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A Kakkos, L Bresson, D Hudry, S Cousin, C Lervat, E Bogart, J P Meurant, S El Bedoui, G Decanter, K Hannebicque, C Regis, A Hamdani, N Penel, E Tresch-Bruneel, F Narducci
BACKGROUND: Totally implantable venous access port systems are widely used in oncology, with frequent complications that sometimes necessitate device removal. The aim of this study is to investigate the impact of the time interval between port placement and initiation of chemotherapy and the neutropenia-inducing potential of the chemotherapy administered upon complication-related port removal. PATIENTS AND METHODS: Between January 2010 and December 2013, 4045 consecutive patients were included in this observational, single-center prospective study...
November 5, 2016: European Journal of Surgical Oncology
Teryl K Nuckols, Emmett Keeler, Sally C Morton, Laura Anderson, Brian Doyle, Marika Booth, Roberta Shanman, Jonathan Grein, Paul Shekelle
Importance: Although quality improvement (QI) interventions can reduce central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI), their economic value is uncertain. Objective: To systematically review economic evaluations of QI interventions designed to prevent CLABSI and/or CRBSI in acute care hospitals. Evidence Review: A search of Ovid MEDLINE, Econlit, Centre for Reviews & Dissemination, New York Academy of Medicine's Grey Literature Report, Worldcat, prior systematic reviews (January 2004 to July 2016), and IDWeek conference abstracts (2013-2016), was conducted from 2013 to 2016...
December 1, 2016: JAMA Internal Medicine
Mary A M Rogers, Neil Blumberg, Steven J Bernstein, Scott A Flanders, Vineet Chopra
BACKGROUND: Mechanisms of red blood cell delivery and their contribution to the incidence of venous thromboembolism are not well understood in the clinical setting. We assessed whether red blood cell transfusion through peripherally inserted central catheters (PICCs) affects the risk of venous thromboembolism compared with transfusion through non-PICC devices. METHODS: We implemented a prospective study between Jan 1, 2013, and Sept 12, 2015, in patients (age ≥18 years) admitted to a general medicine ward or intensive care unit who received a PICC for any reason during clinical care in 47 hospitals in Michigan, USA, with a maximum follow-up of 70 days...
November 3, 2016: Lancet Haematology
Paula Parás-Bravo, María Paz-Zulueta, Raquel Sarabia-Lavin, Francisco Jose Amo-Setién, Manuel Herrero-Montes, Encarnación Olavarría-Beivíde, Mercedes Rodríguez-Rodríguez, Blanca Torres-Manrique, Carlos Rodríguez-de la Vega, Vanesa Caso-Álvarez, Laura González-Parralo, Francisco Manuel Antolín-Juárez
BACKGROUND AND AIM: The use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients. MATERIALS AND METHODS: In this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care...
2016: PloS One
Ulrike Braun, Edelgard Lorenz, Christiane Weimann, Heinz Sturm, Ilham Karimov, Johannes Ettl, Reinhard Meier, Walter A Wohlgemuth, Hermann Berger, Moritz Wildgruber
Central venous port devices made of two different polymeric materials, thermoplastic polyurethane (TPU) and silicone rubber (SiR), were compared due their material properties. Both naïve catheters as well as catheters after removal from patients were investigated. In lab experiments the influence of various chemo-therapeutic solutions on material properties was investigated, whereas the samples after removal were compared according to the implanted time in patient. The macroscopic, mechanical performance was assessed with dynamic, specially adapted tests for elasticity...
December 2016: Journal of the Mechanical Behavior of Biomedical Materials
Charlie C-T Hsu, Gigi N C Kwan, Hannah Evans-Barns, John A Rophael, Mieke L van Driel
BACKGROUND: Totally implantable venous access ports (TIVAPs) provide patients with a safe and permanent venous access, for instance in the administration of chemotherapy for oncology patients. There are several methods for TIVAP placement, and the optimal evidence-based method is unclear. OBJECTIVES: To compare the efficacy and safety of three commonly used techniques for implanting TIVAPs: the venous cutdown technique, the Seldinger technique, and the modified Seldinger technique...
August 21, 2016: Cochrane Database of Systematic Reviews
Lei Luo, Xiao-Mei Jing, Guo-Rong Wang, Ying Qin, Hai-Xin Liang, Shan-Shan Liu
OBJECTIVES: Peripherally inserted central catheters (PICCs) are associated with an increased risk of venous thrombosis. This study had 2 objectives: to estimate the incidence of upper extremity venous thrombosis associated with PICCs in oncology patients and to evaluate the role of Doppler sonography in antithrombotic prophylaxis. METHODS: We conducted a prospective study with each patient being followed for 6 weeks. From April 2014 to October 2014, we analyzed a series of 245 consecutive oncology patients undergoing chemotherapy via PICCs, for an overall number of 246 PICC placements...
August 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Rita L McGill, Robin Ruthazer, Klemens B Meyer, Dana C Miskulin, Daniel E Weiner
BACKGROUND AND OBJECTIVES: Use of peripherally inserted central catheters has expanded rapidly, but the consequences for patients who eventually require hemodialysis are undefined. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our national, population-based analysis included 33,918 adult Medicare beneficiaries from the US Renal Data System who initiated hemodialysis with central venous catheters as their sole vascular access in 2010 and 2011. We used linked Medicare claims to identify peripherally inserted central catheter exposures and evaluate the associations of peripherally inserted central catheter placement with transition to working arteriovenous fistulas or grafts and patient survival using a Cox model with time-dependent variables...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Jeffrey D Crawford, Timothy K Liem, Gregory L Moneta
Central venous catheters or peripherally inserted central catheters are major risk factors for upper extremity deep venous thrombosis (UEDVT). The body and quality of literature evaluating catheter-associated (CA) UEDVT have increased, yet strong evidence on screening, diagnosis, prevention, and optimal treatment is limited. We herein review the current evidence of CA UEDVT that can be applied clinically. Principally, we review the anatomy and definition of CA UEDVT, identification of risk factors, utility of duplex ultrasound as the preferred diagnostic modality, preventive strategies, and an algorithm for management of CA UEDVT...
July 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Brent Burbridge, Ian Y M Chan, Rhonda Bryce, Hyun J Lim, Grant Stoneham, Hager Haggag, Christine Roh
PURPOSE: Placement of arm ports, or totally implanted venous access devices, is a common practice in our interventional radiology suite. We implant a miniaturized port in the upper arm for the provision of long-term chemotherapy. We hypothesized that there was general satisfaction with these arm ports and they have a minimal negative impact on quality of life. In this study we aimed to assess our hypotheses. METHODS: We surveyed subjects, who having previously received an arm port for chemotherapy to treat a malignancy, attended the interventional room for its removal...
August 2016: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Nancy Moureau, Vineet Chopra
Patients admitted to acute care frequently require intravenous access to effectively deliver medications and prescribed treatment. For patients with difficult intravenous access, those requiring multiple attempts, those who are obese, or have diabetes or other chronic conditions, determining the vascular access device (VAD) with the lowest risk that best meets the needs of the treatment plan can be confusing. Selection of a VAD should be based on specific indications for that device. In the clinical setting, requests for central venous access devices are frequently precipitated simply by failure to establish peripheral access...
April 28, 2016: British Journal of Nursing: BJN
Olivia Wu, Kathleen Boyd, Jim Paul, Elaine McCartney, Moira Ritchie, D Mellon, Linda Kelly, Judith Dixon-Hughes, Jon Moss
BACKGROUND: In the United Kingdom, totally implantable venous access systems (TIVAS) are not routinely used. Compared with Hickman catheters, these devices are more expensive and complex to insert. However, it is unclear whether the higher costs may be offset by perceived greater health benefits. This pilot trial aimed to generate relevant data to inform the design of a larger definitive randomised controlled trial. METHODS: This was a phase II prospective, randomised, open trial from two UK oncology centres...
April 26, 2016: British Journal of Cancer
Namrata Krishnan
Hemodialysis catheter-related bacteremia (CRB) is the most common complication associated with catheter use in dialysis patients and portends a high morbidity and mortality. Current CDC and KDIGO guidelines recommend treating CRBs with systemic antibiotics in conjunction with catheter replacement, although the latter has limitations. Antibiotic lock solutions (ABLs) are very effective in both prevention and treatment of CRBs in hemodialysis patients and may be a preferred alternative to catheter replacement especially in patients where catheter salvage is a priority...
July 2016: Seminars in Dialysis
Moritz Wildgruber, Claudia Lueg, Sebastian Borgmeyer, Ilham Karimov, Ulrike Braun, Marion Kiechle, Reinhard Meier, Michael Koehler, Johannes Ettl, Hermann Berger
PURPOSE: We aimed to analyse short and long-term complications of polyurethane (PU) versus silicone catheters used in totally implantable venous-access ports (TIVAPs) implanted at the forearm. METHODS: Retrospective analysis of 698 consecutively implanted TIVAPs was performed. Primary end-points were defined as rates of major complications associated with either type of central venous port catheter. Technical success rate, device service interval as well as minor complications not requiring port explantation were defined as secondary end-points...
May 2016: European Journal of Cancer
Sergio Bertoglio, Beatrice Faccini, Luca Lalli, Ferdinando Cafiero, Paolo Bruzzi
BACKGROUND AND OBJECTIVES: The increasing use of peripherally inserted central venous catheters (PICCs) for chemotherapy has led to the observation of an elevated risk of complications and failures. This study investigates PICC failures in cancer patients. METHODS: A prospective study was conducted at a single cancer institution on 291 PICC placement for chemotherapy. The primary study outcome was PICC failure. RESULTS: Median follow-up was 119 days...
May 2016: Journal of Surgical Oncology
L I Ma, Yueping Liu, Jianxin Wang, Yuan Chang, Long Yu, Cuizhi Geng
Totally implantable venous access port systems (TIVAPS) are widely used in breast cancer patients. However, complications are frequent and may necessitate device replacement or removal, resulting in additional patient stress and treatment delays. The aim of this study was to investigate possible risk factors for complications. A total of 2,996 consecutive female breast cancer patients, with a median age of 50.2 years (range, 21.2-85.5 years) were enrolled in this observational, single-centre study between December, 2008 and April, 2014...
March 2016: Molecular and Clinical Oncology
Nai Ming Lai, Nathorn Chaiyakunapruk, Nai An Lai, Elizabeth O'Riordan, Wilson Shu Cheng Pau, Sanjay Saint
BACKGROUND: The central venous catheter (CVC) is essential in managing acutely ill patients in hospitals. Bloodstream infection is a major complication in patients with a CVC. Several infection control measures have been developed to reduce bloodstream infections, one of which is impregnation of CVCs with various forms of antimicrobials (either with an antiseptic or with antibiotics). This review was originally published in June 2013 and updated in 2016. OBJECTIVES: Our main objective was to assess the effectiveness of antimicrobial impregnation, coating or bonding on CVCs in reducing clinically-diagnosed sepsis, catheter-related blood stream infection (CRBSI), all-cause mortality, catheter colonization and other catheter-related infections in adult participants who required central venous catheterization, along with their safety and cost effectiveness where data were available...
2016: Cochrane Database of Systematic Reviews
Amy Leung, Clare Heal, Jennifer Banks, Breanna Abraham, Gian Capati, Casper Pretorius
Background. Central venous catheters and peripherally inserted central catheters are well established risk factors for upper limb deep vein thrombosis. There is limited literature on the thrombosis rates in patients with peripheral catheters. A prospective observational study was conducted to determine the incidence of peripheral catheter-related thrombosis in surgical patients. Methods. Patients deemed high risk for venous thrombosis with a peripheral catheter were considered eligible for the study. An ultrasound was performed on enrolment into the study and at discharge from hospital...
2016: Thrombosis
Jeffrey J Fletcher, Thomas J Wilson, Venkatakrishna Rajajee, William R Stetler, Teresa L Jacobs, Kyle M Sheehan, Devin L Brown
BACKGROUND: Observational studies suggest peripherally inserted central venous catheters (PICCs) are associated with a high risk of catheter-related large vein thrombosis (CRLVT) in critically ill neurologic patients. We evaluated the difference in thrombosis risk between PICCs and centrally inserted central venous catheters (CICVCs). METHODS: We conducted a pragmatic, randomized controlled trial of critically ill adult neurologic patients admitted to neurological and trauma critical care units at two level I trauma centers...
August 2016: Neurocritical Care
Shamar J Young, Linda J Young, Jeffery Vogel, Raymond Sutkowski, Satish Venkataperumal
PURPOSE: Totally implantable venous access systems (ports) are commonly placed and have a low complication rate. The most common complication is infection, which can have very negative effects on patients resulting in hospitalization and/or treatment delay in the setting of neoplasm. While a number of variables have been studied in relation to diminishing infectious rates, one remaining question is the effect of accessing the port on day of placement, which is the aim of this retrospective study...
May 7, 2016: Journal of Vascular Access
2016-02-08 09:15:10
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