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Ultrasound central venous

Alexandre Lafleur, Gabriel Demchuk, Marie-Laurence Tremblay, Caroline Simard, Étienne Rivière
BACKGROUND: In self-regulated procedural simulation, learners practise on many simulators (e.g. paracentesis), self-regulating their choice of simulators, time and goals. Current needs assessments cannot predict the number of simulators needed to plan cost-effective self-regulated simulation. Knowing the ratios of simulators and participants would allow for better-informed purchase decisions to be made. METHODS: We designed 90-minute sessions of self-regulated procedural simulation for internal medicine residents...
February 13, 2019: Clinical Teacher
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari, Annu Chowdhary, Madhu Kant
Central venous cannulation (CVC) is a commonly performed technique in the perioperative period. Various modifications of the classical internal jugular vein (IJV)/ subclavian vein (SCV) approach have been described which prove handy in situations of difficult cannulation. Lately ultrasound guided brachiocephalic vein (BCV) cannulation has been described wherein the probe is kept transversely on the medial aspect of supraclavicular fossa to visualize the BCV. This article is protected by copyright. All rights reserved...
February 13, 2019: Paediatric Anaesthesia
Shingo Mitsuda, Joho Tokumine, Rena Matsuda, Tomoko Yorozu, Takayuki Asao
RATIONALE: A peripherally inserted central catheter (PICC) is typically inserted with the patient in the supine position. Here, we placed a PICC in a patient in the sitting position, in order to treat congestive heart failure. PATIENT CONCERNS: A 65-year-old man was diagnosed with end-stage lung cancer. He had experienced septic shock and was medicated with continuous infusion of noradrenaline through a peripheral vein, in order to maintain sufficient blood pressure...
February 2019: Medicine (Baltimore)
D S Giraldo Gutiérrez, J Bautista Sánchez, R D Reyes Patiño
The insertion of a central venous catheter is a procedure frequently performed in paediatric anaesthesia. The most frequent approach for this procedure is the internal jugular vein. However, some specific factors in children, such as the short neck and the easy collapse of this vein, which is accentuated in situations such as hypovolaemia and changes in the respiratory pattern, can lead to greater difficulty. The supraclavicular approach of the subclavian vein was described more than 50 years ago. However, it is not often considered nowadays, even after the introduction of ultrasound, and despite the obvious advantages with respect to the internal jugular approach due to the lower incidence of thrombosis and infection...
February 1, 2019: Revista Española de Anestesiología y Reanimación
Fabrizio Brescia, Daniele G Biasucci, Fabio Fabiani, Michela Favarato, Fabio Costa, Ferdinando Longo, Matteo Martuscelli, Michelangelo Vitiello, Mauro Pittiruti
INTRODUCTION: Ultrasound-guided cannulation of the axillary vein in the infraclavicular area has several potential advantages for both short-term and long-term venous access devices. Currently, there are two techniques to approach axillary vein for ultrasound-guided cannulation: out-of-plane puncture in the short-axis view and the in-plane puncture in the long-axis view. We propose a novel ultrasound-guided puncture technique of axillary vein for centrally inserted central catheter placement, which consists in the oblique-axis view of the axillary vein coupled with the in-plane puncture...
January 31, 2019: Journal of Vascular Access
Osamah Al-Asadi, Manar Almusarhed, Hany Eldeeb
Aims: Peripherally inserted central catheters(PICC) lines are becoming increasingly popular in solid cancer patients for the administration of chemotherapy. This study aims looking at the incidence of PICC line related and distant thromboembolism associated with these catheters and exploring risk factors. Methods: Records were reviewed for 158 patients who underwent PICC line insertion over the two years period in the medical oncology unit, Milton Keynes University Hospital...
2019: Thrombosis Journal
Xingwei Sun, Xuming Bai, Long Cheng, Xingshi Gu, Rui Xia, Xiaolong Du, Jianming Shi, Qian Chen, Yong Jin
OBJECTIVES: To compare ultrasound-guided right brachiocephalic vein (BCV) central venous catheter (CVC) placement to right subclavian vein (SCV) CVC insertion in terms of the puncture success rate and complications. METHODS: A retrospective review was performed for all adult patients who received an ultrasound-guided CVC via the right BCV or right SCV access route between January 2016 and March 2018. The puncture success rates and procedure-related complications were analyzed...
January 28, 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
R Eljaiek, Y A Cavayas, E Rodrigue, G Desjardins, Y Lamarche, F Toupin, A Y Denault, W Beaubien-Souligny
BACKGROUND: Right ventricular failure after cardiac surgery is associated with morbidity and mortality. Right ventricular dysfunction results in hepatic venous congestion, which impacts the portal circulation. We aimed to determine whether an increased portal flow pulsatility fraction was associated with right ventricular dysfunction in cardiac surgery patients. We also aimed to describe the haemodynamic factors and postoperative complications associated with an increased portal pulsatility in this setting...
February 2019: British Journal of Anaesthesia
Chang-Chih Shih, Sy-Jou Chen, Yuan-Pin Hsu
A peripherally inserted central venous catheter (PICC) has been widely applied to central venous assess. There were some known complications such as phlebitis, leakage, blockage, dislodgment, breakage, or malposition of PICC. Catheter migration was assessed by using chest radiograph or administering contrast medium. Herein, we report a 77-year-old woman presenting to emergency department with odynophagia and left neck swelling of 3 days duration. The initial impression was deep neck infection. Focused ultrasound identified a hyperechoic tube with thrombosis in left jugular vein, which indicated migration of PICC...
October 2018: Journal of Medical Ultrasound
Maged Labib Boules
Background: Vascular access is a top priority in the critically ill patients. Cannulation - venous and/or arterial - is the first step in any emergency situation. Ultrasound (US)-guided vascular cannulation was found to have a higher success rate and a decreased incidence of mechanical complications as compared with the landmark one. Aim: This study aims to compare subclavian vein (SCV) access through supraclavicular (SC) approach by endocavitary (EC) probe technique versus linear array high-frequency probe technique...
October 2018: Anesthesia, Essays and Researches
Harm J Scholten, Esther Ten Bloemendal, Bente Botter, Hendrikus H M Korsten, R Arthur Bouwman
Accumulating evidence shows that ultrasound (US) guidance improves effectiveness and safety of central venous catheter (CVC) placement. Several international guidelines therefore recommend the use of US for placement of CVCs. However, surveys show that the landmark-based technique is still widely used, while the percentage of physicians using US is increasing less than expected. The goal of this study was to investigate current practice for central venous catheterization in anaesthesiology and intensive care in the Netherlands, identify barriers for further implementation of US guidance and to evaluate whether personality traits are associated with the choice of technique...
January 19, 2019: Journal of Clinical Monitoring and Computing
Taisuke Yokota, Joho Tokumine, Alan Kawarai Lefor, Ayako Hasegawa, Tomoko Yorozu, Takayuki Asao
RATIONALE: Obtaining venous access in a patient with extensive postburn scar contractures is a challenge. PATIENT CONCERNS: A 39-year-old woman suffered a burn 2 years previously with a total body surface area burn of 93%, and a burn index of 85. Reconstructive surgery was previously performed 39 times. Split-thickness skin grafting to the neck was planned. She had no accessible peripheral veins. DIAGNOSIS: Difficult venous access due to excessive burn scar contractures...
January 2019: Medicine (Baltimore)
Fernanda Costa Sampaio Silva
Central venous catheter implantation for hemodialysis is commonly performed in large centers and its complications are sometimes associated with insufficient training of those who perform it, but may also be related to the patient's clinical condition. The present study reports two cases of complications related to use of a short-stay catheter for hemodialysis. In the first case, the cannula was inadvertently inserted into the left subclavian artery, causing arterial thrombosis, which was conservatively managed and good collateral perfusion was documented with vascular echography...
July 2018: Jornal Vascular Brasileiro
Brian C Tashjian, Michael E Schoor, Masilo Grant
We present a central venous catheter misplacement case. A left internal jugular vein percutaneous introducer was inserted for fluid resuscitation with a single-lumen infusion catheter placed through the lumen for medication infusions. Placement was performed under ultrasound guidance, with confirmation of the wire within the venous lumen. Radiographs suggested that the introducer had perforated the innominate vein. Contrast was injected through the single-lumen infusion catheter and showed cannulation of the left internal mammary vein...
January 4, 2019: A&A practice
Hiroki Chiba, Yoshihiro Seo, Seika Sai, Mikiko Namekawa, Tomoko Ishizu, Kazutaka Aonuma
The vasopressin type 2 receptor antagonist tolvaptan may have renoprotective effects in patients with heart failure (HF). This study aimed to reveal the renoprotective effect of tolvaptan from the viewpoint of hemodynamic combined with catheter and ultrasound examinations in a hypertensive HF model. Dahl salt-sensitive rats (n = 24) were fed an 8% high-salt diet after the age of 6 weeks and were treated with tolvaptan (n = 16) or vehicle (control group; n = 8). The tolvaptan-treated rats were divided into two groups: a low-dose group (0...
December 17, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Rui Xia, Xingwei Sun, Xuming Bai, Yubin Zhou, Jianming Shi, Yong Jin, Qian Chen
Central venous catheter (CVC) insertion is difficult to perform and is a high-risk operation; ultrasound (US)-guided cannulation helps increase the odds of success while reducing the associated complications. The internal jugular vein (IJV) and subclavian vein (SCV) are the most commonly sites in US-guided CVC insertion. In the present study, we evaluated the safety and efficacy of US-guided supraclavicular right brachiocephalic vein (BCV) cannulations in adult patients.Between January 2016 and December 2017, 428 adult patients requiring 536 CVC insertions underwent ultrasound-guided right BCV cannulation...
December 2018: Medicine (Baltimore)
Hugo J R Bonatti
Background: Misplacement of central venous catheters (CVC) may have devastating consequences. Patients and methods: Placement of a CVC into the pulmonary artery (PA) and management of the complication is described. Literature search for accidental direct placement of CVCs into the PA was performed. Results: A 46 year old morbidly obese female required an infusaport for chemotherapy. She was anaesthetized and placed in Trendelenburg. Three attempts to access the left subclavian vein (LSCV) using landmarks failed...
2019: Respiratory Medicine Case Reports
M Cajozzo, V D Palumbo, V Mannino, G Geraci, A I Lo Monte, F P Caronia, F Fatica, G Romano, V Puzhlyakov, R D'Anna, G Cocchiara
OBJECTIVES: Port-a-cath catheterization is often required for those patients who need long-term therapies (malnutrition, neoplasm, renal failure, other severe diseases). The use of ports for a wide range of indications is not exempt from complications. Ultrasound-guided central venous catheterization (CVC) is a safe and fast technique for the introduction of the catheter inside a central vein. This retrospective study reports our experience with US-guided CVC in patient eligible for port-a-cath implantation...
November 2018: La Clinica Terapeutica
Janina Hahn, Melanie Nordmann-Kleiner, Thomas K Hoffmann, Jens Greve
OBJECTIVE: Less than 5% of deep vein thrombosis is due to thrombosis of the internal jugular vein. Genetic, malignant or inflammatory underlying diseases as well as insertion of venous catheters can be responsible for this pathology. Due to its rare occurrence, it is difficult to find systematic research about thrombosis of the internal jugular vein. METHODS: We performed a systematic analysis of present patient data from our ENT department with the electronic patient record considering the period from 2012-2017...
December 10, 2018: Auris, Nasus, Larynx
Zain A AlRstum, Tam T Huynh, Steven Y Huang, George T Pisimisis
INTRODUCTION: We sought to assess the incidence and risk factors of bleeding after ultrasound-guided internal jugular (USGIJ) catheter insertion in severely thrombocytopenic cancer patients, as safe platelet (PLT) count threshold remains controversial. METHODS: Retrospective study of 52 patients with hematologic malignancies and severe thrombocytopenia who underwent USGIJ catheter insertion between 2014 and 2016. Group A included patients with prophylactic PLT transfusion and Group B without...
January 2019: American Journal of Surgery
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