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Central venous access devices

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https://www.readbyqxmd.com/read/29135819/prophylactic-rtpa-in-the-prevention-of-line-associated-thrombosis-and-infection-in-short-bowel-syndrome
#1
Lynn M Malec, James Cooper, Jeffrey Rudolph, Marian G Michaels, Margaret V Ragni
BACKGROUND: Central venous access devices (CVADs) are essential for total parenteral nutrition administration in patients with short bowel syndrome (SBS). However, they are fraught with complications including infection and venous thromboembolism (VTE), which increases associated morbidity and mortality in this population. There is evidence linking the development of CVAD-associated thrombosis and line-related infection. Thus, it has been postulated that prevention of catheter-related clot formation could minimize the risk of infection originating from the catheter...
November 10, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29111850/chitosan-based-coatings-in-the-prevention-of-intravascular-catheter-associated-infections
#2
Gracia Mendoza, Anna Regiel-Futyra, Alejandra Tamayo, Marta Monzon, Silvia Irusta, Miguel Angel de Gregorio, Agnieszka Kyzioł, Manuel Arruebo
Central venous access devices play an important role in patients with prolonged intravenous administration requirements. In the last years, the coating of these devices with bactericidal compounds has emerged as a potential tool to prevent bacterial colonization. Our study describes the modification of 3D-printed reservoirs and silicone-based catheters, mimicking central venous access devices, through different approaches including their coating with the well known biocompatible and bactericidal polymer chitosan, with the anionic polysaccharide alginate; also, plasma treated surfaces were included in the study to promote polymer adhesion...
January 1, 2017: Journal of Biomaterials Applications
https://www.readbyqxmd.com/read/29101989/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-central-venous-access
#3
Colette M Shaw, Shrenik Shah, Baljendra S Kapoor, Thomas R Cain, Drew M Caplin, Khashayar Farsad, M-Grace Knuttinen, Margaret H Lee, Joseph J McBride, Jeet Minocha, Elizabeth V Robilotti, Paul J Rochon, Richard Strax, Elrond Y L Teo, Jonathan M Lorenz
Obtaining central venous access is one of the most commonly performed procedures in hospital settings. Multiple devices such as peripherally inserted central venous catheters, tunneled central venous catheters (eg, Hohn catheter, Hickman catheter, C. R. Bard, Inc, Salt Lake City UT), and implantable ports are available for this purpose. The device selected for central venous access depends on the clinical indication, duration of the treatment, and associated comorbidities. It is important for health care providers to familiarize themselves with the types of central venous catheters available, including information about their indications, contraindications, and potential complications, especially the management of catheters in the setting of catheter-related bloodstream infections...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29097337/electrocardiographic-guided-technique-for-placement-of-ventriculo-atrial-shunts-a-valid-and-cost-effective-technical-simplification
#4
Giuseppe Maria Della Pepa, Giovanni Sabatino, Elisabetta Peppucci, Carmelo Lucio Sturiale, Alessio Albanese, Alfredo Puca, Alessandro Olivi, Enrico Marchese, Valerio Perotti
BACKGROUND: Ventriculo-atrial (VA) shunt is a routine technique for the treatment of hydrocephalus. Correct position at superior vena cava-right atrium junction is generally assessed by X-ray. We herein present the first experience of an alternative, non-radiographic technique to assess the distal end of the VA-shunts through an electrocardiographic (EKG) method. Such a technique is mutuated from the very large experience on central-venous catheters (CVC) worldwide: the EKG-guided method is a common and validated alternative to the standard radiological control of the location of the tip of any CVC...
October 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29068728/tissue-adhesive-for-vascular-access-devices-who-what-where-and-when
#5
Amanda Corley, Nicole Marsh, Amanda J Ullman, Claire M Rickard
Despite vascular access devices (VADs) being vital for patient care, device failure rates are unacceptably high with around 25% of central venous devices, and 30-40% of peripheral venous devices, developing complications that result in VAD failure. The use of tissue adhesive is a novel method of securing VADs and is gaining popularity, however the evidence base guiding its clinical use is still emerging. This article aims to review the types and properties of tissue adhesives, provide an overview of the existing evidence base, and discuss how tissue adhesives may be used in clinical practice...
October 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#6
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29023196/home-parenteral-nutrition-vascular-access-and-related-complications
#7
Martyn Dibb, Simon Lal
Patients with chronic intestinal failure are dependent on parenteral nutrition (PN) to maintain health and preserve life. Maintaining safe vascular access is vital to prevent life-threatening complications such as catheter-related bloodstream infection or central venous occlusion. Dedicated central venous catheters with rigorous catheter care aseptic protocols are vital in obtaining good long-term outcomes that allow continuation of PN over many years. Good catheter care requires an experienced multidisciplinary team using appropriate vascular devices, trained to identify and aggressively treat catheter-related bloodstream infections, catheter occlusions, and catheter-related thrombosis...
December 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28978332/central-venous-access-device-securement-and-dressing-effectiveness-for-peripherally-inserted-central-catheters-in-adult-acute-hospital-patients-cascade-a-pilot-randomised-controlled-trial
#8
Raymond J Chan, Sarah Northfield, Emily Larsen, Gabor Mihala, Amanda Ullman, Peter Hancock, Nicole Marsh, Nicole Gavin, David Wyld, Anthony Allworth, Emily Russell, Md Abu Choudhury, Julie Flynn, Claire M Rickard
BACKGROUND: Peripherally inserted central catheters (PICCs) are commonly used for delivering intravenous therapy. PICC failure is unacceptably high (up to 40%) due to mechanical, infectious and thrombotic complications. Poor securement potentiates all complication types. This randomised controlled trial (RCT) aimed to examine the feasibility of a large RCT of four dressing and securement methods to prevent PICC failure. METHODS: This single-centre pilot RCT included 124 admitted medical/surgical/cancer patients aged ≥ 16 years with a PICC...
October 4, 2017: Trials
https://www.readbyqxmd.com/read/28959736/comparative-analysis-of-bacterial-community-composition-and-structure-in-clinically-symptomatic-and-asymptomatic-central-venous-catheters
#9
Franziska A Stressmann, Elodie Couve-Deacon, Delphine Chainier, Ashwini Chauhan, Aimee Wessel, Sylvaine Durand-Fontanier, Marie-Christine Escande, Irène Kriegel, Bruno Francois, Marie-Cécile Ploy, Christophe Beloin, Jean-Marc Ghigo
Totally implanted venous access ports (TIVAPs) are commonly used catheters for the management of acute or chronic pathologies. Although these devices improve health care, repeated use of this type of device for venous access over long periods of time is also associated with risk of colonization and infection by pathogenic bacteria, often originating from skin. However, although the skin microbiota is composed of both pathogenic and nonpathogenic bacteria, the extent and the consequences of TIVAP colonization by nonpathogenic bacteria have rarely been studied...
September 2017: MSphere
https://www.readbyqxmd.com/read/28932593/successful-removal-of-embolized-chemoport-catheter-within-the-heart-and-pericardium-3-case-reports
#10
Shin-Eui Yoon, Chang Hoon Lee
Central venous access devices are routinely used in patients with cancer. Although rare, catheter transaction with subsequent embolization is one of the major complications of intra-vascular devices. We describe two patients with embolized chemoport catheters within the heart that were successfully removed percutaneously using a goose-neck snare technique. We also describe a third patient with a fractured intra-vascular catheter in the pericardium removed by pericardiotomy, which can be the first case of the kind...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28854967/innovative-dressing-and-securement-of-tunneled-central-venous-access-devices-in-pediatrics-a-pilot-randomized-controlled-trial
#11
Amanda J Ullman, Tricia Kleidon, Victoria Gibson, Craig A McBride, Gabor Mihala, Marie Cooke, Claire M Rickard
BACKGROUND: Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate. The aim of this study was to evaluate the feasibility of launching a full-scale randomized controlled efficacy trial of innovative dressing and securement products for pediatric tunneled CVAD to prevent complication and failure...
August 30, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28806225/preventing-retained-central-venous-catheter-guidewires-a-randomized-controlled-simulation-study-using-a-human-factors-approach
#12
RANDOMIZED CONTROLLED TRIAL
Maryanne Z A Mariyaselvam, Ken R Catchpole, David K Menon, Arun K Gupta, Peter J Young
BACKGROUND: Retained central venous catheter guidewires are never events. Currently, preventative techniques rely on clinicians remembering to remove the guidewire. However, solutions solely relying upon humans to prevent error inevitably fail. A novel locked procedure pack was designed to contain the equipment required for completing the procedure after the guidewire should have been removed: suture, suture holder, and antimicrobial dressings. The guidewire is used as a key to unlock the pack and to access the contents; thereby, the clinician must remove the guidewire from the patient to complete the procedure...
October 2017: Anesthesiology
https://www.readbyqxmd.com/read/28777415/repositioning-of-central-venous-access-devices-using-a-high-flow-flush-technique-a-clinical-practice-and-cost-review
#13
Timothy R Spencer
BACKGROUND: Malpositioned central venous access device (CVAD) tip locations can cause significant mechanical and chemical vessel-related injuries and complications if left in inappropriate positions.The aim of this study is to determine the use of a high-flow flush technique (HFFT) in successful correction of malpositioned catheters into the lower superior vena cava or cavoatrial junction and provide a cost comparison to interventional/fluoroscopic-based repositioning. METHODS: This is a retrospective chart and radiographic review of all inserted CVADs found malpositioned between 1996-2014 in a multi-specialty 1000-bed tertiary trauma center in Sydney, Australia...
September 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28744885/water-infused-surface-protection-as-an-active-mechanism-for-fibrin-sheath-prevention-in-central-venous-catheters
#14
David W Sutherland, Xin Zhang, Joseph L Charest
Protein adhesion in central venous catheters (CVCs) leads to fibrin sheath formation, the precursor to thrombotic and biofilm-related CVC failures. Advances in material properties and surface coatings do not completely prevent fibrin sheath formation and post-formation treatment options are limited and expensive. We propose water infused surface protection (WISP), an active method for prevention of fibrin sheath formation on CVCs, which creates a blood-free boundary layer on the inner surface of the CVC, limiting blood contact with the CVC lumen wall...
July 26, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#15
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/28687683/substantial-harm-associated-with-failure-of-chronic-paediatric-central-venous-access-devices
#16
Amanda J Ullman, Tricia Kleidon, Marie Cooke, Claire M Rickard
Central venous access devices (CVADs) form an important component of modern paediatric healthcare, especially for children with chronic health conditions such as cancer or gastrointestinal disorders. However device failure and complications rates are high.Over 2½ years, a child requiring parenteral nutrition and associated vascular access dependency due to 'short gut syndrome' (intestinal failure secondary to gastroschisis and resultant significant bowel resection) had ten CVADs inserted, with ninesubsequently failing...
July 6, 2017: BMJ Case Reports
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/28681653/comparison-of-the-single-syringe-push-pull-technique-with-the-discard-technique-for-obtaining-blood-samples-from-pediatric-central-venous-access-devices
#18
Sarah Hess, Mary Decker
The discard technique is the most widely used method of obtaining blood samples from patients with central venous access devices (CVADs), but risks removing more blood than is necessary for laboratory testing and may increase a patient's risk of anemia. We hypothesized that laboratory results from pediatric blood specimens obtained via CVAD using the single-syringe push-pull (formerly called the mixing) method and the discard method would be similar. Blood samples were obtained from pediatric oncology patients in a hospital setting using both collection methods and laboratory values were analyzed for concordance using the pairwise t-test, intraclass correlation coefficient, and Bland-Altman analysis methods...
November 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28681633/major-and-minor-classifications-for-surgery-in-people-with-hemophilia-a-literature-review
#19
Luigi Piero Solimeno, Miguel A Escobar, Snejana Krassova, Stephanie Seremetis
Agents that control bleeding and the usage of bypassing agents have made surgery an option to consider in people with hemophilia. However, the lack of consistent definitions for major or minor surgery may lead to inconsistencies in patient management. This literature review has evaluated how surgical procedures in people with hemophilia were categorized as major or minor surgery and assessed the consistency across publications. After screening 926 potentially relevant articles, 547 were excluded and 379 full-text articles were reviewed...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28665466/long-term-clinical-outcomes-of-the-single-incision-technique-for-implantation-of-implantable-venous-access-ports-via-the-axillary-vein
#20
Tae-Seok Seo, Myung Gyu Song, Jun Suk Kim, Chul Won Choi, Jae Hong Seo, Sang Cheul Oh, Eun Joo Kang, Jae-Kwan Lee, Sung-Yong Lee
PURPOSE: To evaluate long-term clinical outcomes and complications of the single-incision technique for implantation of totally implantable venous access ports (TIVAPs) via the axillary vein. MATERIALS AND METHODS: A total of 932 TIVAPs were placed in 927 patients between May 2012 and October 2014 using a single-incision technique. Patients included 620 men and 307 women with a mean age of 60.0 years. TIVAPs were placed via the left (n = 475) and right (n = 457) axillary veins after making a single oblique vertical incision and medial side pocket without subcutaneous tunneling...
July 14, 2017: Journal of Vascular Access
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