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Results for “Catheterization, Peripheral”

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At least 397 records · Page 22Linked to original sources

PubMed1999

Peripherally inserted central venous catheters: success of scalp-vein access in infants and newborns.

The authors assessed the feasibility of placing peripherally inserted central venous catheters via scalp veins in infants and newborns. In 60 newborns and infants, aged 3 days to 10 months, placement of 62 2-F peripherally inserted central venous catheters was attempted with scalpvein access. The tip location was central in 30 of the 62 catheters (48%) and long peripheral intravenous in 17 (27%); access failed in 15 (24%). Scalp-vein access for peripherally inserted central venous catheters offers a safe and effective alternative route for gaining central venous access in infants and newborns.

Brachiocephalic Veins↗

PubMed1996

Intravenous therapy needle choices in ambulatory cancer patients.

The purpose of this research utilization project was to evaluate a set of research-based decision rules designed to guide needle choice for peripheral intravenous (i.v.) therapy in ambulatory cancer patients. A consecutive series of 100 patients receiving i.v. therapy for one day were assigned to receive either a plastic catheter or a steel needle using the decision rules based on age, weight, vein condition, solution to be administered, and infusion volume, and were evaluated for phlebitis, local or systemic infection, and extravasation. None of the patients experienced phlebitis or infection, and a 25% cost savings ($6,800 Canadian) was obtained. Two patients (5%) from the "steel needle group" experienced an extravasation of 5FU but neither required treatment nor experienced changes to subsequent peripheral i.v. therapy. Our nursing procedure for initiation of i.v. therapy has been changed to reflect the needle choice decision rules evaluated in this project.

Ambulatory Care↗

PubMedDate not supplied

The peripherally inserted central catheter.

Peripherally inserted central catheters (PICCs) are commonly inserted by nurses. This article gives an overview of the care and management of the PICC in general adult nursing.

Adult↗

PubMed2005

Infections related to vascular catheters in a pediatric intensive care unit.

We determined the rate and risk factors for colonization of 103 peripheral intravenous catheter and 32 central venous catheters. 52.5% peripheral catheters had colonization. Common organisms isolated were Pseudomonas (33.3%) and coagulase negative Staphylococci (29.6%). Colonization was higher in catheters inserted in the lower limb. Overall 62.5% of the central catheters were colonized, chiefly by coagulase negative Staphylococci, Pseudomonas and Candida. All central catheters in place for more than 11 days were colonized. Subclavian vein catheters had a higher rate (68.2%) of colonization in comparison to femoral vein insertions (40%). We conclude that upper limb placements are preferable to lower limbs when using peripheral lines. Changing peripheral intravenous catheters every 48 hours and central venous catheters every 10 days may decrease the rate of colonization.

Adolescent↗

PubMedDate not supplied

Accurate micromethod of neonatal blood sampling from peripheral arterial catheters.

Blood sampling from peripheral arterial catheters is an important, but inadequately standardized, technique in neonatal intensive care. In this study two peripheral arterial sampling methods were evaluated in a neonatal animal model. One commonly used method (the drip technique) involves inserting a needle into the hub of the peripheral arterial catheter and discarding up to 10 drops of infusate fluid and blood before the sample is collected. This method was compared with a new micromethod where two needles are used (two-needle technique). Blood gas values in the peripheral samples were compared with control values drawn from a femoral artery catheter. Accuracy of peripheral arterial PCO2 and total blood loss constituted the final study variables. The results demonstrated that the two needle technique was more accurate, yielding peripheral arterial PCO2 values that were 98% of control values. Withdrawal of fewer than six drops of infusate fluid and blood with the drip technique resulted in spuriously low PCO2 values. The new technique also resulted in significantly less total blood loss per sample compared with the drip technique (189 +/- 3 microliters vs 398 +/- 3.8 microliters, mean +/- SEM, p < 0.01). We conclude that the two-needle micromethod is an accurate technique for blood sampling from peripheral arterial catheters and is particularly appropriate for low-birth-weight infants in whom minimization of blood loss is desirable.

Animals↗

PubMed2006

Developing a Research base for Intravenous Peripheral cannula re-sites (DRIP trial). A randomised controlled trial of hospital in-patients.

BACKGROUND: There is currently no high grade evidence on which to base decisions about the frequency of intravenous cannula re-sites. OBJECTIVE: To assess the safety of changing peripheral venous cannulas when clinically indicated. DESIGN: Randomised controlled trial. SETTING: A tertiary referral hospital in Brisbane, Australia. PARTICIPANTS: Two hundred and six hospitalised patients from surgical, medical and orthopaedic wards. INTERVENTIONS: Peripheral intravenous cannulas were re-sited only when complications occurred (intervention group) or every 3 days (control group). MAIN OUTCOME MEASURES: The primary endpoint was any unplanned cannula removal, the secondary outcome was cost. RESULTS: Forty six patients had unplanned removals in the intervention group compared with 41 in the control group [relative risk 1.12, 95% confidence interval 0.81-1.55 (p=0.286)], a non-significant difference. Total duration of peripheral cannulation was similar in both groups (mean 123.3h in the intervention group and 125.9h in the control group: P=0.82) but significantly more re-sites occurred in the control group (167 in intervention group, 202 in the control group: p=0.022). Cost of cannula replacements in the intervention group was AUD$3,183.62 and in the control group AUD$3,837.56 (p=0.006). CONCLUSION: Re-siting peripheral venous cannulas when clinically indicated compared with changing them routinely every 3 days does not lead to more complications and reduces costs.

Catheterization, Peripheral↗

PubMedDate not supplied

The effects of heparin versus normal saline for maintenance of peripheral intravenous locks in pregnant women.

OBJECTIVE: To compare the efficacy of two available preparations (heparin, 10 U/mL, 1 mL, vs. normal saline, 1 mL) used for maintaining patency in peripheral intravenous (IV) locks during pregnancy. DESIGN: Prospective, randomized, and double-blind. Eligible patients who were to receive a peripheral intermittent IV lock were randomly assigned to receive either heparin flushes or normal saline flushes for IV lock maintenance. IV locks were flushed after each medication administration, or at least every 24 hours, with the assigned blinded flush solution. Intermittent IV lock sites were also evaluated every 12 hours for the development of phlebitis. SETTING: A large academic medical center in the Midwest that has both community-based and regional-referral obstetric practices with more than 2,000 deliveries per year. PARTICIPANTS: A convenience sample included 73 hospitalized pregnant women who were between 24 and 42 weeks gestation. Exclusions from the study were women with significant abnormalities in the fetal heart tracing on admission, cervical dilation > 4 cm, presence of hypersensitivity to heparin, presence of clotting abnormalities, and anticoagulation therapy (including low-dose aspirin). RESULTS: Data indicate there were no statistically significant differences in IV lock patency nor in phlebitis between heparin or normal saline flushes. CONCLUSIONS: This study provides support that both normal saline and heparin in the doses studied may be equally effective in the maintenance of peripheral IV locks. Due to small sample size, additional studies are needed to determine optimal therapy over time.

Adolescent↗

PubMedDate not supplied

Blood sample collection from a peripheral catheter system compared with phlebotomy.

Hospital experiences often are punctuated with pain related to common procedures, such as venipuncture. An alternative to venipuncture involves obtaining samples from an existing peripheral vascular saline lock device. To validate such a collection, this study compared the accuracy of serum chemistry tests performed on samples taken concurrently from the saline locks and by phlebotomy. No clinical differences were noted within the 17 sets of ion assays, and both potassium and chloride determinations demonstrated no significant statistical differences between the sample groups. Documented rates of sample hemolysis (21%) and difficulties experienced in collection suggest that blood sampling from an existing peripheral saline lock device is best suited to inpatients undergoing multiple blood sampling necessitated by short-term investigative procedures or crisis management.

Blood Chemical Analysis↗

PubMed2004

Choice and use of peripherally inserted central catheters by nurses.

Patients requiring i.v. treatment of between six weeks and six months will benefit from having a peripheral or central i.v. line. PICCs have a number of advantages over other peripheral or central devices. There is less risk of complications and infection than with central devices and repeated venepunctures are avoided as one PICC should provide adequate access throughout.

Catheterization, Central Venous↗

PubMed1992

New peripherally inserted midline catheter: a better alternative for intravenous antibiotic therapy in patients with cystic fibrosis.

A study was performed on outpatients with cystic fibrosis (CF) to evaluate the performance of an over-the-needle peripherally inserted midline catheter for the delivery of 2-week courses of antibiotic therapy. The midline is a 7-inch catheter inserted in the antecubital region with the tip located in the axillary region. It is made of a newly developed biomaterial that softens and expands upon contact with body fluids. The hypotheses for the study were that the midline catheter: 1) is useful for intermediate-length therapies; 2) can prevent multiple 3-day conventional peripheral catheter restarts; 3) can prevent or delay the use of more invasive central devices; 4) is comfortable for patients; and 5) is economical. A total of 41 midlines were inserted in 27 patients with an average age and weight of 22 years and 109 pounds, respectively. Prior to this study implanted ports and primarily conventional short peripheral catheters were used to administer I.V. therapy to these patients; fifty percent of these short peripheral catheters failed within 2.6 days. At 2 weeks of dwell, 80% of the midline catheters placed in these patients were still indwelling. Also, 80% of all midline catheter removals were for non-catheter-related reasons. There were no cases of midline catheter phlebitis. In contrast, the phlebitis rates published for peripherally inserted central catheters (PICCs) and conventional short peripheral catheters at 7 days of dwell are 20% and greater than 51% respectively. The midline catheters were comfortable and well liked by most patients and became more economical than conventional peripheral catheters for therapies lasting approximately 6 days through 1 to 2 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2003

Upper extremity deep vein thrombosis associated with indwelling peripheral venous catheters in gynecology oncology patients.

OBJECTIVE: The goal of this study was to review the clinical presentation, management, and outcome of upper extremity deep vein thrombosis (UEDVT) in women with gynecologic malignancies who had indwelling peripheral venous access catheters. METHODS: From a retrospective review of medical records, we identified 13 patients with various gynecologic malignancies who were diagnosed with UEDVT during their disease course. We obtained tumor data, detailed information regarding the indwelling catheters used, and the diagnosis and management of UEDVT. RESULTS: Two hundred sixty-four women with gynecologic malignancies underwent insertion of an indwelling peripheral catheter by interventional radiology over a 5-year period. A total of 325 catheters were placed in these patients. Thirteen patients developed UEDVTs, and all had a catheter in situ at the time of DVT diagnosis. Eleven of thirteen patients had Peripheral Access System (PAS) Ports and two had peripheral indwelling central catheters (PICCs). The mean age of the patients was 53 years (range, 32-70). At the time of UEDVT diagnosis patients had the following: progressive cancer (n = 8), stable disease (n = 1), no evaluable disease (n = 4), and actively receiving chemotherapy (n = 7). Clinical signs/symptoms at the time of diagnosis included: catheter occlusion (n = 2), arm swelling and pain (n = 10), and superior vena cava syndrome (n = 1). Diagnosis of thrombosis was confirmed using Doppler ultrasound (n = 4), venography (n = 5), and both modalities (n = 4). Management of UEDVT consisted of anticoagulation with warfarin (2-6 months) (n = 9), urokinase infusion (n = 2), intravenous antibiotics for 21 days and heparin for 10 days (n = 1), arm elevation only (n = 1), Lovenox for 60 days (n = 1), and no therapy (n = 1). There were no complications associated with anticoagulation. No patient had a pulmonary embolism. The incidence of UEDVT among our patients with indwelling venous catheters was 5.7%. CONCLUSION: Symptomatic UEDVT is an uncommon complication of indwelling peripheral venous catheters in women with gynecologic malignancies. The risk of pulmonary embolism is low in this patient population.

Adult↗

PubMed1990

Effect of fluids on life span of peripheral arterial lines.

This study examines the effect of two different fluids to maintain peripheral arterial line patency at 1 to 2 ml/hr in a randomized controlled trial. Sixty sick newborn infants requiring ventilatory support and frequent blood gas monitoring were randomly assigned to receive either heparinized normal saline (HNS) or heparinized 5% dextrose water (HD5W) to maintain peripheral arterial line patency. One unit of heparin was added to each mililiter of both solutions. The duration of functional arterial lines, sodium balance, and number of peripheral punctures for blood glucose monitoring were compared using Student's t test for independent samples. HNS peripheral arterial catheters functioned significantly longer than HD5W without increased risk of hypernatremia. We conclude that HNS in arterial catheters is safe, lasts longer, and saves the infant (1500 gm or more) from the unnecessary stress of multiple peripheral punctures for blood glucose measurements, which can be obtained from the arterial catheter if glucose is not part of the infusate.

Arterial Occlusive Diseases↗

PubMed1993

IV therapy: a financial feasibility study.

Results of a feasibility study comparing peripheral catheters to midline catheters are summarized. A step-by-step process involving audit studies, cost figures, data collection, calculation parameters, and cost analysis determined the effectiveness of the new technology.

Catheterization, Peripheral↗

PubMedDate not supplied

Disseminated fusariosis.

A 7-year-old boy with T cell acute lymphoblastic leukemia developed disseminated hyalohyphomycosis due to Fusarium solani. The clinical features included fever, severe myalgia, documented fungemia with F. solani, an ecthyma gangrenosum-like lesion next to a peripheral venous catheter, and disseminated pustules. Severe neutropenia due to chemotherapy was the most relevant risk factor. Histopathologic study of the ecthyma gangrenosum-like lesion, as well as pustular lesions, revealed epidermal necrosis and an inflammatory infiltrate in the upper dermis, with numerous septate hyphae demonstrated by periodic acid-Schiff stain. Clinical resolution was achieved with granulocyte colony-stimulating factor and amphotericin B administration. Our case suggests that the peripheral venous access was probably the portal of entry of the fungus.

Amphotericin B↗

PubMedDate not supplied

Antibiotic sampling from central venous catheters versus peripheral veins.

This study was developed to determine if there are statistically or clinically significant differences in antibiotic levels of blood samples obtained from a central venous catheter (CVC) versus a peripheral vein. Currently there is limited and contradictory information comparing aminoglycoside levels drawn from a central line used for antibiotic infusions versus a separate peripheral blood draw. In this study antibiotic levels drawn from a central line were compared with levels drawn simultaneously from a peripheral vein. Significant clinical and statistical differences were identified based on the type of central catheter in place.

Anti-Bacterial Agents↗

PubMed1995

Peripheral ports are a new option for central venous access.

BACKGROUND: Peripheral ports represent a new option for central venous access that have a low complication rate while providing long duration. This study provides five years of evaluation of this device. STUDY DESIGN: All patients had follow-up evaluation concurrently, with detailed information collected for the first 70 patients. Data were maintained by a nurse specialist team with periodic questionnaires sent to treating physicians for follow-up information. Port duration, complications, ease of placement, patient and staff acceptance, and comparative costs were evaluated. Methods of placement evolved during the past five years and culminated in the described approach. RESULTS: One hundred forty ports were evaluated. The mean duration was 343 days, with 45 ports in place longer than one year. The median port duration in patients without acquired immunodeficiency syndrome was 950 days. The overall complication rate was 1.76/1,000 days. The infection rate was very low at 0.32/1,000 days, and the rate of phlebitis was 0.16/1,000 days. Only 9 percent of the ports were removed for complications, which included infection and thrombosis. Because of the ease of insertion, 80 percent of the ports are placed outside the hospital, allowing for cost savings when compared with central ports. CONCLUSIONS: Peripheral ports as a means of central venous access have been highly successful in our experience. These devices have been very well accepted by the patients and nursing staff.

Arm↗

PubMed1998

A randomized trial comparing Arglaes (a transparent dressing containing silver ions) to Tegaderm (a transparent polyurethane dressing) for dressing peripheral arterial catheters and central vascular catheters.

The purpose of this trial was to prepare for a large randomized trial comparing Arglaes film dressing, a recent innovation containing silver ions, against Tegaderm, a transparent polyurethane dressing. Thirty-one patients admitted to the intensive care unit and requiring the insertion of an arterial line or central venous catheter were recruited into the study. Skin swabs were taken from the insertion sites prior to catheterization and on removal of the intravascular device to measure skin colonization rate between the two dressings. The catheter tips were also cultured on removal to establish if there was a difference between the two groups. No statistical differences were found in bacterial growth between the two dressings.

Adolescent↗

PubMedDate not supplied

Diagnostic tools and therapeutic interventions that may influence the integrity of vascular and nonvascular access devices.

Current technology introduces many new vascular and nonvascular devices to the medical field. With the assistance of these devices, patients can be offered many more diagnostic tests and therapeutic treatments that aid in the diagnosis and treatment of diseases. As with any new infusion technology, these devices can be associated with complications attributable to the rapid rate of infusion. This article defines vascular and nonvascular devices; describes diagnostic medication, tests, and treatments that may have an impact on outcome or compromise vascular access; and describes the role of nurses and radiologic technicians in preventing complications related to vascular access.

Angiography↗