Vascular Access

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19 papers 0 to 25 followers
Pablo Blanco
BACKGROUND: Up to one-third of critically ill patients have difficult intravenous access (DIVA). This occurs often in obese patients, those with generalized edemas or in patients with previous venous cannulations. In DIVA patients, the conventional technique often fails. In contrast, ultrasound-guided cannulation has demonstrated a high success rate, improving patient satisfaction and even a reduction in the need of central venous lines. However, a high rate of premature catheter failure has been shown in cannulations performed by ultrasound guidance and thus a comprehensive knowledge of several aspects related to this procedure is mandatory to improve cannulation success, avoid complications and lengthen the survival of the catheter...
October 17, 2019: The ultrasound journal
Arun Rath, Shakti Bedanta Mishra, Bhabani Pati, Sanjib Kumar Dhar, Snigdha Ipsita, Samir Samal, Afzal Azim
OBJECTIVES: Ultrasound-guided internal jugular vein cannulation is a standard procedure performed in ICUs worldwide. According to the guidelines, the short-axis approach is recommended over the long-axis approach for IJV cannulation. Double-operator cannulation is more convenient for the said procedure. However, the guidelines favor single-operator cannulation due to limited trials. We hypothesized that double-operator long-axis cannulation will be faster and have fewer complications than double-operator short-axis cannulation...
June 14, 2019: American Journal of Emergency Medicine
Srikar Adhikari, Michael Blaivas, Daniel Morrison, Lina Lander
OBJECTIVE: The purpose of this study was to compare infection rates of peripheral intravenous (IV) lines placed under ultrasound guidance with traditionally placed IV lines. METHODS: We conducted a retrospective review of emergency department (ED) and hospital records of adult patients who had a peripheral IV line placed in the ED and were admitted to the hospital over a 1-year period. This study took place at a level I academic urban ED with an annual census of 75,000...
May 2010: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
B G Denys, B F Uretsky, P S Reddy
BACKGROUND: Central venous access is an essential part of patient management in many clinical settings and is usually achieved with a blinded, external landmark-guided technique. The purpose of this study is to evaluate whether an ultrasound technique can improve on the traditional method. METHODS AND RESULTS: We prospectively evaluated an ultrasound-guided method in 302 patients undergoing internal jugular venous cannulation and compared the results with 302 patients in whom an external landmark-guided technique was used...
May 1993: Circulation
Adam H Miller, Brett A Roth, Trevor J Mills, Jay R Woody, Charles E Longmoor, Barbara Foster
OBJECTIVE: To compare ultrasound (US)-guided vs. landmark-guided techniques for central venous access (CVA) in the emergency department. METHODS: This was a prospective study of consecutive patients enrolled at a university teaching hospital with an annual census of approximately 100,000. On even days patients had CVA with ultrasonic assistance; patients presenting on odd days had CVA via traditional landmark techniques. Ultrasound users were emergency medicine faculty or residents who completed a one-hour training session...
August 2002: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Michael Gottlieb, Frances M Russell
No abstract text is available yet for this article.
January 2018: Annals of Emergency Medicine
J Matthew Fields, Anthony J Dean, Raleigh W Todman, Arthur K Au, Kenton L Anderson, Bon S Ku, Jesse M Pines, Nova L Panebianco
INTRODUCTION: Ultrasound-guided peripheral intravenous catheters (USGPIVs) have been observed to have poor durability. The current study sets out to determine whether vessel characteristics (depth, diameter, and location) predict USGPIV longevity. METHODS: A secondary analysis was performed on a prospectively gathered database of patients who underwent USGPIV placement in an urban, tertiary care emergency department. All patients in the database had a 20-gauge, 48-mm-long catheter placed under ultrasound guidance...
September 2012: American Journal of Emergency Medicine
Manoj M Lalu, Ashraf Fayad, Osman Ahmed, Gregory L Bryson, Dean A Fergusson, Carly C Barron, Patrick Sullivan, Calvin Thompson
OBJECTIVE: Although ultrasound guidance for subclavian vein catheterization has been well described, evidence for its use has not been comprehensively appraised. Thus, we conducted a systematic review and meta-analysis to determine whether ultrasound guidance of subclavian vein catheterization reduces catheterization failures and adverse events compared to the traditional "blind" landmark method. All forms of ultrasound were included (dynamic 2D ultrasound, static 2D ultrasound, and Doppler)...
July 2015: Critical Care Medicine
Christopher L Moore
Vascular access is the most commonly performed invasive procedure in medicine. For more than 20 years, ultrasound has been shown to improve the success and decrease complications of central venous access; however, it is still not universally used for this procedure. Ultrasound may also be used to facilitate difficult peripheral vascular access, potentially avoiding other more invasive procedures such as central or intraosseus vascular access. This article reviews some of the indications and evidence for ultrasound-guided vascular access, provides tips for successful ultrasound guidance, and discusses barriers to adoption...
July 2014: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sarah K Sommerkamp, Victoria M Romaniuk, Michael D Witting, Deanna R Ford, Michael G Allison, Brian D Euerle
OBJECTIVE: The axillary vein is an easily accessible vessel that can be used for ultrasound-guided central vascular access and offers an alternative to the internal jugular and subclavian veins. The objective of this study was to identify which transducer orientation, longitudinal or transverse, is better for imaging the axillary vein with ultrasound. METHODS: Emergency medicine physicians at an inner-city academic medical center were asked to cannulate the axillary vein in a torso phantom model...
March 2013: American Journal of Emergency Medicine
Hamid Shokoohi, Keith Boniface, Melissa McCarthy, Tareq Khedir Al-tiae, Mehdi Sattarian, Ru Ding, Yiju Teresa Liu, Ali Pourmand, Elizabeth Schoenfeld, James Scott, Robert Shesser, Kabir Yadav
STUDY OBJECTIVE: We examine the central venous catheter placement rate during the implementation of an ultrasound-guided peripheral intravenous access program. METHODS: We conducted a time-series analysis of the monthly central venous catheter rate among adult emergency department (ED) patients in an academic urban ED between 2006 and 2011. During this period, emergency medicine residents and ED technicians were trained in ultrasound-guided peripheral intravenous access...
February 2013: Annals of Emergency Medicine
Mariantina Fragou, Andreas Gravvanis, Vasilios Dimitriou, Apostolos Papalois, Gregorios Kouraklis, Andreas Karabinis, Theodosios Saranteas, John Poularas, John Papanikolaou, Periklis Davlouros, Nicos Labropoulos, Dimitrios Karakitsos
OBJECTIVE: Subclavian vein catheterization may cause various complications. We compared the real-time ultrasound-guided subclavian vein cannulation vs. the landmark method in critical care patients. DESIGN: Prospective randomized study. SETTING: Medical intensive care unit of a tertiary medical center. PATIENTS: Four hundred sixty-three mechanically ventilated patients enrolled in a randomized controlled ISRCTN-registered trial (ISRCTN-61258470)...
July 2011: Critical Care Medicine
Michael Mallin, Hunter Louis, Troy Madsen
OBJECTIVE: Ultrasound-guided subclavian (SC) access is an inadequately described procedure in the current literature. We recommend using the endocavitary (EC) probe to perform supraclavicular (SUP) SC line placement and evaluate emergency medicine residents' skill and comfort in using this technique after an education session. METHODS: The EC probe placed in the SUP fossa was used for direct visualization of SUP SC cannulation. Fifteen residents at the University of Utah were educated on this technique...
October 2010: American Journal of Emergency Medicine
Michael B Stone, Cynthia Moon, Darrell Sutijono, Michael Blaivas
OBJECTIVES: Ultrasound guidance for central venous catheterization improves success rates and decreases complications when compared to the landmark technique. Prior research has demonstrated that arterial and/or posterior vein wall puncture still occurs despite real-time ultrasound guidance. The inability to maintain visualization of the needle tip may contribute to these complications. This study aims to identify whether long-axis or short-axis approaches to ultrasound-guided vascular access afford improved visibility of the needle tip...
March 2010: American Journal of Emergency Medicine
Michael Blaivas, Srikar Adhikari
OBJECTIVES: To evaluate the frequency of unsuspected posterior vessel wall penetration of the internal jugular vein during ultrasound-guided needle cannulation. DESIGN: Prospective, single-blinded observational study. SETTING: Urban level I emergency department with an annual census of 80,000. PATIENTS: Residents who had previously completed a 2-day ultrasound course including a 3-hr didactic and hands-on session on ultrasound-guided central venous cannulation...
August 2009: Critical Care Medicine
Michael Phelan, Daniel Hagerty
BACKGROUND: Numerous studies have shown significant benefits of using real-time ultrasonography for central line intravenous access. Traditionally, the ultrasound probe is placed along the short axis of the vein to visualize and direct needle placement. This view has some limitations, particularly being able to visualize the needle tip. Some practitioners place the ultrasound probe in the long axis of the vessel to direct needle placement, allowing better visualization of the needle entering the vein, but this does not allow visualization of relevant anatomic structures...
November 2009: Journal of Emergency Medicine
Julie Leung, Martin Duffy, Andrew Finckh
STUDY OBJECTIVE: We compare real-time ultrasonographic guidance and the traditional landmark technique for the insertion of internal jugular vein catheters in an emergency department (ED) setting. METHODS: This was a prospective, randomized, clinical study performed in a tertiary ED between August 2003 and May 2005 on patients requiring central venous access. Ultrasonographically guided catheters were inserted under real time using the Sonosite ultrasonographic system with a 10 to 5 MHz 38-mm linear array transducer...
November 2006: Annals of Emergency Medicine
Truman Milling, Carlos Holden, Lawrence Melniker, William M Briggs, Robert Birkhahn, Theodore Gaeta
OBJECTIVES: Use of ultrasound guidance for central line placement generally requires two operators: one to hold the transducer and the other to guide the needle. The authors propose a single-operator technique and compare it with the two-operator technique for placement of internal jugular central lines. METHODS: This was a randomized clinical trial conducted from June to September 2004 in a U.S. urban teaching hospital. Enrollment packets were randomized to dynamic single operator (D1) and dynamic two operator (D2)...
March 2006: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Truman J Milling, John Rose, William M Briggs, Robert Birkhahn, Theodore J Gaeta, Joseph J Bove, Lawrence A Melniker
CONTEXT: A 2001 Agency for Healthcare Research and Quality Evidence Report on patient safety addressed point-of-care limited ultrasonography guidance for central venous cannulation and strongly recommended real-time, dynamic guidance for all central cannulas. However, on the basis of one limited study, the report dismissed static assistance, a "quick look" with ultrasound to confirm vein location before preparing the sterile field, as unhelpful. OBJECTIVE: The objective of this trial was to compare the overall success rate of central cannula placement with use of dynamic ultrasound (D), static ultrasound (S), and anatomical landmarks (LM)...
August 2005: Critical Care Medicine
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