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Results for “Catheterization, Peripheral”

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At least 289 records · Page 16Linked to original sources
PubMed1996

Prolonged peripheral parenteral nutrition with an ultrafine cannula and low-osmolality feed.

Peripheral parenteral nutrition is an attractive alternative to centrally delivered parenteral nutrition because it obviates the need for central venous cannulation and its attendant complications. Some 45 consecutive patients were fed peripherally using a 22-G polyurethane catheter and a fat-based, low-osmolality feed. Of these patients, 36 were fed for a median of 8.5 (range 3-31) days without peripheral vein thrombophlebitis (PVT). Seven patients developed PVT after a median of 6 (range 5-7) days. The cumulative daily risk of PVT was 0.016 episodes per day. These results suggest that prolonged (more than 7 days) problem-free peripheral parenteral nutrition is possible.

Adult↗
PubMed1993

Delayed ischaemia of the hand necessitating amputation after radial artery cannulation.

We present a case of ischaemic hand injury in a patient, who had 95% occlusion of both the ulnar and radial arteries, after atraumatic placement of a left radial artery catheter. The presence of cigarette burns on the dorsum of the hand was highly suggestive of vascular compromise. There were no signs of vascular compromise after placement of the arterial line which was removed 24 hr later. Ten days after placement the patient complained of pain with ensuing ischaemic changes resulting in necrosis of the finger tips and eventual amputation of the hand. We recommend using other sites of arterial access such as axillary or superficial temporal artery in patients with severe peripheral vascular disease.

Adult↗
PubMed1991

Differential routes of cocaine administration indicate a peripheral cardiotoxic action.

The present study utilized different routes of administration in unanesthetized Wistar Kyoto (WKY) rats to determine whether cocaine-induced death was mediated through a peripheral or central site of action. Administration of cocaine via a route that resulted in high concentrations of cocaine reaching the heart produced arrhythmias, convulsions, a decrease in heart rate and mean arterial pressure, and death. However, administration of the same dose via a route that resulted in passage of cocaine through the liver before reaching the heart produced only a pressor response. Additionally, administration of the same dose via a route that resulted in high levels of cocaine reaching the brain did produce a pressor response that was followed by a decrease in blood pressure and heart rate, arrhythmias, convulsions and death. However, these effects were delayed in comparison to the response when high concentrations of cocaine reached the heart immediately. These results support a peripheral site of action for cocaine-induced death.

Animals↗
PubMed2001

[Effectiveness of locoregional rt-PA lysis in acute leg and arm vein thrombosis].

39 patients suffering from a thrombosis of the peripheral venous system were treated with a loco-regional lysis, using rt-PA. Two cycles of 40 mg rt-PA a day were applicated by means of a special drainage-management, using perforans veins. During lytic therapy, 20,000 to 30,000 IE of unfractionized heparin were additionally administered. Laboratory work including aPTT and fibrinogen measurement was performed every 8 hours. Additionally a phlebography was performed after 24 hours. Patients received an anticoagulative therapy using sintrom or marcumar the following 3 months. We obtained a successful thrombolysis without any major complications in 90%. Minor complications included 3 peripheral pulmonary embolisms. Duplex sonographic and plethysmographic follow up was performed in 25 patients one year after operation. In two patients with ankle edema insufficient valves at the popliteal vein were found with both diagnostic modalities. 23 patients showed no signs of insufficient valves neither clinically nor at duplex sonography and plethysmography. The locoregional lysis appears to be an effective method for the treatment of acute peripheral vein thrombosis.

Acute Disease↗
PubMed1992

Significantly improved peripheral intravenous catheter performance in neonates: insertion ease, dwell time, complication rate, and costs.

A prospective, randomized, controlled study was performed in neonates in an intensive care nursery to compare the performance of a peripheral intravenous catheter made of Aquavene material (test catheter) with that of a conventional peripheral catheter made of Teflon material (control catheter). Aquavene is a newly developed biomaterial that softens and expands on contact with body fluids. A total of 105 catheters (50 test and 55 control) were inserted in 63 neonates. The median time to a catheter-related complication was 3.60 days for the test catheters and 1.75 days for the control catheters (p = 0.0007). Infiltration rate for the test catheters was 56% as compared with 78% for the control catheters (p = 0.03). The test catheters provided fewer catheter-related complications (p = 0.006), with 34% of the test catheters reaching end of therapy as compared with 9% of the control catheters (p = 0.004). On average, 1.8 test catheters were used per insertion versus 2.3 control catheters (p = 0.08). The test catheters were rated easier to insert (p = 0.05), with a shorter time required for insertion. Because of improved performance, cost savings were realized with the test catheters after the first day of therapy, even though the per unit cost of the test catheter was greater. These data indicate that the test catheter, made of Aquavene material, is superior to the Teflon catheter for peripheral intravenous therapy in neonates.

Biocompatible Materials↗
PubMed2003

Review of peripherally inserted central catheters in the Singapore acute-care hospital.

Peripherally inserted central catheters are frequently used whenever reliable central venous access is required for a prolonged period of time. The objective of this study was to review utilisation profile, complication rates and outcomes of patients who were treated in our hospital with the therapy that required placement of the peripherally inserted central catheter. We reviewed the medical records of all patients who had peripherally inserted central catheter placed between the beginning of July and the end of October 2002. Five patients who remained hospitalised at the time of review (six weeks after the last day of study period) were excluded. Seventy-eight patients with 94 peripherally inserted central catheters were analysed in detail. Sixty-four peripherally inserted central catheters (68.1%) were placed for prolonged antibiotic therapy, 27 (28.7%) mainly to administer total parenteral nutrition and 3 (3.2%) were inserted for other reasons. Catheters were in place before removal for a mean 17.2 days. Forty-eight catheters (51.1%) were removed after completion of therapy on average 20.2 days after insertion. Complications were frequent but minor. Thirty-three catheters (35.1%) were removed due to catheter-related complications. The most common complication were phlebitis followed by accidental removal. In summary, peripherally inserted central catheters proved to be reasonably safe and a reliable way of providing therapy requiring prolonged intravenous access. Complications were frequent but relatively minor. Complication rates in our study were similar to those reported in other studies on this subject. Peripherally inserted central catheters remain a convenient and reasonable alternative to other centrally or peripherally inserted venous devices.

Acute Disease↗
PubMed1990

Rapid correction of hypokalemia using concentrated intravenous potassium chloride infusions.

There are conflicting recommendations regarding the use of intravenous potassium chloride infusions for acute correction of hypokalemia. We examined the effects of 495 sets of potassium chloride infusions administered to a medical intensive care unit population. The infusion sets consisted of one to eight consecutive individual infusions, each containing 20 mEq of potassium chloride in 100 mL of saline administered. The mean preinfusion potassium level was 3.2 mmol/L, and the mean postinfusion potassium level was 3.9 mmol/L. The mean increment in serum potassium level per 20-mEq infusion was 0.25 mmol/L. No temporally related life-threatening arrhythmias were noted; however, there were 10 instances of mild hyperkalemia. Our data endorse the relative safety of using concentrated (200-mEq/L) potassium chloride infusions at a rate of 20 mEq/h via central or peripheral vein to correct hypokalemia in patients in the intensive care unit.

Catheterization, Central Venous↗
PubMed2003

The VB-1 catheter: a novel catheter for peripheral arterial revascularization.

Despite recent advances in catheter-based technologies for peripheral arterial revascularization, adequate guide catheter positioning and support remains a leading procedural challenge. This report describes the adaptation of the Behar Internal Mammary VB-1 catheter for peripheral revascularization procedures in patients with complex anatomy not amendable to other conventional peripheral guide catheters.

Aged↗
PubMed2001

Peripheral vascular disease: perspectives on aortoiliac, renal, and femoral treatments using catheter-based techniques.

The percutaneous treatment of peripheral vascular disease has advanced over the past two decades and is fast becoming the preferred treatment of choice. Stents have positively altered the clinical outcomes in peripheral revascularizations. Anatomic variability is an important factor in determining if the patient is an ideal percutaneous interventional candidate. Future technological developments in percutaneous interventions will help include new patients with peripheral vascular disease previously considered nonideal percutaneous candidates.

Aorta↗
PubMedDate not supplied

Care and management of peripherally inserted central catheters.

It is estimated that 85% of all patients admitted to hospitals in the USA in 1991 were recipients of a vascular access device (Barbone, 1995). Down-sizing of hospitals and the shift towards more outpatient and day-care procedures has meant that patients admitted to hospitals in the UK are more likely to be recipients of a vascular access device than they were 10 years ago, as their conditions are more likely to be acute. This article will discuss how, with careful management, peripherally inserted central catheters can improve the reliability and quality of vascular access for many patients.

Bandages↗
PubMed1994

Intravascular catheter associated sepsis: a common problem. The Australian Study on Intravascular Catheter Associated Sepsis.

OBJECTIVE: To estimate the number of episodes of intravascular catheter associated sepsis that occur in Australia per year. DESIGN AND SETTING: Data were collected from 15 Australian hospitals (mainly tertiary referral hospitals). All positive results of blood cultures were followed up and the primary sepsis site identified and recorded. The average study period was 1.2 years. RESULTS: Eight hundred and nine episodes of systemic sepsis associated with intravascular catheters were identified from 4957 separate episodes of bacteraemia or fungaemia. Of those in which the catheter site was known, there were 491 episodes of sepsis associated with central vein catheters and 233 with peripheral vein catheters. Systemic sepsis with peripheral vein catheters occurred with 0.36 of every 1000 catheters purchased, but with central vein catheters it was 23 episodes per 1000 catheters (relative risk, 64; 95% confidence interval, 54-76). In these hospitals, 8.2 episodes of intravascular catheter associated sepsis occurred annually per 100 beds and 1.5 episodes per 1000 admissions. From these figures, at least 3000 cases of intravascular sepsis may occur per year in Australia. CONCLUSIONS: Intravascular catheter sepsis is common. Central vein catheters cause more sepsis than peripheral vein catheters. With the greater use of catheters this problem is likely to increase.

Australia↗