Koerper, T C Abshire, D DiMichele, W K Hoots, P Mathew, D J Nugent, S Geraghty, B L Evatt, J M Soucie
AIM: To describe the prevalence and complications in babies ≤2 years with haemophilia. METHODS: We used a standardized collection tool to obtain consented data on eligible babies aged ≤2 years with haemophilia enrolled in the Centers for Disease Control and Prevention Universal Data Collection System surveillance project at US Hemophilia Treatment Centers (HTCs). RESULTS: Of 547 babies, 82% had haemophilia A, and 70% were diagnosed within one month of birth...
March 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27768210/fracture-of-totally-implanted-central-venous-access-devices-a-propensity-score-matched-comparison-of-risks-for-groshong-silicone-versus-polyurethane-catheters
#20
Soichi Kojima, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Toshiharu Mitsuhashi, Susumu Kanazawa
PURPOSE: To evaluate retrospectively the fracture risk of totally implanted venous access devices connected to Groshong silicone (SC) versus polyurethane (PU) catheters, inserted via the internal jugular vein. MATERIALS AND METHODS: The study population comprised 384 SC and 221 PU central venous catheters implanted via the internal jugular vein. The presence of catheter fracture was evaluated. Variables possibly related to catheter fracture were evaluated. First, in order to determine the factors associated with fracture, fracture rates were compared with the log-rank test between the two groups divided by each of the variables...
November 2, 2016: Journal of Vascular Access
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