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Ultrasound guided vascular access

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March 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Paru Patrawalla, Mangala Narasimhan, Lewis Eisen, Ariel L Shiloh, Seth Koenig, Paul Mayo
OBJECTIVE: Training in critical care ultrasonography is an essential tool in critical care medicine and recommended for fellowship programs in pulmonary and critical care medicine. Major barriers to implementing competency-based training in individual fellowship programs include a lack of expert faculty, time, and funding. Our objective was to investigate whether regional collaboration to deliver an introductory critical care ultrasonography course for fellows might overcome these barriers while achieving international training standards...
February 12, 2019: Journal of Intensive Care Medicine
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
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)
Daihiko Eguchi, Kenichi Honma
Objectives : We aim to assess the effect and significance of ultrasound-guided axillary nerve block on the diameter of basilic vein in vascular access surgery. Methods : 78 consecutive patients who underwent vascular access surgery with ultrasound-guided axillary nerve block were studied retrospectively. Diameter of basilic vein at the elbow level before and after the nerve block were measured and the dilatation rate was also calculated to assess the effect of nerve block on venous diameter. Results : Basilic vein diameter increased from 3...
December 25, 2018: Annals of Vascular Diseases
Ahmed Amro, Kanaan Mansoor, Mohammad Amro, Amal Sobeih, Rameez Sayyed
We report a case of cardiac catheterization that was done entirely by accidentally accessing the inferior epigastric artery (IEA) through an unintentional puncture of the U-shaped portion of the inferior epigastric artery. Luckily the patient did not have any trauma to the IEA and was d/c home with no complications. A 48-year-old female with history of hypertension and CAD S/P left circumflex stent many years ago who presented to our facility with persistent crescendo angina for which decision was made to proceed with LHC...
2018: Case Reports in Cardiology
Bradley C Clark, Christopher M Janson, Lynn Nappo, Robert H Pass
BACKGROUND: Axillary venous access with ultrasound guidance for pediatric transvenous lead implantation may reduce risks for pneumothorax and hemothorax. The objective was to retrospectively evaluate ultrasound-guided axillary vein access as an alternative to the subclavian approach. METHODS: The technique consists of ultrasonographic identification of the axillary vein at the deltopectoral groove after initial contrast venography. A micropuncture kit is used for initial ultrasound-guided percutaneous access with fluoroscopic confirmation of wire position...
December 4, 2018: Pacing and Clinical Electrophysiology: PACE
Monica L Schoch, Judy Currey, Liliana Orellana, Paul N Bennett, Vicki Smith, Alison M Hutchinson
Background: Point-of-care ultrasound (POCUS) has been used in various vascular access contexts; however, to date, it has not been widely adopted in haemodialysis clinics. People with end-stage kidney disease receiving haemodialysis require an arteriovenous fistula (AVF), arteriovenous graft (AVG), or central venous access device (CVAD) in order to access their blood for therapy/treatment. Cannulation issues, such as haematoma and extravasation, related to AVFs and AVGs are common. This pilot and feasibility study will assess the feasibility of a randomised controlled trial aimed at evaluating whether POCUS-guided cannulation results in more successful and accurate AVF needle placement than the standard practice of blind cannulation...
2018: Pilot and Feasibility Studies
Joseph R Pare, Samara E Pollock, James H Liu, Megan M Leo, Kerrie P Nelson
OBJECTIVES: Ultrasound guided peripheral intravenous catheters (USPIV) are frequently utilized in the Emergency Department (ED) and lead to reduced central venous catheter (CVC) placements. USPIVs, however, are reported to have high failure rates. Our primary objective was to determine the proportion of patients that required CVC after USPIV. Our secondary objective was to determine if classic risk factors for difficult vascular access were predictive of future CVC placement. METHODS: We performed a retrospective review for patients treated at a large academic hospital...
February 2019: American Journal of Emergency Medicine
Ziming Wan, Qiquan Lai, Bo Tu
BACKGROUND: Kidney allograft loss becomes an important cause of end-stage kidney disease and requires dialysis reinitiation. We report a case of a patient who restarted hemodialysis after his second kidney graft failure using a long-discarded autologous arteriovenous fistula. CASE PRESENTATION: A 62-year-old man was diagnosed with end-stage renal disease 20 year ago, and a native arteriovenous fistula was created for hemodialysis. After the patient received his first kidney transplantation, the hemodialysis fistula was discarded and chronically thrombosed for 13 years...
October 26, 2018: BMC Nephrology
Mahmut Tuna Katırcıbaşı, Hakan Güneş, Ahmet Çağrı Aykan, Ekrem Aksu, Sami Özgül
Background: Many techniques, methods and closure devices have been developed in order to reduce vascular complications that occur after coronary and peripheral interventions. The aim of the present study was to identify which method i.e. ultrasound (US) guidance or traditional access technique, is better for common femoral artery cannulation. Methods: The study included 939 patients, who were assigned to either the US-guided cannulation group (n = 449) or manual technique group (n = 490)...
September 2018: Acta Cardiologica Sinica
Michael Wagner, Kirstin Hauser, Francesco Cardona, Georg M Schmölzer, Angelika Berger, Monika Olischar, Tobias Werther
OBJECTIVES: Critically ill neonatal and pediatric patients often require central vascular access. Real-time ultrasound guidance for central venous catheterization is beneficial. Because the diameter of central veins is much smaller in neonates than in adults, extensive training is needed to master the visualization and catheterization of central veins in neonates. This study assessed the learning effect of a standardized simulation-based teaching program on ultrasound-guided cannulation in a low-cost cadaver tissue model...
September 18, 2018: Pediatric Critical Care Medicine
Selvakumar Palaniappan, Venkatesh Subbiah, V Raja Gopalan, Poornima Vijaya Kumar, R John Santa Vinothan
Background and Aims: Arteriovenous (AV) fistula surgery is commonly performed for AV access for hemodialysis. However the ideal anaesthetic technique of choice remains debated. We aimed to assess operative conditions, vascular patency, and complication rate following AV fistula surgery with isolated brachial plexus block among end-stage renal disease (ESRD) patients. Methods: This prospective, observational study included 214 patients undergoing AV fistula surgery under isolated supraclavicular brachial plexus block between January and December 2017...
August 2018: Indian Journal of Anaesthesia
Zaghloul Elsafy Gouda, Mahmoud Mohamed Emara, Hany Said Elbarbary, Mahmoud Abdel Aziz Koura, Ahmed Rabie Elarbagy
INTRODUCTION: Internal jugular vein occlusion often makes necessary the use of less desirable routes as external jugular, subclavian, and femoral vein approaches in addition to inferior vena cava approaches. This a prospective cross-sectional follow-up study of the alternative approaches for placement of cuffed hemodialysis catheters in end-stage renal disease patients with bilateral internal jugular vein occlusion from the interventional nephrology point of view. METHOD: The study was conducted on 134 end-stage renal disease patients who were referred for insertion of a challenging hemodialysis catheter due to bilateral internal jugular vein occlusion...
August 24, 2018: Journal of Vascular Access
Danielle M Hundley, Aimee C Brooks, Elizabeth J Thomovsky, Paula A Johnson, Lynetta J Freeman, Ryan M Schafbuch, Hock Gan Heng, George E Moore
OBJECTIVE To compare time to achieve vascular access (TTVA) between an ultrasound-guided technique (UST) and landmark-based technique (LMT) for central venous catheter (CVC) placement in healthy anesthetized dogs. ANIMALS 39 purpose-bred hounds. PROCEDURES Anesthetized dogs that were hemodynamically stable following completion of a terminal surgical exercise were enrolled in the study during 2 phases, with a 45-day intermission between phases. For each dog, a UST and LMT were used for CVC placement via each external jugular vein by 2 operators (criticalist and resident)...
June 2018: American Journal of Veterinary Research
Julien Le Coz, Silvia Orlandini, Luigi Titomanlio, Victoria Elisa Rinaldi
IMPORTANCE: Point-of-care ultrasonography (POCUS) allows to obtain real-time images to correlate with the patient's presenting signs and symptoms. It can be used by various specialties and may be broadly divided into diagnostic and procedural applications. OBJECTIVE: We aimed at reviewing current knowledge on the use of POCUS in Pediatric Emergency Departments (PEDs). FINDINGS: US diagnostic capacity in paediatric patients with suspected pneumonia has been studied and debated whereas literature regarding the usefulness of point-of-care echocardiography in the pediatric setting is still limited...
July 27, 2018: Italian Journal of Pediatrics
Amit Bahl, Bophal Hang, Abigail Brackney, Steven Joseph, Patrick Karabon, Ammanee Mohammad, Ijeoma Nnanabu, Paul Shotkin
INTRODUCTION: Establishing peripheral intravenous (IV) access is a vital step in providing emergency care. Ten to 30% of Emergency Department (ED) patients have difficult vascular access (DVA). Even after cannulation, early failure of US-guided IV catheters is a common complication. The primary goal of this study was to compare survival of a standard long IV catheter to a longer extended dwell catheter. METHODS: This study was a prospective, randomized comparative evaluation of catheter longevity...
July 19, 2018: American Journal of Emergency Medicine
Yanji Lv, Haitao Liu, Pulin Yu, Guiyue Wang, Miao Liu, Yuhang Li, Hongliang Wang, Kaijiang Yu, Changsong Wang
BACKGROUND: Our goal was to conduct a network meta-analysis of randomized controlled trials to compare the effects of the long-axis (LAX), short-axis (SAX), and oblique-axis (OAX) ultrasound guidance approaches for vascular access cannulation. METHODS: We searched 5 databases, including the Cochrane Central Register of Controlled Trials in the Cochrane Library, Embase, MEDLINE, CINAHL, and Web of Science. Seven randomized clinical trials assessing ultrasound guidance for vascular access cannulation via the LAX, SAX, or OAX approach were included...
July 19, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Mary E Mollie Meek, James C Meek, Blake Hollowoa, Ruizong Li, Linda A Deloney, Kevin D Phelan
RATIONALE AND OBJECTIVES: Competency in ultrasound (US) imaging and US-guided procedures is often difficult for medical students and residents to master. The use of simulation training has been strongly encouraged but the quality of phantom models available for US-guided procedures is limited. As a feasible alternative, we describe the innovative use of a lightly embalmed cadaver for realistic practice of common interventional radiology (IR) procedures prior to direct patient care. MATERIALS AND METHODS: Lightly embalmed cadavers were positioned as patients would be in the IR suite: supine, prone, and erect seated position...
July 14, 2018: Academic Radiology
Erwin Ströker, Carlo de Asmundis, Kaspars Kupics, Ken Takarada, Giacomo Mugnai, Jeroen De Cocker, Dirk Stockman, Juan Sieira, Bruno Schwagten, Pedro Brugada, Yves De Greef, Gian Battista Chierchia
Aims: Vascular complications are the most common complications of atrial fibrillation (AF) ablation. Cryoballoon (CB) ablation for AF needs the insertion of a large 15 Fr sheath in the femoral vein. Our aim was to investigate the impact of vascular ultrasound (US) in guiding access and evaluating post-procedural subclinical complications in a large, multi-centre patient cohort that underwent CB ablation. Methods and results: A total cohort of 1435 consecutive patients were subdivided in 870 US -/-, 265 US -/+, and 300 US +/+ patients depending on US performance for: venipuncture guidance/post-procedural evaluation...
July 11, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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