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Results for “Catheterization, Peripheral”

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PubMedDate not supplied

A comparison of continuous infusion and intermittent flushing methods in peripheral intravenous catheters in neonates.

The purpose of this study was to compare two methods of maintaining peripheral intravenous devices in neonates: continuous infusion (CI) and intermittent flushing (IF). There was no significant difference in the mean duration of patency between the two groups, but there was a significant difference with respect to reasons for removal or loss of patency. The main reason for removal in the CI group was infiltration or phlebitis, and in the IF group the reason was occlusion.

Anticoagulants↗

PubMedDate not supplied

[Experience in the use of needle peripheral venous catheters in children].

The use of peripheral venous catheters manufactured by Johnson & Johnson Medical Ltd. in children was evaluated in terms of painfulness of venipuncture and cannulation, number of attempts needed to succeed, convenience of handling, and duration of the cannulation period. The intravenous catheters of Johnson & Johnson Medical Ltd. minimized the pain of venipuncture and cannulation and proved to be safe and convenient for patients and nursing staff.

Adolescent↗

PubMed1995

Effects of dicentrine on the mechanical properties of systemic arterial trees in dogs.

We evaluated the effects of dicentrine on the physical properties of systemic arterial trees. Dicentrine, isolated from Lindera megaphylla, was identified as a potent, selective alpha 1-adrenoceptor antagonist. We used high-fidelity multisensor catheter to measure the ascending aortic pressure and flow signals in 9 mongrel dogs. A succinct T-tube model with vascular nonuniformity was adopted to relate the pulsatile pressure and flow waves. The model-estimated parameters were capable of representing the mechanical properties of the blood vessel walls. Dicentrine had a beneficial effect on the rigidity of head and body circulation, respectively. There were great improvements not only in the tube distensibility and wave transmission time, but also in the peripheral load compliance and resistance. In global circulation that was defined as the parallel combination of head and body circulation, dicentrine significantly reduced values in characteristic impedance of the ascending aorta from 164 +/- 67 to 105 +/- 43 dynes/s/cm5, and in wave reflection factor from 0.46 +/- 0.14 to 0.36 +/- 0.13, and in total peripheral vascular resistance from 4,751 +/- 1,226 to 3,581 +/- 1,277 dynes/s/cm5. On the other hand, total peripheral load compliance was increased from 0.2950 +/- 0.1794 to 0.4457 +/- 0.2199 ml/mm Hg. Cardiac output (CO) and heart rate (HR) remained unchanged, however. Dicentrine had an impact on the mechanical properties of Windkessel vessels and resistance vessels in the systemic circulation.

Adrenergic alpha-Antagonists↗

PubMedDate not supplied

The management of the difficult peripherally inserted central venous catheter line removal.

Difficulty with removing peripherally inserted central catheters is being encountered with increasing frequency. The most common cause of this phenomenon is venous spasm. Although gentle traction may overcome mild spasm, aggressive pulling is contraindicated. Methods and maneuvers to alleviate spasm are discussed, the simplest of which is to attempt catheter removal again after a short (20 to 30 minutes) or intermediate (12 to 24 hours) length of time, at which time spasm may have spontaneously abated.

Catheterization, Central Venous↗

PubMed2002

Comparison of a central and a peripheral (cephalic vein) injection site for the measurement of cardiac output using the lithium-dilution cardiac output technique in anesthetized dogs.

The objective of this study was to determine the agreement between cardiac output measured by central (cranial vena cava) versus peripheral (cephalic vein) venous injection of lithium chloride for lithium-dilution cardiac output (LiDCO) determination in the dog. Five dogs (2 males, 3 females), anesthetized with halothane, were used. With each dog, 12 alternating central and peripheral LiDCO measurements were made, resulting in 10 paired comparisons. A total of 50 comparisons were obtained, the cardiac output measurements ranging from 1.11 to 2.76 L/min. The LiDCO measurement from the cephalic vein was similar to that obtained from the recommended central venous site: the difference between the central and cephalic vein determinations for all measurements was 0.098+/-0.336 L/min (mean +/- 2 standard deviations). Linear regression analysis demonstrated a slope of 1.050 (95% confidence interval 0.904 to 1.196) and a y intercept of 0.005 (r = 0.902). Therefore, although the central venous site is recommended by the manufacturer, the cephalic vein can be used instead in the dog, eliminating the need for central venous catheterization and thus reducing time and expense.

Animals↗

PubMed1991

[Venous access in emergencies].

A reliable venous access is necessary for pharmacological treatment in case of emergency. The indication, pharmacology of the drug or the infusion and the expected period of intravascular penetration are decisive for choosing the location for the punction. As a principle all visible veins could be punctured and used for injection; all but varicose or thrombotic veins. Primarily the distal veins of the extremities should be punctured with a venous catheter and only in case of failing one should try more proximal. In case of accidently artery punction the cannula has to be left in place and a pharmacological therapy has to be started immediately. If a peripheral venous punction is impossible the central venous catheter is an alternative even of its remarkable higher rate of complications. Three ways of access to the central veins can bei recommended: the jugular interna vein, the subclavian vein and the basilic vein. Advantages as well as disadvantages are elaborated. As a result the physician in cases of emergency should use the technique of venous punction he is used too in a routine situation.

Bloodletting↗

PubMed2004

Subintimal angioplasty for chronic arterial occlusions.

Percutaneous treatment of peripheral arterial disease has evolved greatly. The prevalence of superficial femoral artery occlusions has necessitated new devices and techniques to treat these patients percutaneously. Presently several therapies are available or under investigation. These range from stents, drug eluting stents, covered stents, cryoangioplasty, laser recanilization, blunt micro dissection, and subintimal angioplasty. This paper will discuss the indications, technique, and results of subintimal angioplasty.

Angioplasty, Balloon↗

PubMedDate not supplied

Clinical factors associated with the development of phlebitis after insertion of a peripherally inserted central catheter.

A descriptive comparison study was conducted to determine if there were any coagulation, immune, nutritional, or insertion-related differences between 64 adult hospitalized clients who experienced phlebitis after insertion of a peripherally inserted central catheter (PICC) compared with a matched group of 64 adult hospitalized clients who did not develop phlebitis. Factors that significantly decreased the development of phlebitis in this study included smaller catheter gauge, placement in the basilic vein, tip location in the superior vena cava, no manipulation or movement at the exit site, and higher platelet levels.

Adult↗

PubMedDate not supplied

Retrograde visualization of the portal venous system using CO2 intraarterial digital subtraction angiography.

Carbon dioxide (CO2) intraarterial digital subtraction angiography (IADSA) provides retrograde visualization of the portal vein via a peripheral segmental hepatic artery. IADSA was performed in 12 patients with known hepatic diseases by injecting a peripheral hepatic artery with both CO2 gas and an iodinated contrast medium. The portal vein was constantly visualized only with CO2 IADSA in all patients. The injected CO2 may flow back into the portal vein through an anastomotic system known as the peribiliary or periportal plexus. This new method is safe and useful to image the portal venous system in patients with hepatic malignancy.

Angiography, Digital Subtraction↗

PubMed1994

Puncture site hemostasis.

The Angio-Seal hemostatic puncture closure device was designed to provide diagnostic as well as post-complex angioplasty hemostasis in coronary and peripheral procedures without compromising blood flow to the distal extremity: 1) by allowing immediate removal of the introducer sheath, and 2) by providing puncture hemostasis without the need for manual pressure. The Angio-Seal is currently in clinical trials and is being evaluated by the FDA. We are hopeful that its future use will reduce the cost of medicine while greatly enhancing the quality of patient care as initial clinical trial results indicate.

Animals↗

PubMed1988

[Fatal peripheral catheter phlebitis].

A 75-year-old man suffered from suppurative thrombophlebitis as a complication of a peripheral venous catheter (1.2 x 45 mm Teflon). In spite of rapid removal of the catheter at the time of clinical diagnosis of phlebitis and adequate antibiotic treatment, the Staphylococcus aureus sepsis developed into lethal endocarditis. The risk of thrombophlebitis can be minimized by limiting (less than 72 hours) the duration of cannulation. If pus is detected within the lumen of the vein, surgical excision of the involved vein remains the treatment of choice.

Aged↗

PubMed1990

Sensitivity and specificity of blood cultures obtained through intravascular catheters.

The reliability of blood cultures obtained through indwelling intravascular catheters is controversial. In this study, the results of 200 catheter blood cultures were compared with those of an equal number of peripheral blood cultures drawn at the same time. Catheter blood cultures were found to be 96% sensitive (95% confidence interval, 89% to 100%) and 98% specific (95% confidence interval, 96% to 100%) for the detection of septicemia. Factors thought to have influenced these favorable results were the relatively short duration of catheter placement and the particular emphasis given to aseptic technique.

Bacteriological Techniques↗

PubMed2005

Thromboelastographic study of the effect of manipulation of central veins on coagulability of venous blood.

AIM: To measure whole blood coagulability in vitro using thromboelastography before and after direct and indirect manipulation of the internal jugular and subclavian veins. METHODS: We studied 10 patients (American Society of Anaesthesiologists (ASA) grades I or II) with malignant disease of the head and neck who were having selective neck dissections. We excluded patients with diabetes, those who were being given any anticoagulant, those who were actively infected, and those with known coagulopathy. We took 3 ml samples of venous blood during insertion of a peripheral cannula, after insertion of a central venous cannula, and after dissection of the internal jugular vein. Thromboelastography was done on recalcified citrated samples within 1h of sampling. The variables r, k, alpha angle, and maximum amplitude were recorded at each point and the values before and after manipulation were compared using t-tests. RESULTS: The only change was seen in the variable r, which showed an insignificant increase in coagulability.

Blood Coagulation↗

PubMed1990

Tussive effect of a fentanyl bolus administered through a central venous catheter.

One hundred and ten male patients scheduled for coronary artery bypass grafting were allocated randomly into one of three groups. Patients in group A received fentanyl 7 micrograms/kg via a central venous catheter, those in group B were given fentanyl 7 micrograms/kg through a peripheral venous cannula, and patients in group C received sterile water via a central venous catheter. In group A, 45.9% of patients coughed after injection of fentanyl; the mean onset time from the end of fentanyl administration to the beginning of coughing was 10.6 seconds. Only one patient in group B and no patient in the control group exhibited a cough response (p less than 0.0001). We hypothesise that fentanyl can evoke the pulmonary chemoreflex.

Catheterization, Central Venous↗

PubMed2002

[Comparison of a transparent dressing with gauze. Venous blood vessel maintenance].

The authors describe a prospective, random study which compares the usefulness, advantages and inconveniences between a 3M Tegaderm transparent surgical dressing and a gauze dressing under a protocol for the maintenance of peripheral venous blood vessels. Their conclusions highlight as major differences the ease and speed in the use of the 3M Tegaderm transparent surgical dressing, the vision in the syringe nozzle insertion zone allowed by this dressing and a higher degree of early detection of phlebitis when this dressing is used. This article was awarded the second place prize in the First 3M Tegaderm Contest.

Adult↗

PubMedDate not supplied

Planning, implementation, and evaluation of a successful hospital-based peripherally inserted central catheter program.

Peripherally inserted central catheters (PICC) and extended catheters have become an acceptable norm within the medical community. In late 1991, the Kaiser Foundation Hospital in Fontana, California decided to take a serious look at these catheters. A task force led this project, developing a multiphased plan that began with raising awareness and moved on a continuum to full implementation. During 1992, more than 3,000 patients days were saved as a result of early referral to home care.

Catheterization, Central Venous↗

PubMed1988

The percutaneous common femoral vein catheter for volume replacement in critically injured patients.

The acquisition of venous access with the potential for massive volume infusion can be a major determinant in the survival of a critically injured patient. A percutaneously placed 8.5 Fr common femoral vein catheter (CFVC) was inserted in 366 patients in whom upper extremity veins were unavailable or inadequate for volume resuscitation. Flow rates were further maximized by replacing standard intravenous tubing with genitourinary irrigating tubing (GIT). Infusion rates of up to 1,622 cc/minute (one liter in 37 seconds) of lactated Ringer's solution were achieved in this group of patients with a mean Trauma Score of 9.3 and a mean Injury Severity Score of 32.1. Although 90% of trauma patients can be managed with a peripheral vein catheter, venous access in patients with the potential need for massive volume infusion can be achieved in a rapid, safe, and efficient manner using the CFVC in conjunction with the GIT. We conclude that this system can be used effectively in trauma patients with hemodynamic instability, unavailable or inaccessible upper extremity veins, suspected cervicothoracic major vascular injury and when massive volume or blood replacement is anticipated.

Adult↗

PubMedDate not supplied

Initiating a pediatric peripherally inserted central catheter and midline catheter program.

The lack of published literature specific to the pediatric population (1 month to 18 years) was a major deterrent to the initiation of a peripherally inserted central catheter (PICC) and midline catheter program in a 260-bed pediatric hospital. The intravenous team assumed responsibility for the program initiated by the physicians. The following challenges were encountered: administrative issues, insertion-related discomfort, adverse clinical reactions, equipment inadequacies, catheter maintenance, and staff education. To date, the i.v. team has successfully placed 84 catheters and concludes that the procedure is invaluable for pediatric patients requiring an extended course of i.v. therapy.

Adolescent↗