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Results for “Catheterization, Peripheral”

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At least 19 recordsLinked to original sources
PubMed1992

Umbilical vs peripheral vein catheterization for parenteral nutrition in sick premature neonates.

The efficacy and safety of using umbilical venous catheters vs. peripheral venous catheters for the delivery of parenteral nutrition was studied in 129 critically ill premature infants who were treated in a neonatal intensive care unit for the first 3 weeks of life. Infants who received parenteral nutrition by umbilical venous catheter had greater parenteral caloric intake, lower physiologic weight loss and greater weight gain during the study as compared to infants who received parenteral nutrition by peripheral vein. While the overall incidence of sepsis was comparable in both groups (19% vs 19.7%), benign and transient episodes of hyperglycemia were seen more commonly in infants receiving parenteral nutrition by umbilical catheters. None of the hyperglycemic infants, however, required insulin therapy. The incidence of other metabolic complication was comparable in both groups. At follow up, no evidence of portal hypertension was detected in any of the infants up to 66 months of age treated with umbilical venous catheters. We conclude that the use of umbilical venous catheter allows for a comparably safe and a more appropriate parenteral nutrition support than peripheral catheters in critically ill premature neonates.

Catheterization, Peripheral↗
PubMed1989

[Peripheral venous catheterization: influence of catheter composition on the occurrence of thrombophlebitis].

Infusion thrombophlebitis is a common troublesome complication of intravenous therapy. This study compared peripheral intravenous Teflon and Vialon catheters. The incidence of phlebitis, bacterial adherence and mechanical resistance (distortion) were assessed on 170 catheters, 85 of each type. The Vialon catheter resulted in less phlebitis than the Teflon one (18 vs. 35; p less than 0.01). During the period 49 to 72 h after the insertion of the catheter, the risk of phlebitis in the Teflon group was twice that in the Vialon group. The study of bacterial adherence using a semi-quantitative culture method demonstrated that 9.0% of the catheters were infected with Staphylococcus epidermidis. There was no statistically significant difference between the two groups (5.7% Vialon group vs. 12.5% Teflon group). The Teflon catheters were much more distorted than vialon catheters: 1.7% vs. 55.7% in the macroscopic study; 1.75% vs. 8.2% in the microscopic study. As Vialon softens at body temperature, it would seem likely that it generates a lesser degree of endothelial injury, explaining the lower rate of phlebitis with Vialon catheters.

Actuarial Analysis↗
PubMed1978

[Selective catheterization of peripheral arteries for the monitoring of patients in intensive care units].

In critical ill patients, determination of blood gases is a crucial part of patient evaluation and management. In intensive care situations many blood-gas determinations are required in a single day. The introduction of an arterial catheter into a small peripheral artery is an invaluable technique that allows continuous blood-sampling. During the past three years we had catheterized either the radial, ulnar or the pedal artery in 450 instances. The arterial catheter was left in place from 1 to 15 days. There were no serious complication. Haemorrhage due to accidental opening of the catheter occurred in three occasions. No case of ischaemia was encountered after a single artery catheterization. Temporary ischaemia of the upper limb appeared in three patients after simultaneous catheterization of both ulnar and radial arteries. The infection rate was nil. Arterial catheterization and maintenance of indwelling catheter for repeated blood-samples is a simple and safe procedure with minimal complications, invaluable in the management of critical ill patients.

Acid-Base Equilibrium↗
PubMed1989

Closed intravenous administration of gonadotropin-releasing hormone: safety of extended peripheral intravenous catheterization.

The use of pulsatile gonadotropin-releasing hormone is an effective means of inducing ovulation, but requires prolonged intravenous (IV) or subcutaneous administration. We hypothesized that the use of self-contained infusion pumps using fluids maintained in a closed system would permit safe peripheral IV administration of gonadotropin-releasing hormone, and possibly other hormones, over prolonged intervals. Thirty-eight female patients undergoing pulsatile IV gonadotropin-releasing hormone therapy were followed for 1958 catheter days (230 catheters). Catheters were removed for signs of local inflammation, at the completion of a treatment episode or, initially, at routine intervals of 7-10 days. There were no episodes of fever (temperature over 37.5C) and three episodes of local inflammation. The incidence of significant catheter-tip cultures was 11%, and none were associated with local inflammation. There were four positive blood cultures (2%), none associated with local or systemic signs of infection. We conclude that the use of a closed system of prolonged peripheral IV cannulation is relatively safe when combined with fastidious care of the catheter site and careful outpatient monitoring for long-term administration of pulsatile gonadotropin-releasing hormone.

Adult↗
PubMed1989

Hemodynamic monitoring in childhood.

Hemodynamic monitoring is indicated in children with impending or manifest cardiocirculatory failure. Since cardiocirculatory failure is characterized by an imbalance between oxygen delivery and oxygen demand due to perfusion failure, the parameters monitored should aid in the assessment of these oxygen variables. Oxygen delivery depends on oxygen content and cardiac output. Cardiac output is determined by heart rate and stroke volume; stroke volume by preload, afterload and contractility. Since the direct measurement of oxygen consumption routinely is almost impossible, global oxygen utilization represented by mixed venous oxygen saturation may be used to quantify the relationship between oxygen delivery and oxygen consumption. Justification of invasive hemodynamic monitoring depends among other things on an optimal balance between usefulness of information and complications associated with the techniques used. In future, the development of further noninvasive techniques and the scientific evaluation of recommended monitoring techniques are prospects in cardiovascular monitoring in childhood.

Cardiac Output↗
PubMed1991

Central venous pulsations associated with a falsely low oxygen saturation measured by pulse oximetry.

Venous pulsations are thought, but to our knowledge have never been demonstrated, to result in underestimation of oxygen saturation measured by pulse oximetry (SpO2); however, to our knowledge, this has never been demonstrated. A patient with ischemic cardiomyopathy requiring intra-aortic balloon counterpulsation (IABC) had to withstand a temporary cessation of IABC (period I), during which she had marked central venous pulsations and a pulse oximeter bias of -18%. After IABC was reinstituted (period II), the venous pulsations disappeared and the bias was reduced to 0%. Cardiac output, systemic vascular resistance, and temperature during both periods were comparable. Pulmonary vascular resistance, however, was much lower during period II. We postulate that the bias was caused by venous pulsations significantly contributing to the AC, or variable component, of light absorption.

Aged↗
PubMed2026

Safety and efficacy of distal versus conventional radial artery cannulation for invasive blood pressure monitoring: a systematic review and meta-analysis.

To compare the safety and effectiveness of distal radial artery (DRA) versus conventional radial artery (CRA) catheterization for invasive arterial blood pressure monitoring. This meta-analysis followed PRISMA guidelines. Randomized controlled trials published up to December 30, 2025 were systematically searched in PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, CNKI, Wanfang, VIP, and SinoMed. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Meta-analyses were conducted using Review Manager 5.4 and Stata 18.0, and evidence quality was evaluated with the GRADE system. 12 randomized controlled trials (RCTs) involving 1,790 participants were included. For the primary outcomes, compared with CRA, DRA was associated with lower incidences of haematoma (RR = 0.42, 95% CI: 0.24-0.73), catheter blockage (RR = 0.33, 95% CI: 0.14-0.81), and bleeding (RR = 0.25, 95% CI: 0.11-0.59), but a longer catheter insertion time (MD = 26.89, 95% CI: 5.28-48.50). For the secondary outcomes, DRA was associated with a shorter haemostasis time and reduced waveform instability, with no significant differences in first-attempt success rate or pain scores. Subgroup analysis showed a higher first-attempt success rate in patients aged ≤ 65 years (RR = 1.14, 95% CI: 1.02-1.28). DRA catheterization for invasive arterial blood pressure monitoring appears to be associated with fewer complications and more stable arterial waveform acquisition than CRA catheterization, despite a longer insertion time. DRA may represent a feasible alternative in surgical and intensive care settings; however, further high-quality studies are needed to confirm its long-term safety and generalizability.

Humans↗
PubMed1992

Effects of smoking on survival and morbidity in patients randomized to medical or surgical therapy in the Coronary Artery Surgery Study (CASS): 10-year follow-up. CASS Investigators.

OBJECTIVES: The goal of this study was to ascertain how continued cigarette smoking or smoking cessation related to long-term survival and morbidity in patients with established coronary artery disease managed with medical therapy or coronary bypass surgery. BACKGROUND: Although the association of cigarette smoking with coronary artery disease is well established, the morbidity and mortality associated with smoking behavior in patients with such disease receiving medical or surgical therapy are less well established. METHODS: The 780 patients randomized to medical therapy or coronary bypass surgery in the Coronary Artery Surgery Study (CASS) were subgrouped according to smoking behavior during a mean 11.2-year follow-up interval. Comparisons between smokers and nonsmokers were accomplished by univariate and Cox time-dependent multivariate analyses. RESULTS: Survival at 10 years after entry into the study was 82% among 468 patients who reported no smoking during follow-up (nonsmokers) compared with 77% among the 312 smokers (p = 0.025). Survival was 80% among those who smoked at entry but stopped (quitters) versus 69% among those who continued smoking (p = 0.025). For patients who smoked at baseline and were randomized to bypass surgery, survival at 10 years was 84% among quitters and 68% among nonquitters (p = 0.018); the difference in survival between quitters (75%) and nonquitters (71%) was less among those randomized to medical therapy (p = NS). Among those who smoked at baseline, continued smoking increased the relative risk of death by 1.73. After 10 years, smokers, in comparison with nonsmokers, were less likely to be angina free and more likely to be unemployed and had more activity limitation and more hospital admissions (primarily for chest pain, heart attack, cardiac catheterization, peripheral vascular surgery and stroke). CONCLUSIONS: Thus, among patients with documented coronary artery disease, continued cigarette smoking may result in decreased survival--especially among those undergoing bypass surgery. Moreover, smokers have more angina, more unemployment, a greater limitation of physical activity and more hospital admissions.

Coronary Artery Bypass↗
PubMed1992

Thermodilution cardiac output: comparison between automated and manual injection of indicator.

In clinical practice, cardiac output (CO) is usually reported as the average of thermodilution determinations with injection of the thermal indicator performed at end-exhalation. However, an average of multiple determinations with injections equally dispersed throughout the respiratory cycle has been shown to provide the best estimate of mean CO. This study sought to determine the reproducibility of CO determinations obtained with manual injections of indicator solution performed at end-exhalation, compared with those determined by computer-controlled injections equally dispersed throughout the breathing cycle of 27 patients undergoing cardiac operations. Mean CO was calculated by averaging the four determinations obtained with each technique before induction of anesthesia, after induction of anesthesia, after sternotomy, after cardiopulmonary bypass, and after sternal closure. A total of 130 pairs of mean CO estimations were obtained with manual and automated injections. Mean CO values obtained with manual injections were significantly lower than those obtained with the dispersed injection technique (5.0 +/- 1.4 L/min vs 5.3 +/- 1.6 L/min, P = 0.002). The bias between CO values measured with the manual technique was -0.25 +/- 0.47 L/min lower than those obtained with the dispersed technique. The mean relative bias for the group was 7 +/- 18% with 95% confidence intervals of +/- 26%. During mechanical ventilation, the thermodilution technique with manual injection of indicator solution significantly underestimated CO. Variability in the manual injection technique and inappropriate representation of the mean CO by injections timed to occur at end-exhalation contributed to the disparity. These results indicate that the manual technique of determining CO at end-exhalation may not accurately reflect the average CO.

Anesthesia, General↗
PubMed1992

Bacteremia and fungemia of unknown origin in adults.

Two hundred fifteen (23%) of 955 episodes of bacteremia (defined as including fungemia) detected in adult patients during 2 years were of unknown origin. Sixty-six percent of episodes of unknown origin were hospital acquired. The median age of patients with bacteremia of unknown origin was 65 years, and their most common underlying disorders were solid malignancy (28% of patients) and diabetes mellitus (18%). Only three factors were associated with bacteremia of unknown origin (as opposed to episodes with a known source): peripheral venous catheterization, hemodialysis, and plasmapheresis. Gram-negative bacteria were isolated from the blood in 62% of episodes of unknown origin; 10% of episodes were polymicrobial. Staphylococci were isolated from 67% of patients undergoing hemodialysis and from 37% of those with diabetes; Pseudomonas species from 15% of patients with hospital-acquired episodes; and Candida species from 21% of patients with a central venous catheter. Fifteen percent of episodes in cancer patients were polymicrobial. Empirical antibiotic treatment was inappropriate in 49% of episodes of unknown origin and in 35% of episodes with a known source (P less than .001). Death rates were 44% and 25% in episodes of unknown and known origin, respectively. An unknown source of bacteremia was independently associated with a fatal outcome.

Adolescent↗
PubMed1990

Obtaining reliable plasma sodium and glucose determinations from pulmonary artery catheters.

In critically ill patients, blood specimens are frequently withdrawn from intravascular catheters without consideration of possible infusate contamination, of test accuracy, or of undue blood loss. The reliability of sodium (Na+) and glucose determinations withdrawn from the venous infusion port of a pulmonary artery catheter was studied in 30 patients after cardiac surgery. Catheter patency was maintained by a saline and heparin infusate. Venipuncture samples for Na+ and glucose served as controls. A sample containing the dwell volume of the catheter and the stopcock (1 ml) was withdrawn and discarded, followed by fifteen 1 ml samples being taken for analysis. It was concluded that Na+ values are stable after discard of the catheter dwell volume and an additional milliliter of blood. Minimal clinical differences were found in the glucose values after discard of the catheter dwell volume and two additional milliliters of blood.

Adult↗