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Results for “Catheterization, Peripheral”

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PubMedDate not supplied

[Nursing research on the use of venous catheters for hospitalized patients].

This report shows that intravenous catheterisation has been required for 59.4% of the patients in this sample. The main reason identified for catheterisation was the difficulty in accessing peripheral veins. The wound dressing was applied for 100% of the patients and the procedure itself was carried out each 48 hours in 89.8% of them. The intravenous catheter stood for 10 days in 52% of the cases and it was removed in 34.8% for intravenous drugs interruption and the other reasons were related as to technical problems. The most present microorganism was Staphylococcus aureus in 20.3% of the catheter cultures.

Bandages↗

PubMedDate not supplied

PICCs: how Doppler ultrasound can extend their use.

Peripherally inserted central catheters were relatively unknown in the UK five years ago. Now, however, they are used in more than 100 centres around the country. PICCs have played a key role in improving vascular access for a wide range of patients and the growth in their use has been nurse led. This article explains how nurses can help to extend the use of PICCs to a group of patients who have traditionally been excluded, those with apparently inaccessible antecubital fossa.

Catheterization, Central Venous↗

PubMed1993

Ceftriaxone versus ceftazidime plus aminoglycoside therapy for infections in patients with neutropenia after cytotoxic chemotherapy. Short communication.

One hundred and one patients undergoing anticancer chemotherapy due to hematologic malignancy were retrospectively divided into two groups: 67 patients were treated with ceftriaxone plus amikacin, receiving once daily (od) 2-4 g ceftriaxone, 1-1.5 g amikacin (those without a peripheral or central venous catheter) and 34 patients with central or peripheral venous catheter (CPVC) receiving ceftizidime 2 g three times daily (tid) plus amikacin 0.5 g tid i.v. Both groups were similar as to their isolated pathogens, localization of infection, and basic diagnoses of hematologic malignancies. There was no significant difference in efficacy between ceftriaxone plus amikacin versus ceftazidime plus amikacin, but the toxicity was lower in once daily ceftriaxone plus amikacin group.

Amikacin↗

PubMed1990

Limb shortening secondary to complications of vascular cannulae in the neonatal period.

Four cases of limb shortening presenting in childhood are described. All four children had been managed in a neonatal intensive care unit and had developed complications following the insertion of intravascular cannulae. In two, lower limb shortening and deformity were secondary to direct epiphyseal damage following extravasation of calcium or dextrose from a peripheral venous line. In the other two, forearm shortening followed ischaemia, secondary to either radial artery thrombosis from a radial artery cannula or spasm of the brachial artery following extravasation from a venous cannula in a neonate who also had a radial artery cannula. These cases highlight an important complication of the use of vascular cannulae in neonates and the problems this may pose to the orthopaedic surgeon.

Arm↗

PubMed1988

In vitro use of arthroscopic irrigation tubing for rapid fluid administration.

The in vitro use of arthroscopic irrigation tubing (AIT) to achieve intravenous flow rates superior to those of previously reported studies are described. Using AIT with a peripheral type of 12 GA. catheter, flow rates of 934 cc/min with gravity and 1,928 cc/min with pressure were achieved. AIT connected to a 12 FR. central-type catheter yielded flow rates in excess of 2,000 cc and 3,000 cc/min with gravity and pressure, respectively. Such a delivery system may be lifesaving in situations where there are limited venous access sites or when there is a need for rapid volume resuscitation with limited personnel.

Arthroscopes↗

PubMed1997

The peripheral intravenous cannula: a cause of venous air embolism.

Venous air embolism has been reported as a complication of invasive diagnostic and therapeutic procedures or accidental trauma. Little is known about the incidence of air embolism after minimal intravenous manipulations, such as the insertion of a peripheral intravenous cannula. Small air emboli in the central veins, central arteries, and cardiac chambers can be detected during electron-beam computed tomography studies of the chest. Electron-beam computed tomography of the chest was performed on 208 patients after the insertion of a peripheral intravenous cannula. The images were analyzed using a digital workstation. Small air embolism was visible in 10 of 208 (4.8%) patients in the following locations: the pulmonary trunk in 6 patients, the right ventricle in 2, the right atrium in 1, and the left brachiocephalic vein in 1. The embolism was asymptomatic in each patient. Although the potential risks in patients with septal defects and shunts remain unclear, caution should be taken with minimal intravenous manipulations.

Catheterization, Peripheral↗

PubMedDate not supplied

The Safe Medical Device act and its impact on clinical practice.

Hospital patients often require vascular access devices to deliver infusion therapies. These can include peripheral intravenous catheters (PIVs), peripherally inserted central venous catheters (PICCs), triple lumens, ports, and Tesio, Swann-Ganz, and Hickman catheters. Although these products are used in large numbers without significant sequelae, when a device fails, the impact is realized throughout the industry. The infusion clinicians within our institution followed a systematic approach to dealing with the failure of devices that occurred over a 3-month period. This article describes the response process when a device fails and the methods of achieving positive patient outcomes.

Catheterization, Central Venous↗

PubMedDate not supplied

The use of implantable venous access devices (IVADs) in children with hemophilia.

PURPOSE: Implantable venous access devices (IVADs), either centrally or peripherally implanted, have become increasingly popular in children with hemophilia to assist in the early treatment of bleeding episodes and in the prevention of arthropathy. Their use has been associated with complications including thrombosis, thrombophlebitis, and infection. We attempted to better define whether the benefits associated with IVADs in this population outweight the associated risks. PATIENTS AND METHODS: We studied the medical records of 35 children from the University of Minnesota's Comprehensive Hemophilia Center who received IVADs between 1992 and 1996. RESULTS: There was no bleeding or thrombophlebitis associated with IVADs in our population. One patient required removal of a central IVAD due to thrombosis. The central IVADs were associated with local infection and bacteremia rates of 3% and 33%, respectively. The rates of local infection and bacteremia associated with peripheral IVADs were both 25%. The majority of infections were cleared with antibiotics, and ports remained intact. Both types of IVADs were associated with a high patient/parent satisfaction. CONCLUSION: Despite being associated with a significant incidence of infection, we believe the benefits of IVADs for children with hemophilia and their families outweigh the risks. Possible explanations for the observed infection rates are discussed.

Adolescent↗

PubMedDate not supplied

Impact on patient care. 2652 PIC catheter days in the alternative setting.

Management of parenteral therapies in the home or nonacute setting is essential. Peripherally inserted long-line catheters establish venous access in patients in a safe, cost-effective, and improved manner. Data were collected on 130 cases from 24 offices in 16 states. The most frequently occurring types of therapies used were antibiotic, pain control, and parenteral nutrition. Average length of therapy was 20.4 days. The major reasons for catheter removal other than completion of therapy (58%) were occlusion (14%), breakage (5%), and phlebitis (4%).

Adolescent↗

PubMed1995

Peripherally inserted central venous catheters: US-guided vascular access in pediatric patients.

Ultrasound (US)-guided peripheral venipuncture was performed for peripheral insertion of 222 central venous catheters over a 12-month period. Initial placement was successful in 218 patients but unsuccessful in eight; placement was successful in four the next day (success rate, 98%; complication rate, 5%). Catheters were in place from 3 days to 6 months (mean, 36 days). US guidance allowed successful venipuncture for placement of central venous catheters in children.

Adolescent↗

PubMed2006

Venous leg congestion treated with distal venous drainage during peripheral extracorporeal membrane oxygenation.

Distal venous drainage during extracorporeal membrane oxygenation (ECMO) via femoral cannulation is described. It was performed to relieve distal venous congestion due to obstruction by the venous cannula. Venous drainage was performed with an 11 Fr introducer catheter connected as a T to the main venous line. Its effectiveness was confirmed by clinical examination and Doppler ultrasound in a patient presenting with acute myocarditis. In addition to distal limb perfusion during ECMO, this technique appears safe and simple for adequate distal limb drainage, and can be useful in cases where a change of cannulas is not possible.

Catheterization, Peripheral↗

PubMedDate not supplied

[Prevention of infections caused by venous catheters in intensive care units].

The importance of the prevention of infections related to venous catheters comes from the frequent morbility which derives from these devices in ICU and the foresecable increase of infections which are secondary to them with the consequent increase in the load of Nursing work and costs in Spain, bacteriemias related to central catheters are 8%, under 5% for Swan-Ganz and almost inexistent for peripherals. Germs responsible for infectious incidences caused by catheters are basically Staphylococcus coagulase-negative and Staphylococcus aureus. The most affected veins are the jugular, followed by femoral, antecubital, subclavian and peripheral. The colonization of the patient's skin and the connections of catheters are the most frequent origin of infections and, since certain germs create defensive structures which make them more resistant to treatment, it is very important to carry out protocols of prevention and care which should encompass hand washing efficiency, daily care of the wound, use of suitable disinfectants and, very especially, the protection of catheter connections.

Catheterization, Peripheral↗

PubMed1999

Large-volume leukapheresis procedure for peripheral blood progenitor cell collection in children weighing 15 kg or less: efficacy and safety evaluation.

BACKGROUND: We update our experience on large-volume leukapheresis (LVL) in very small patients with malignancies. LVLs were performed with the aim of reducing the psychological impact of leukaphereses by reducing the number of procedures while collecting large numbers of cells. PROCEDURE: Seventeen LVLs were performed using a Cobe Spectra separator in 14 patients weighing < or = 15 kg. A median of 3.8 patient's blood volumes corresponding to 296 mL/kg (range, 202-565) of blood was processed per session of 190 minutes (120-279) duration. A femoral catheter was installed specially for collection for 88% LVL (vs. 35% for standard leukaphereses). A median volume of 16.9 mL/kg was collected with 5.4 x 10(8) MNC/kg (range, 0.6-16.3) and 8.2 x 10(6) CD34+ cells/kg (range, 1.3-31.7). RESULTS: No signs of complications due to citrate toxicity were encountered. No hypotensive or hypothermic episodes were observed. Platelet counts were significantly diminished after each procedure (median: -59%). When the extracorporal line was not primed with red blood cells (RBC), the difference between pre-LVL and post-LVL hemoglobin levels was significant with a median 32 g/L decrease. CONCLUSIONS: The LVL approach for peripheral blood progenitor cells (PBPC) collection in very small children may expose them to the risk of anemia and thrombocytopenia and an excess of special central line installation. The application of this technique in these patients should be reserved for special cases when a very large number of cells must be collected and should be performed by an experienced team.

Anemia↗

PubMed2002

Peripheral aneurysms of the lateral posterior choroidal artery: clinical presentation and endovascular treatment: report of two cases.

OBJECTIVE AND IMPORTANCE: To describe the clinical presentation and endovascular management of peripheral aneurysms of the lateral posterior choroidal artery. Aneurysms in this location are exceptionally rare and optimal treatment may be difficult. CLINICAL PRESENTATION: Two patients with peripheral aneurysms of the distal portion of the lateral posterior choroidal artery presented with headaches from extensive intraventricular hemorrhage. INTERVENTION: Endovascular surgical therapy by use of superselective n-butylcyanoacrylate embolization of the aneurysm and adjacent distal parent artery was successful in both patients. CONCLUSION: Patients with peripheral aneurysms of the lateral posterior choroidal artery usually present with intraventricular hemorrhage. They may be difficult to treat by open surgical techniques owing to their intraventricular location and the frequent inability to preserve the parent artery by aneurysm clipping. Instead, it is typical that either proximal parent artery occlusion or aneurysm trapping must be used. An equivalent endovascular surgical technique may be an attractive alternative method of management.

Adult↗

PubMedDate not supplied

Median nerve bisection: a morbid complication of a peripherally inserted central catheter.

Considering the reported safety, efficiency, and low cost of peripherally inserted central catheters (PICCs), they are increasingly preferred to central venous catheters for short-term delivery of medical therapies. Here, we report a case of severe median nerve bisection during PICC placement via a brachial vein. While such nerve damage is uncommon, the case indicates that when the brachial vein is selected as an access site over the basilic and cephalic veins, caution should be exercised during PICC placement since the brachial vein traverses in close proximity to the median nerve.

Arm↗

PubMed2006

[Arterial and central venous catheters in neonates and infants].

In neonates and infants, arterial and central venous catheters are of vital importance to optimize perioperative surveillance during surgery as well as postoperative care in the intensive care unit. The insertion of umbilical venous (UVC) and umbilical arterial catheters (UAC) in neonates in the first days of life is relatively simple and associated with a low procedure-related risk. As with other centrally placed catheters, correct positioning must be verified and the catheters should not be used for more than 5-7 days. Peripherally inserted central catheters (PICC) are commonly used in neonates and can be an alternative to conventional central venous lines in older infants. In order to minimize the risk associated with catheter malposition, correct position must always be verified by appropriate imaging studies or ECG guidance. Surgically placed Broviac catheters are mainly used in patients with a long-term need for central venous access. Finally, it has been shown that adherence to strict guidelines for insertion and handling can significantly reduce catheter-associated infections.

Catheterization, Central Venous↗

PubMed1993

Vascular catheter-related bloodstream infection due to Acinetobacter johnsonii (formerly Acinetobacter calcoaceticus var. lwoffi): report of 13 cases.

Although Acinetobacter baumannii (formerly Acinetobacter calcoaceticus var. anitratus) is known to be an important nosocomial pathogen, the clinical impact of other Acinetobacter species is not fully understood. Acinetobacter johnsonii (formerly a subset of A. calcoaceticus var. lwoffii) is considered a commensal on human skin, and infections due to this organism have not been reported previously. During a study period of 18 months, however, 13 patients at 6 hospitals developed catheter-related bloodstream infections caused by A. johnsonii. All patients had an indwelling peripheral or central venous catheter, and 11 patients were receiving a continuous intravenous infusion of heparin via the offending catheter. The clinical course of A. johnsonii bacteremia was usually benign. Infections responded readily to removal of the catheter, with or without administration of appropriate antibiotics. No insertion-site infections were documented. Thus A. johnsonii must be regarded as an organism that can cause rare cases of bloodstream infection in immunocompetent patients.

Acinetobacter Infections↗

PubMed1997

Percutaneously implantable catheter-port system: preliminary technical results.

The function and safety of a percutaneously implantable catheter-port system were studied in 44 patients with different diseases (32 patients with malignant disease, 11 with peripheral arterial disease, and one with recurrent asthmatic attacks). Most patients required repeated local-regional arterial infusion. Infection (two patients) and catheter-related complications (10 patients) were observed during the follow-up period (maximum length of follow-up, 542 days; mean, 177 days). Port migration or leakage did not occur. The data suggest that this new catheter-port system is safe and easy to handle.

Adolescent↗