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CVC tip position

Claudia Lucarelli, Enea Gino Di Domenico, Luigi Toma, Domenico Bracco, Grazia Prignano, Maria Fortunati, Lorella Pelagalli, Fabrizio Ensoli, Patrizio Pezzotti, Aurora García-Fernández, Annalisa Pantosti, Loredana Ingrosso
BACKGROUND: Ralstonia spp, an environmental microorganism, has been occasionally associated with healthcare infections. The aim of this study was to investigate an outbreak caused by Ralstonia mannitolilytica in oncology patients. METHODS: Case definition: Oncology outpatients attending a day ward, with positive blood and/or central venous catheter (CVC) culture for Ralstonia spp from September 2013 - June 2014. We analysed medical records, procedures and environmental samples...
2017: Antimicrobial Resistance and Infection Control
Harkirat Singh, Aftab Alam, T V S V G K Tilak, Prateek Kinra, Brijesh K Soni
Inflammatory lesions may sometimes show intense tracer uptake and mimic neoplastic lesions on (18) F-fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). We report one such false positive case on FDG PET/CT, where septic pulmonary emboli (SPE) mimicked pulmonary metastases. A 45-year-old man with stomach cancer had an indwelling central venous catheter (CVC) in situ while on neoadjuvant chemotherapy. He underwent FDG PET/CT scan for response assessment and the images revealed multiple, intensely FDG avid, peripheral, lung nodules with feeding vessels, which were suspicious for pulmonary metastases...
October 2016: Indian Journal of Radiology & Imaging
Max B van Gent, Wendeline J van der Made, Perla J Marang-van de Mheen, Koen E van der Bogt
OBJECTIVE: To analyze the rate of infections and complications after surgeon-performed, largely ultrasound-guided, central venous catheter (CVC) placement in a pediatric population and to identify patients at high risk of complications. METHODS: All children aged between 4 months and 19 years with a percutaneous CVC inserted between January 1, 2000, and July 31, 2013, were included. Patient records were reviewed retrospectively for the occurrence of infection and other complications until CVC removal or the last outpatient clinic visit and compared between patient groups and with the recent literature...
February 2017: Surgical Infections
Tejesh C Anandaswamy, Vinay Marulasiddappa
BACKGROUND AND AIMS: Subclavian central venous catheterisation (CVC) is employed in critically ill patients requiring long-term central venous access. There is no gold standard for estimating their depth of insertion. In this study, we compared the landmark topographic method with the formula technique for estimating depth of insertion of right subclavian CVCs. METHODS: Two hundred and sixty patients admitted to Intensive Care Unit requiring subclavian CVC were randomly assigned to either topographic method or formula method (130 in each group)...
July 2016: Indian Journal of Anaesthesia
Neeraj Kumar Barnwal, Sona T Dave, Raylene Dias
BACKGROUND AND AIMS: The complications of central venous catheterisation can be minimized by ensuring catheter tip placement just above the superior vena cava-right atrium junction. We aimed to compare two methods, using an electrocardiogram (ECG) or landmark as guides, for assessing correct depth of central venous catheter (CVC) placement. METHODS: In a prospective randomised study of sixty patients of <12 years of age, thirty patients each were allotted randomly to two groups (ECG and landmark)...
July 2016: Indian Journal of Anaesthesia
Manuel F Struck, Theresa Jünemann, Konrad Reinhart, Wolfram Schummer
Considerable numbers of patients undergo central venous catheterization (CVC) under mechanical ventilation. We hypothesized that the return of spontaneous breathing and tracheal extubation could be associated with distal CVC tip migration towards intracardiac positions due to decreasing intrathoracic pressures and subsequent readjustment of mediastinal organs. Patients scheduled for cardiac surgery were randomized for right or left internal jugular vein (IJV) CVC placement under general anesthesia and mechanical ventilation...
July 28, 2016: Journal of Clinical Monitoring and Computing
Madhur Kumar, Amarjit Singh, Kuldeep Singh Sidhu, Avleen Kaur
Although Central Venous Catheter (CVC) placement is a relatively simple procedure but its insertion and maintenance are associated with significant risks. Malposition (defined as any CVC tip position outside the superior vena cava) may be associated with catheter insertion and may require immediate intervention. It may result in complications like haemothorax, pleural effusions, pneumothorax, sepsis, thrombosis and cardiac tamponade. This case report presents timely detection of the complication after placement of CVC...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
M Vinay, C A Tejesh
BACKGROUND: Central venous catheters (CVCs) are inserted in many critically ill patients, but there is no gold standard in estimating their approximate depth of insertion. Many techniques have been described in literature. In this study, we compare the topographic method with the standard formula technique. MATERIALS AND METHODS: 260 patients, in whom central venous catheterization was warranted, were randomly assigned to either topographic method or formula method (130 in each group)...
July 2016: Saudi Journal of Anaesthesia
María Jesús Pérez-Granda, María Guembe, Raquel Cruces, Emilio Bouza
BACKGROUND: Superficial culture has a high negative predictive value in the assessment of catheter tip colonization (CC) and catheter-related bloodstream infection (C-RBSI). However, the process of hub culture requires the hubs to be swabbed, and this carries a risk of dislodging the biofilm. At present, most catheter hubs are closed by needleless connectors (NCs) that are periodically replaced. Our objective was to compare the yield of SC (skin + hub culture) with that of skin + NC culture in the assessment of CC and C-RBSI...
May 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
Miyuki Kurabe, Tatsunori Watanabe, Tatsuro Kohno
We describe a very rare case of an indwelling central venous catheter (CVC) through the left internal jugular vein that perforated the superior vena cava (SVC) wall postoperatively, although the CVC was placed in the appropriate position preoperatively. Three days after CVC insertion, a chest radiograph showed that the CVC tip had moved from the lower SVC to the upper SVC. Five days after the insertion, computed tomography showed SVC perforation and the resulting hydrothorax. In cases of CVC insertion through the left side, the CVC tip should not be placed in the upper SVC (zone B)...
June 2016: Journal of Clinical Anesthesia
David H Ballard, Navdeep S Samra, Karen Mathiesen Gifford, Robert Roller, Bruce M Wolfe, John T Owings
Central venous catheters (CVCs) are associated with occlusive, infectious, and thrombotic complications. The aim of this study was to determine if internal CVC tip position was correlated with subsequent complications. This was an institutional review board approved single-center retrospective review of 169 consecutive patients who underwent placement of 203 semipermanent CVCs. Using post-placement chest X-rays, a de novo scale of internal catheter tip position was developed. Major complications were recorded...
June 2016: Emergency Radiology
Anne-Marie Chaftari, Mary Jordan, Ray Hachem, Zanaib Al Hamal, Ying Jiang, Ammar Yousif, Kumait Garoge, Poonam Deshmukh, Issam Raad
BACKGROUND: The Centers for Disease Control and Prevention recently introduced the concept of mucosal barrier injury (MBI) in an attempt to recognize the possibility of a gastrointestinal source for certain bloodstream infections. This could underestimate the central venous catheter (CVC) as the source of central line-associated bloodstream infection (CLABSI) in cancer. The definition of catheter-related bloodstream infection (CRBSI) by the Infectious Diseases Society of America is a more specific and stringent definition that identifies the CVC as the source of infection...
August 1, 2016: American Journal of Infection Control
Hongfei Jiang, Hang Hu, Haitao Ren, Chunmao Han, Xingang Wang, Chuangang You, Ruiyi Zhao
PURPOSE: This is a single-center, descriptive report of the management and complications of venous catheter use in 19 severely burned passengers from a bus fire that occurred on July 5, 2014, in Hangzhou. METHODS: We recorded the parameters of the catheters insertion and indwelling. Sampling of each removed catheter was conducted to monitor for catheter-related infections. Bedside ultrasound screening was performed for recording central venous catheter (CVC)-related complications...
July 12, 2016: Journal of Vascular Access
Se-Chan Kim, Ingo Gräff, Alexandra Sommer, Andreas Hoeft, Stefan Weber
PURPOSE: The ultrasound-guided central venous catheter (CVC) guidewire tip positioning has been demonstrated for catheterization of the right internal jugular vein. We explored the feasibility of an ultrasound-guided right subclavian vein (RScV) CVC tip positioning via a right supraclavicular approach using a microconvex probe. METHODS: Twenty patients scheduled for elective surgery were consecutively included in this observational feasibility study following written informed consent...
September 21, 2016: Journal of Vascular Access
Kai Chen, Arnav Agarwal, Maria Cristina Tassone, Nadia Shahjahan, Mark Walton, Anthony Chan, Tapas Mondal
Central venous catheter (CVC) placement is associated with increased risk of thrombosis in the paediatric population, particularly in relation to the type of catheter and the manner of its insertion. Here, we investigate risk factors associated with CVC-related thrombosis in children, with particular emphasis on positioning of the catheter tip. Patients aged 0-18 who underwent at least one CVC placement from 2008 to 2013 at a single centre with a subsequent follow-up echocardiogram were included for a total of 104 patients and 147 lines...
June 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Manpreet S Mundi, Jithinraj Edakkanambeth Varayil, Megan T McMahon, Akiko Okano, Nishanth Vallumsetla, Sara L Bonnes, James C Andrews, Ryan T Hurt
BACKGROUND: Parenteral nutrition (PN) is a life-saving therapy for patients with intestinal failure. Safe delivery of hyperosmotic solution requires a central venous catheter (CVC) with tip in the lower superior vena cava (SVC) or at the SVC-right atrium (RA) junction. To reduce cost and delay in use of CVC, new techniques such as intravascular electrocardiogram (ECG) are being used for tip confirmation in place of chest x-ray (CXR). The present study assessed for accuracy of ECG confirmation in home PN (HPN)...
April 2016: Nutrition in Clinical Practice
O Evans, J Gowardman, D Rabbolini, M McGrail, C M Rickard
BACKGROUND: One of the most common and potentially fatal complications in critically ill burns patients is catheter related bloodstream infection (CR-BSI). Lack of in situ diagnostic techniques requires device removal if CR-BSI is suspected with 75-85% of catheters withdrawn unnecessarily. AIMS: To assess the sensitivity, specificity and accuracy of two in situ diagnostic methods for CR-BSI in an adult ICU burns population: Differential Time to Positivity (DTP) and Semi-Quantitative Superficial Cultures (SQSC)...
March 2016: Burns: Journal of the International Society for Burn Injuries
Manuel F Struck, Thomas Schmidt, Bernd E Winkler, Konrad Reinhart, Wolfram Schummer
PURPOSE: Whether formulas for prediction of central venous catheter (CVC) insertion depths have different applicability in patients with different body heights is not known. Goal of study was to test formulas for catheterizations of internal jugular veins (IJVs) in a population of different body height classes with correct CVC tip positions. METHODS: Consecutive adult patients requiring CVC for cardiac surgery were enrolled and those with tip positions at the junction of the superior vena cava and the right atrium ±1 cm underwent formula analysis...
March 2016: Journal of Vascular Access
Patrick Kellner, Viola Schleusener, Frank Bauerfeind, Jens Soukup
Hemodynamic measurements are often conducted by the transpulmonary thermodilution (TPTD)-based PiCCO(®)-system. This requires a central-venous (CVC) and a thermistor-tipped arterial catheter, usually placed in the femoral artery. In certain clinical situations, CVC devices have to be placed in the inferior vena cava. However, little is known about the influence of different CVC positions (i.e. ipsi- vs. contra-lateral to the arterial catheter) on the accuracy of the TPTD measurement results. In this prospective observational study surgical intensive care unit patients who had been inserted with CVCs either into the superior (CVCVCS) or the inferior vena cava (CVCinf) in addition to an arterial PiCCO(®)-catheter, were enrolled...
October 2016: Journal of Clinical Monitoring and Computing
Michael Doctor, Sebastian D Siadecki, Gabriel Rose, Rachel Berkowitz, Danielle Matilsky, Turandot Saul
INTRODUCTION: The placement of a central venous catheter (CVC) remains an important intervention in the care of critically ill patients in the emergency department, and bedside ultrasound can be used for procedural guidance as well as conformation of placement. Microbubble contrast-enhanced ultrasound may facilitate CVC tip position localization, and the addition of autologous blood can significantly increase its echogenicity. The purpose of this study was to describe the preferences of a group of resident physicians regarding the performance of various concentrations of air-blood-saline sonographic microbubble contrast agents...
October 2015: American Journal of Emergency Medicine
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