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https://www.readbyqxmd.com/read/28459919/the-arm-is-not-the-leg-pathophysiology-diagnosis-and-management-of-upper-extremity-deep-vein-thrombosis
#1
Adam M Noyes, John Dickey
Upper extremity deep venous thrombosis (UEDVT) involves thrombosis of the deep veins of the arm as they enter the thorax. They are increasing in frequency, largely due to the rising use of central venous catheters and implantable cardiac devices, and represent more than 10% of all DVT cases, Upper extremity deep venous thrombosis has been historically misunderstood when compared to lower extremity deep vein thrombosis (LEDVT). Their associated disease states may carry devastating complications, with mortality rates often higher than that of LEDVT...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28463827/taurolidine-citrate-lock-therapy-for-primary-prevention-of-catheter-related-infections-in-cancer-patients-results-of-a-prospective-randomized-phase-iv-trial-atapac
#2
Raffaele Longo, Mathieu Llorens, Christophe Goetz, Christian Platini, Nada Eid, Jocelyne Sellies, Nadia Ouamara, Philippe Quétin
BACKGROUND: Totally implantable venous access port (TIVAP)-related infections (RIs) remain a serious health problem in cancer patients receiving an intravenous (i.v.) therapy. PATIENTS AND METHODS: The ATAPAC study was a prospective, randomized, monocentric, phase IV trial evaluating the efficacy of taurolidine lock solution versus standard saline solution for primary TIVAP-RI prevention in nonhematological cancer patients receiving i.v. chemotherapy. The primary endpoint was the TIVAP-RI incidence rate...
May 3, 2017: Oncology
https://www.readbyqxmd.com/read/28407421/central-venous-catheters-and-biofilms-where-do-we-stand-in-2017
#3
REVIEW
Marie Gominet, Fabrice Compain, Christophe Beloin, David Lebeaux
The use of central venous catheters (CVC) is associated with a risk of microbial colonization and subsequent potentially severe infection. Microbial contamination of the catheter leads to the development of a microbial consortia associated with the CVC surface and embedded in an extracellular matrix, named biofilm. This biofilm provides bacterial cells the ability to survive antimicrobial agents and the host immune system and to disseminate to other sites of the body. The best preventive strategy is to avoid any unnecessary catheterization or to reduce indwelling duration when a CVC is required...
April 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28422778/ultrasound-as-a-screening-tool-for-central-venous-catheter-positioning-and-exclusion-of-pneumothorax
#4
Rabia Amir, Ziyad O Knio, Feroze Mahmood, Achikam Oren-Grinberg, Akiva Leibowitz, Ruma Bose, Shahzad Shaefi, John D Mitchell, Muneeb Ahmed, Amit Bardia, Daniel Talmor, Robina Matyal
OBJECTIVES: Although real-time ultrasound guidance during central venous catheter insertion has become a standard of care, postinsertion chest radiograph remains the gold standard to confirm central venous catheter tip position and rule out associated lung complications like pneumothorax. We hypothesize that a combination of transthoracic echocardiography and lung ultrasound is noninferior to chest radiograph when used to accurately assess central venous catheter positioning and screen for pneumothorax...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28364951/between-the-lines-the-50th-anniversary-of-long-term-central-venous-catheters
#5
REVIEW
Kenneth W Gow, David Tapper, Robert O Hickman
BACKGROUND: Tunneled central venous catheters (CVC) were developed five decades ago. Since then, several clinician-inventors have created a variety of catheters with different functions. Indeed, many catheters have been named after their inventor. Many have wondered who the inventors were of each catheter, and what specifically inspired their inventions. Many of these compelling stories have yet to be told. DATA SOURCE: A literature review of common catheters and personal communication with inventors...
May 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28323880/randomized-controlled-trials-in-central-vascular-access-devices-a-scoping-review
#6
Mari Takashima, Gillian Ray-Barruel, Amanda Ullman, Samantha Keogh, Claire M Rickard
BACKGROUND: Randomized controlled trials evaluate the effectiveness of interventions for central venous access devices, however, high complication rates remain. Scoping reviews map the available evidence and demonstrate evidence deficiencies to focus ongoing research priorities. METHOD: A scoping review (January 2006-December 2015) of randomized controlled trials evaluating the effectiveness of interventions to improve central venous access device outcomes; including peripherally inserted central catheters, non-tunneled, tunneled and totally implanted venous access catheters...
2017: PloS One
https://www.readbyqxmd.com/read/28279405/vascular-access-guidelines-summary-rationale-and-controversies
#7
Adrian Sequeira, Mihran Naljayan, Tushar J Vachharajani
Dialysis vascular access management in the United States changed significantly after National Kidney Foundation-Kidney Disease Outcome Quality Initiative (NKF-KDOQI) clinical practice guidelines were first published in 1997. The Centers for Medicare and Medicaid Service adopted these guidelines and in collaboration with the End-Stage Renal Disease Networks established the Fistula First Breakthrough Initiative (FFBI) in 2003 to improve the rate of arteriovenous fistula use over arteriovenous graft and central venous catheter in the dialysis population...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28254252/improvement-in-the-diagnosis-of-catheter-related-bloodstream-infections-in-a-tertiary-cancer-center
#8
Patrick Chaftari, Anne-Marie Chaftari, Javier Adachi, Ray Hachem, Sammy Raad, Elizabeth Natividad, Nora Oliver, Bena Ellickalputhenpura, Ying Jiang, Jeffrey Tarrand, Issam Raad
BACKGROUND: Identifying a central venous catheter (CVC) as the source of bacteremia requires drawing simultaneous blood cultures (BCs) from the CVC and peripheral site and correct labeling of the BC source. In our emergency center (EC), 52% of BCs collected from febrile cancer patients lacked source information, making the diagnosis and management of catheter-related bloodstream infections (CRBSIs) challenging. METHODS: Between January 2015 and June 2015, we conducted a quality improvement project in our EC aiming to increase the occurrence of simultaneous BC drawing with accurate source labeling by 10%...
March 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28106685/totally-implantable-venous-access-devices-a-review-of-complications-and-management-strategies
#9
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/28063456/normal-saline-versus-heparin-for-patency-of-central-venous-catheters-in-adult-patients-a-systematic-review-and-meta-analysis
#10
Lei Zhong, Hai-Li Wang, Bo Xu, Yao Yuan, Xin Wang, Ying-Ying Zhang, Li Ji, Zi-Mu Pan, Zhan-Sheng Hu
BACKGROUND: Heparin saline (HS) is theoretically superior to normal saline (NS) for maintaining the patency of central venous catheters (CVCs), but the comparative efficacy of them remains controversial. The aim of this systematic review and meta-analysis was to assess the efficacy of NS versus HS in the maintenance of the patency of CVCs in adult patients. METHODS: We searched PubMed, Embase and the Cochrane library databases. Randomized controlled trials (RCTs) evaluating the use of NS vs...
January 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28032563/surgeon-not-technique-defines-outcomes-after-central-venous-port-insertion
#11
Audrey E Ertel, Zachary D McHenry, Vijay K Venkatesan, Dennis J Hanseman, Koffi Wima, Richard S Hoehn, Shimul A Shah, Daniel E Abbott
BACKGROUND: Although central venous access for port placement is common and relatively safe, complications and poor resource utilization occur. We hypothesized that despite the simplicity of port placement, surgeon and/or resident performance-rather than technique-is associated with clinical outcomes and operating room efficiency. MATERIALS AND METHODS: Medical records of 1200 patients who underwent port placement between 2012 and 2015 at our institution were retrospectively reviewed...
March 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27995028/cost-effectiveness-analysis-of-ultrasound-guided-seldinger-peripherally-inserted-central-catheters-picc
#12
Jianghong Tan, Liping Liu, Jing Xie, Lingli Hu, Qiaolan Yang, Honghong Wang
BACKGROUND: Ultrasound-guided cannulation of deep mid-arm veins by a modified Seldinger (US-Seldinger) technique has been demonstrated to yield better puncture success rates and lower postoperative complication rates than direct cannulation of superficial veins near the elbow with a short peripheral cannula and peripherally inserted central catheter (PICC) insertion through the cannula (non-US conventional method). Economic factors have been evaluated across different operators (i.e. nurses, radiologists, and general practitioners) and different venous catheter types (i...
2016: SpringerPlus
https://www.readbyqxmd.com/read/28029197/application-of-peripherally-inserted-central-catheter-in-acute-myeloid-leukaemia-patients-undergoing-induction-chemotherapy
#13
M-H Chen, W-L Hwang, K-H Chang, L C J Chiang, C L J Teng
Increasingly, peripherally inserted central catheters (PICC) are applied in patients with haematological malignancies. The feasibility and safety of PICC for induction chemotherapy in acute myeloid leukaemia (AML) remain unclear. Medical records of 89 newly diagnosed adult de novo AML patients, who achieved complete remission, were retrospectively reviewed (PICC group, n = 43; intravenous [IV] line group, n = 46). Patients' clinical characteristics and the number of blind punctures for blood sampling were compared between these two groups, and risk factors associated with bacteraemia were identified by univariate analysis...
December 28, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27957644/tip-malposition-of-peripherally-inserted-central-catheters-a-prospective-randomized-controlled-trial-to-compare-bedside-insertion-to-fluoroscopically-guided-placement
#14
Frédéric Glauser, Stephane Breault, Fabio Rigamonti, Charalampos Sotiriadis, Anne-Marie Jouannic, Salah D Qanadli
OBJECTIVE: Peripherally inserted central catheter (PICC) use continues to increase, leading to the development of a blind bedside technique (BST) for placement. The aim of our study was to compare the BST with the fluoroscopically guided technique (FGT), with specific regard to catheter tip position (CTP). MATERIALS AND METHODS: One hundred eighty patients were randomized to either the BST or the FGT. All procedures were done by the same interventional team and included postprocedural chest X-ray to assess CTP...
December 12, 2016: European Radiology
https://www.readbyqxmd.com/read/27889197/complication-related-removal-of-totally-implantable-venous-access-port-systems-does-the-interval-between-placement-and-first-use-and-the-neutropenia-inducing-potential-of-chemotherapy-regimens-influence-their-incidence-a-four-year-prospective-study-of-4045
#15
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...
April 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27775764/economic-evaluation-of-quality-improvement-interventions-for-bloodstream-infections-related-to-central-catheters-a-systematic-review
#16
REVIEW
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
https://www.readbyqxmd.com/read/27818170/association-between-delivery-methods-for-red-blood-cell-transfusion-and-the-risk-of-venous-thromboembolism-a-longitudinal-study
#17
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...
December 2016: Lancet Haematology
https://www.readbyqxmd.com/read/27588946/complications-of-peripherally-inserted-central-venous-catheters-a-retrospective-cohort-study
#18
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
https://www.readbyqxmd.com/read/27552159/mechanic-and-surface-properties-of-central-venous-port-catheters-after-removal-a-comparison-of-polyurethane-and-silicon-rubber-materials
#19
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
https://www.readbyqxmd.com/read/27544827/venous-cutdown-versus-the-seldinger-technique-for-placement-of-totally-implantable-venous-access-ports
#20
REVIEW
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
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