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"Intravenous Cannula" OR "Intravenous Cannulation" OR "Intravenous Access" OR "Vascular Access"

Julio Lairet, Vikhyat S Bebarta, Joseph K Maddry, Lauren Reeves, Alejandra Mora, Lorne Blackbourne, Todd Rasmussen
OBJECTIVE: Care provided to a casualty in the prehospital combat setting can influence subsequent medical interactions and impact patient outcomes; therefore, we aimed to describe the incidence of specific prehospital interventions (lifesaving interventions (LSIs)) performed during the resuscitation and transport of combat casualties. METHODS: We performed a prospective observational, IRB approved study between November 2009 and March 2014. Casualties were enrolled as they were cared for at nine U...
March 1, 2019: Military Medicine
Peter J Carr, James C R Rippey, Marie L Cooke, Niall S Higgins, Michelle L Trevenen, Aileen Foale, Gerben Keijzers, Claire M Rickard
BACKGROUND: It is well established that the idle peripheral intravenous catheter (PIVC) provides no therapeutic value and is a clinical, economic and above all, patient concern. This study aimed to develop a decision aid to assist with clinical decision making to promote clinically indicated peripheral intravenous catheter (CIPIVC) insertion in the emergency department (ED) setting. Providing evidence for a uniform process could assist clinicians in a decision-making process for PIVC insertion...
2019: PloS One
Nail Kahraman, Deniz Demir
BACKGROUND: Complications such as stenosis, thrombosis, aneurysmal dilatation, and infection occur in at least one-third of all arteriovenous fistulas (AVFs). Due to these complications, vascular access dysfunction develops in hemodialysis patients. OBJECTIVES: We investigated AVF rescue operations, which we performed for the pathologies causing dysfunctional vascular access, and outcomes of these operations by surgeon-performed preoperative ultrasound (US) in our clinic...
2019: American Journal of Translational Research
Leonard L L Yeo, Pervinder Bhogal, Anil Gopinathan, Yang Cunli, Benjamin Tan, Tommy Andersson
Thrombectomy is a technique that has completely changed the management of acute stroke and current devices have shown that they can achieve upwards of 90% successful recanalization in selected cohorts. However, despite the effectiveness of these devices, there are a proportion of patients who still fail to achieve reperfusion of the affected vascular territory and an even larger portion of patients who have poor functional outcomes in spite of successful recanalization. There are no guidelines on how to treat these patients when such failures occur...
March 20, 2019: Clinical Neuroradiology
Giordano Fumagalli, Fabio Trovato, Massimiliano Migliori, Vincenzo Panichi, Stefano De Pietro
OBJECTIVE: The arteriovenous fistula (AVF) is recommended as the preferred hemodialysis access. However, placing an AVF in all patients may result in poor access outcomes and increased central venous catheter (CVC) use because of increased comorbid conditions, age, and suboptimal vessels. In patients with inadequate superficial veins for AVFs, the use of the brachial veins for creation of forearm arteriovenous grafts (AVGs) has received limited attention. This retrospective study aimed to evaluate outcomes of forearm brachial-brachial AVGs (BB-AVGs) placed in patients with poor superficial veins...
March 17, 2019: Journal of Vascular Surgery
Steven G Schauer, Patrick C Ng, Michael D April, Guyon J Hill, Allyson A Arana, Vikhyat S Bebarta
BACKGROUND: Vascular access in critically ill pediatric patients can be challenging with delays potentially leading to worse outcomes. Intraosseous (IO) access has a low rate of complications and can be utilized to administer lifesaving medications. Combat medics are trained to treat adults but may also be required to treat children in the deployed setting. Vascular access in children can be challenging, especially in a hypovolemic state. There are limited data on prehospital lifesaving interventions in children in the combat setting...
March 19, 2019: Pediatric Emergency Care
Wesley H Chou, Tanya N Rinderknecht, Paul K Mohabir, Andrew W Phillips
Rapid infusion catheters (RICs) allow expedient conversion of peripheral intravenous (PIV) catheters to peripheral sheaths; however, little is known about potential complications. In this case, a 64-year-old male polytrauma patient had a 20-gauge PIV catheter in the right cephalic vein upsized to an 8.5 French (Fr) RIC without incident during an arrest with pulseless electrical activity (PEA). On RIC post-placement day two, the patient developed edema and ecchymosis extending from the right dorsal mid-hand to the antecubital fossa, just distal to the RIC insertion point...
January 8, 2019: Curēus
Matteo Tozzi, Maurizio Gallieni
No abstract text is available yet for this article.
March 19, 2019: Journal of Nephrology
Vineet Chopra, Scott Kaatz, Lakshmi Swaminathan, Tanya Boldenow, Ashley Snyder, Rachel Burris, Steve J Bernstein, Scott Flanders
BACKGROUND: While midline vascular catheters are gaining popularity in clinical practice, patterns of use and outcomes related to these devices are not well known. METHODS: Trained abstractors collected data from medical records of hospitalised patients who received midline catheters in 12 hospitals. Device characteristics, patterns of use and outcomes were assessed at device removal or at 30 days. Rates of major (upper-extremity deep vein thrombosis [DVT], bloodstream infection [BSI] and catheter occlusion) and minor complications were assessed...
March 18, 2019: BMJ Quality & Safety
Marc Bosiers, Koen Deloose, Joren Callaert
The selection of an optimal vascular access strategy for lower limb endovascular intervention is key for procedural safety and success, and is particularly relevant in diabetic patients, in whom extensive occlusive disease commonly involves the infrapopliteal arteries. Individualizing vascular access requires careful planning, including determining normal and abnormal arterial anatomy; the patient's co-medical conditions, especially renal insufficiency; and review of noninvasive vascular laboratory testing...
June 2018: Seminars in Vascular Surgery
Lalathaksha Kumbar, Jerry Yee
Infection-related causes are second only to cardiovascular events for mortality among end-stage renal disease patients. This review will provide an overview of hemodialysis catheter-, graft-, and fistula-related infections with emphasis on diagnosis and management in specific settings. Use of catheters at the initiation of dialysis has remained unchanged at 80%. Of all access-related bloodstream infections (BSIs), 70% occur in patients with catheters. The risk factors for BSIs in tunneled, cuffed catheters include the duration of the catheter, past catheter-related bacteremia, left-sided internal jugular vein catheters, hypoalbuminemia, and immunosuppression...
January 2019: Advances in Chronic Kidney Disease
Adam Suleman, Virginia Jarvis, Adnan Hadziomerovic, Marc Carrier, Sheryl McDiarmid
BACKGROUND: Implanted vascular access devices (IVADs) have significantly improved the management of cancer patients. These patients are at an increased risk of venous thromboembolism and IVADs are a known risk factor. We sought to assess the incidence of IVAD-related upper extremity deep vein thrombosis (IVAD-related UEDVT) associated with BioFlo® IVADs (Angiodynamics, Inc.). METHODS: A total of 394 cancer patients were enrolled over 12 months. The primary outcome was the incidence of IVAD-related UEDVT confirmed by diagnostic imaging...
March 6, 2019: Thrombosis Research
William C Pederson, Luke Grome
Reconstruction of bony and soft tissue defects of the lower extremity has been revolutionized by the advent of microsurgical tissue transfer. There are numerous options for reconstruction. Possibilities include transfer of soft tissue, composite (bone and soft tissue) tissue, and functional muscle. Many lower extremity reconstructions require staged procedures. Planning is of paramount importance especially in regard to vascular access when multiple free flaps are required. Soft tissue reconstruction of the lower extremity may be accomplished with muscle flaps such as the rectus femoris and latissimus dorsi covered with a skin graft...
February 2019: Seminars in Plastic Surgery
Christopher George Ghazala, Benjamin Alexander Marrow, Dermot Kearney, John William Kenneth Harrison
Coronary angiography and percutaneous coronary intervention (PCI) are frequently performed procedures in the UK and the developed world, with the radial artery becoming the preferred route of access. A chronically retained macroscopic fragment of radial artery introducer sheath is a very rare complication that has not, to our knowledge, been reported. We report the case of a 62-year-old woman who underwent PCI and developed a persisting infected sinus and abscess at the cannulation site despite multiple courses of antibiotics...
March 12, 2019: BMJ Case Reports
Thomas J Sorenson, Patrick J Nicholson, Christopher A Hilditch, Mohammad H Murad, Waleed Brinjikji
PURPOSE: The transfemoral approach is widely utilized by neurointerventionalists for accessing the femoral artery in patients undergoing diagnostic and therapeutic endovascular procedures. In patients with more difficult anatomy, duplex ultrasound (DUS) may be a valuable adjunct for femoral vascular access. We aimed to assess the evidence for the effectiveness of DUS-guided femoral access within interventional neuroradiology. METHODS: We searched MEDLINE; Scopus and EMBASE and included five randomized controlled trials...
March 9, 2019: World Neurosurgery
Rukshana Shroff, Francis Calder, Sevcan Bakkaloğlu, Evi V Nagler, Sam Stuart, Lynsey Stronach, Claus P Schmitt, Karl H Heckert, Pierre Bourquelot, Ann-Marie Wagner, Fabio Paglialonga, Sandip Mitra, Constantinos J Stefanidis
BACKGROUND: There are three principle forms of vascular access available for the treatment of children with end stage kidney disease (ESKD) by haemodialysis: tunnelled catheters placed in a central vein (central venous lines, CVLs), arteriovenous fistulas (AVF), and arteriovenous grafts (AVG) using prosthetic or biological material. Compared with the adult literature, there are few studies in children to provide evidence based guidelines for optimal vascular access type or its management and outcomes in children with ESKD...
March 11, 2019: Nephrology, Dialysis, Transplantation
Piotr Mazur, Sylweriusz Kosiński, Paweł Podsiadło, Anna Jarosz, Roman Przybylski, Radosław Litiwnowicz, Jacek Piątek, Janusz Konstanty-Kalandyk, Robert Gałązkowski, Tomasz Darocha
The incidence of accidental hypothermia (core temperature ≤35 °C) is difficult to estimate, as the affected population is heterogeneous. Both temperature and clinical presentation should be considered while determining severity, which is difficult in a prehospital setting. Extracorporeal rewarming is advocated for all Swiss Staging System class IV (hypothermic cardiac arrest) and class III (hypothermic cardiac instability) patients. Veno-arterial extracorporeal membrane oxygenation (ECMO) is the method of choice, as it not only allows a gradual, controlled increase of core body temperature, but also provides respiratory and hemodynamic support during the unstable period of rewarming and reperfusion...
January 2019: Annals of Cardiothoracic Surgery
Néstor Fontseré, Gaspar Mestres, Xavier Yugueros, Mario Jiménez, Marta Burrel, Fernando Gómez, Raquel Ojeda, Lida María Rodas, Valentín Lozano, Vicens Riambau, Francisco Maduell
BACKGROUND: The basilic vein is a deep vein which usually requires superficialisation and surgical transposition. MATERIAL AND METHODS: This is a retrospective study of 119 BBAVF-ST in patients with stage 5D chronic kidney disease who received an implant with a one-stage surgical technique (2011-2015). The percentage of primary (PP), assisted primary (APP) and secondary (SP) permeabilities were assessed, as well as the related complications. We analysed the permeabilities using Kaplan-Meier survival curves and a univariate Log Rank analysis (Mantel-Cox)...
March 7, 2019: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Toshiharu Fujii, Yuji Ikari, Hideki Hashimoto, Kazushige Kadota, Tetsuya Amano, Shiro Uemura, Hiroaki Takashima, Masato Nakamura
This study evaluated whether radial access intervention had a lower risk of post-treatment adverse events in acute coronary syndrome (ACS) even in Japan where the use of a strong antithrombotic regimen was not approved. We retrospectively analyzed a large nation-wide registry in Japan to compare the incidence of post-treatment adverse events according to the types of vessel access (trans-radial; TRI vs. trans-femoral; TFI) among ACS cases (n = 76,835; 43,288 TRI group and 33,547 TFI group). Primary outcome was a composite of in-hospital death, myocardial infarction associated with percutaneous coronary intervention, bleeding complication requiring transfusion, and stent thrombosis during in-hospital stay...
March 7, 2019: Cardiovascular Intervention and Therapeutics
Andrew M Goldsweig, Kevin F Kennedy, J Dawn Abbott, W Schuyler Jones, Poonam Velagapudi, Frank J Rutar, Jeptha C Curtis, Thomas T Tsai, Herbert D Aronow
OBJECTIVES: The aims of this study were to determine the incidence of actionably high radiation dosages and to identify predictors of increased patient dosage. BACKGROUND: Peripheral endovascular intervention using fluoroscopic imaging has become a mainstay of treatment for lower extremity peripheral artery disease but exposes patients to ionizing radiation. METHODS: Patient radiation dosage, quantified as dose-area product (DAP), was obtained from the National Cardiovascular Data Registry Peripheral Vascular Intervention Registry...
March 11, 2019: JACC. Cardiovascular Interventions
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