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Central venous catheterization is a basic skill applicable in various medical fields. However, because it may occasionally cause lethal complications, we developed this practical guide that will help a novice operator successfully perform central venous catheterization using ultrasound guidance. The focus of this practical guide is patient safety. It details the fundamental knowledge and techniques that are indispensable for performing ultrasound-guided internal jugular vein catheterization (other choices of indwelling catheters, subclavian, axillary, and femoral venous catheter, or peripherally inserted central venous catheter are also described in alternatives)...
April 2020: Journal of Anesthesia
Jesse C Craig, Ryan M Broxterman, D Taylor La Salle, James Cerbie, Stephen M Ratchford, Jayson R Gifford, Kanokwan Bunsawat, Ashley D Nelson, Amber D Bledsoe, David E Morgan, D Walter Wray, Russell S Richardson, Joel D Trinity
KEY POINTS: •Exercise in patients with hypertension can be accompanied by an abnormal cardiovascular response that includes attenuated blood flow and an augmented pressor response. •Endothelin-1, a very potent vasoconstrictor, is a key modulator of blood flow and pressure during in health and has been implicated as a potential cause of the dysfunction in hypertension. •We assessed the role of endothelin-1, acting through endothelin A (ETA ) receptors, in modulating the central and peripheral cardiovascular responses to exercise in patients with hypertension via local antagonism of these receptors during exercise...
November 9, 2019: Journal of Physiology
Paula Krempser, Cristina Arreguy-Sena, Pedro Miguel Dos Santos Dinis Parreira, Anabela de Sousa Salgueiro-Oliveira
OBJECTIVE: to create, apply and analyze in clinical practice the effectiveness of a bundle to prevent peripheral vascular trauma to approach the peripheral venous puncture process. METHOD: action research with 435 adult participants in an emergency service from 2011 to 2013. Creation of the bundle for prevention of vascular trauma based on scientific evidence, ease of operation, observation and measurement with implantation through an educational intervention of the team of nursing...
2019: Revista Brasileira de Enfermagem
Ricardo Franco-Sadud, Daniel Schnobrich, Benji K Mathews, Carolina Candotti, Saaid Abdel-Ghani, Martin G Perez, Sophia Chu Rodgers, Michael J Mader, Elizabeth K Haro, Ria Dancel, Joel Cho, Loretta Grikis, Brian P Lucas, Nilam J Soni
PREPROCEDURE: 1) We recommend that providers should be familiar with the operation of their specific ultrasound machine prior to initiation of a vascular access procedure.2) We recommend that providers should use a high-frequency linear transducer with a sterile sheath and sterile gel to perform vascular access procedures.3) We recommend that providers should use two-dimensional ultrasound to evaluate for anatomical variations and absence of vascular thrombosis during preprocedural site selection...
September 6, 2019: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Hoon Suk Park, Joonsung Choi, Jun Hyun Baik
Central venous disease (CVD) is difficult to treat and often resistant to treatment. In CVD, hemodialysis vascular access should sometimes be abandoned, or in serious cases, the patient's life may be threatened. Therefore, prevention is ideal. However, as the prevalence of chronic kidney disease (CKD) has increased steadily with population aging, CKD patients with a peripherally inserted central catheter (PICC) are encountered frequently. PICCs can cause CVD, and the basilic vein, which is regarded as the important last option for native arteriovenous fistula (AVF) creation in end-stage renal disease (ESRD) patients, is destroyed frequently after its use as the entry site of PICC...
September 30, 2019: Kidney Research and Clinical Practice
Jun Takeshita, Takayuki Yoshida, Yasufumi Nakajima, Yoshinobu Nakayama, Kei Nishiyama, Yukie Ito, Yoshiyuki Shimizu, Muneyuki Takeuchi, Nobuaki Shime
OBJECTIVES: This study evaluated whether the dynamic needle tip positioning technique increased the success rate of ultrasound-guided peripheral venous catheterization in pediatric patients with a small-diameter vein compared with the static ultrasound-guided technique. DESIGN: Randomized controlled study. SETTING: Single institution, Osaka Women's and Children's Hospital. PATIENTS: The study population included 60 pediatric patients less than 2 years old who required peripheral venous catheterization in the PICU...
September 2019: Pediatric Critical Care Medicine
Jacek Legutko, Paweł Kleczyński, Artur Dziewierz, Lukasz Rzeszutko, Dariusz Dudek
Introduction: Intravenous infusion of adenosine via the femoral vein is commonly used to achieve maximum hyperemia for fractional flow reserve (FFR) assessment in the catheterization laboratory. In the era of transradial access for coronary interventions, obtaining additional venous access with sheath insertion in the groin is unpractical and may be associated with a higher risk of bleeding complications. In a vast majority of cases, patients scheduled for the catheterization laboratory are already equipped with peripheral vein access in antecubital fossa vein...
2019: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Melissa Panter, DaiWai M Olson, Sonja E Stutzman, Venkatesh Aiyagari
BACKGROUND: Venous access, via a midline peripheral catheter (midline) or a peripherally inserted central catheter, is used regularly in the neurointensive care unit as a means for prolonged infusion of drugs or medications. There is little research on how to choose the appropriate access device to use in this setting. The aim of this study is to trial an algorithm to assist clinicians in determining which device to use, as a way to reduce patient complications such as central line-associated bloodstream infection and deep vein thrombosis...
June 2019: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Zi Ge, Zhijie Xia, Ke Ma, Jun Cao, Shanlin Mao, Lilin Gong
OBJECTIVE: To explore the effect of clinical pathway of emergency respiratory and cardiac arrest on management of patients with sudden respiratory and cardiac arrest. METHODS: The clinical data of patients with sudden respiratory and cardiac arrest admitted to Huashan North Hospital Affiliated to Fudan University from 1 year before to 1 year (started in July 2017) after the implementation of clinical pathway of emergency respiratory and cardiac arrest were retrospectively analyzed...
March 2019: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Marcello C Laurenti, Adrian Vella, Ron T Varghese, James C Andrews, Anu Sharma, Nana Esi Kittah, Robert A Rizza, Aleksey Matveyenko, Giuseppe De Nicolao, Claudio Cobelli, Chiara Dalla Man
The characteristics of pulsatile insulin secretion are important determinants of type 2 diabetes pathophysiology, but they are understudied due to the difficulties in measuring pulsatile insulin secretion noninvasively. Deconvolution of either peripheral C-peptide or insulin concentrations offers an appealing alternative to hepatic vein catheterization. However, to do so, there are a series of methodological challenges to overcome. C-peptide has a relatively long half-life and accumulates in the circulation...
May 1, 2019: American Journal of Physiology. Endocrinology and Metabolism
Xiang-Yang Li, Jin-Bao Ye, Long-Guang Zhang, Yi-Zhen Jia, Ru-Ming Zhou, Pearl Pai
BACKGROUND: Central venous catheter (CVC) is commonly used to provide access for hemodialysis (HD) when arteriovenous access is not available. The misplacement of CVC into azygos vein (AV) is a rare but a potential serious complication. Previous reports communicated the opinion that left-sided catheterization predisposed to AV misplacement, but these reports concentrated on peripherally inserted CVCs, placed for indications rather than HD. Unintended AV misplacement of HD catheters (HDCs) has not been well studied...
February 14, 2019: Blood Purification
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)
Aaqib H Malik, Nauman Siddiqui, Wilbert S Aronow
Background: Unstable angina (UA) has been one of the most common presentations of acute coronary syndrome. The numbers of admitted UA patients have been diminishing in the recent past. However, we are seeing higher costs and higher length of inpatient stay. We attempt to identify the trends and characteristics of length of hospitalization in patients admitted with UA using a nationally representative dataset. Methods: We used the nationwide inpatient sample (NIS) from 2002-2014 to assess the factors associated with length of stay in patients admitted with unstable angina using ICD-9-CM primary diagnosis codes (411...
December 2018: Annals of Translational Medicine
Linda Sandström, Angelica Forsberg
The aim of this study was to explore general registered nurses' (RNs) assessments of problems associated with difficult peripheral intravenous catheterization (PIVC) depending on their years of working experience, that is, those who had worked 3 years or less and those who had worked more than 3 years. The design was a quantitative, nonexperimental, descriptive, and analytic survey. The participating RNs (n = 83) were divided into two groups according to the length of their working experience, and the analysis was performed using the SPSS, version 24, software...
December 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Thomas Ritzenthaler, Mickael Beraud, Florent Gobert, Frédéric Dailler
BACKGROUND: An efficient vascular access is mandatory for the proper conduction of therapeutic plasma exchanges (TPE). Peripheral and central venous catheters may be used, with respective advantages and limitations. In this study, vascular access devices (IV catheter, dialysis cannula, central venous catheter) and anatomic vein characteristics were evaluated. METHOD: From January to June 2016, 162 TPE in 29 patients were reviewed. Only TPE using centrifugation method (Spectra Optia apheresis system) were evaluated...
November 8, 2018: Journal of Clinical Apheresis
Thais Queiroz Santolim, André Mathias Baptista, Arlete Mazzini Miranda Giovani, Juan Pablo Zumárraga, Olavo Pires DE Camargo
Objectives: The advantages of using a peripherally inserted central catheter (PICC) in hospitalized patients make this device very important for intravenous therapy. This study describes the use of PICCs at the Institute of Orthopedics and Traumatology at the Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo over the last 10 years. Methods: This retrospective study analyzed 1,057 medical records and included 1,023 medical files with complete information on the punctured vein, diagnosis, duration of catheterization, complications, and catheter tip positioning...
May 2018: Acta Ortopedica Brasileira
Dai Kimura, Jordy Saravia, Sridhar Jaligama, Isabella McNamara, Luan D Vu, Ryan D Sullivan, Salvatore Mancarella, Dahui You, Stephania A Cormier
Pulmonary hypertension (PH) has been observed in up to 75% of infants with moderate to severe respiratory syncytial virus (RSV) bronchiolitis and is associated with significant morbidity and mortality in infants with congenital heart disease. The purpose of the present study was to establish a mouse model of PH secondary to RSV bronchiolitis that mimics the disease etiology as it occurs in infants. Neonatal mice were infected with RSV at 5 days of age and then reinfected 4 wk later. Serum-free medium was administered to age-matched mice as a control...
September 1, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Sevil Inal, Duygu Demir
BACKGROUND: Pediatric nurses should be able to use techniques that increase the success rate or shorten the procedural duration of peripheral intravenous catheterization (PIVC). OBJECTIVES: This study was performed to define the effect of the infrared vein visualization device support on the success of PIVC in pediatric patients aged 0 to 3 years. Success was determined based on the number of attempts per patient, the duration of the procedure, the success rate of first attempts, and the pain levels of the children...
May 15, 2018: Pediatric Emergency Care
Angelica Forsberg, Åsa Engström
The aim of this study is to describe the experiences of critical care nurses (CCNs) when performing successful peripheral intravenous catheterization (PIVC) on adult inpatients in difficult situations. This study uses a descriptive design with a qualitative approach. Semistructured interviews were given to CCNs (n = 22) at a general central county hospital in northern Sweden. The interview text was analyzed with qualitative thematic content analysis. Three themes emerged: "releasing time and creating peace," "feeling self-confidence in the role of expert nurse," and "technical interventions promoting success...
June 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Binbin Xu, Jinghui Zhang, Siyuan Tang, Jianmei Hou, Mengdan Ma
PURPOSE: This study aimed to investigate the effects and complications of different types of peripherally inserted central catheters through femoral vein catheterization in patients with lung cancer undergoing chemotherapy. METHODS: A retrospective analysis of 158 patients with lung cancer undergoing implantation of a venous access through femoral vein catheterization was performed. The patients were divided into two groups by convenience sampling: the single-lumen silicone Groshong peripherally inserted central catheters with valved tip were used in patients in group A, the single-lumen power-injectable polyurethane peripherally inserted central catheters with no valve were used in patients in group B...
April 1, 2018: Journal of Vascular Access
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