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Intravenous Catheter (intravenous + catheter)

Distribution by Scientific Domains

Medical Sciences	94%

Selected Abstracts

Role of the Peripheral Intravenous Catheter in False-positive D-dimer Testing

ACADEMIC EMERGENCY MEDICINE, Issue 2 2001
Alan C. Heffner MD
Abstract. Objective: To determine whether inserting a peripheral intravenous catheter (IV) can significantly increase the circulating D-dimer concentration. Methods: Twenty healthy young adult volunteers underwent cannulation of an antecubital vein with a 20-gauge Teflon IV. Time 0 venous blood was drawn during IV insertion. The IV was salinelocked and left in place for 90 minutes, at which time a second venipuncture was performed in a contralateral antecubital vein (+90 min). A qualitative D-dimer assay [erythrocyte-agglutination assay, SimpliRED (SRDD)] and a quantitative spectrophotometric assay [enzyme-linked immunosorbent assay (EIA), Dimertest Gold] were performed on all samples. Time 0 means (±SD) were compared with +90 min means by paired t-test, and SRDD pairs were compared with McNemar's test. Results: Time 0 initial venipuncture blood samples yielded a mean D-dimer concentration of 15 ± 24 ng/mL, with 2/20 SRDD tests read as positive (95% CI = 1% to 32%). At +90 min, the D-dimer concentration was 33 ± 21 ng/mL (p = 0.04 vs time 0), with 5/20 SRDD tests read as positive (95% CI = 9% to 49%, p = 0.248). Conclusions: Insertion of an IV increased the circulating D-dimer concentration (determined by EIA), but did not lead to a significant increase in false-positive conversion of the SRDD. An effort should be made to perform D-dimer testing on "first-stick" blood to optimize specificity. However, a strongly positive D-dimer reaction cannot be ascribed to the presence of an IV. [source]

A NEW HAEMODIALYSIS CATHETER-LOCKING AGENT REDUCES INFECTIONS IN HAEMODIALYSIS PATIENTS

JOURNAL OF RENAL CARE, Issue 3 2008
Caroline Taylor
SUMMARY Background: Intravenous catheters for haemodialysis increase the risk of sepsis. This study investigates the use of a taurolidine/citrate catheter-locking agent for patients receiving hospital-based haemodialysis, auditing the number and cost of infections before and after its introduction. Methods: The incidence and cost of treatment of catheter sepsis occurring in all patients receiving haemodialysis via a line were investigated over 6-month periods before and after introducing the taurolidine/citrate line-locking agent. Results: A reduction of 4.62 infections per 1000 catheter days, or 88.5%, was shown after the introduction of the new line-locking agent. The total costs of line infections in the first 6 months were ,52 500, (£41 000); after the introduction of the taurolidine/citrate locks, these reduced to ,33 300, (£26 000), a reduction of ,19 200 (£15 000). Conclusions: The use of a taurolidine/citrate haemodialysis catheter-locking agent in our haemodialysis population has significantly reduced the line sepsis rate, with a positive impact on morbidity, mortality and cost. [source]

Heart Rate Response to Intravenous Catheter Placement

ACADEMIC EMERGENCY MEDICINE, Issue 9 2003
Joel M. Bartfield MD
Abstract Objective: To investigate the relationship between change in heart rate and pain and anxiety caused by intravenous catheter (IV) placement. Methods: An observational study was performed in a university-based tertiary care emergency department. Patients who required IV placement as part of their management were considered as possible subjects. Heart rates were recorded at the following times: baseline, tourniquet placement, and IV placement. Immediately after IV placement, subjects recorded pain and anxiety scores using 100-mm visual analog scales. Percentage change in heart rate (compared with baseline) was calculated at time of tourniquet placement (anxiety) and IV placement (pain). Simple linear regression analyses were performed comparing pain scores with percent change in heart rate at the time of IV and tourniquet placement. Significance was defined as p < 0.05. Results: Ninety subjects were enrolled. Subjects had a mean age of 48 years, and 54% were women. There was a normal distribution of heart rate changes, with greater than 80% of all subjects having a 10% or less change in heart rates. The results of the analysis of pain scores versus percentage change in heart rate at IV placement yielded a Pearson correlation coefficient of 0.13 (p = 0.2). The results of the analysis of anxiety scores versus percentage change in heart rate at tourniquet placement yielded a Pearson correlation coefficient of 0.014 (p = 0.9). Conclusions: Changes in heart rate do not correlate with pain and anxiety associated with IV placement. [source]

Role of the Peripheral Intravenous Catheter in False-positive D-dimer Testing

Two-thumb vs Two-finger Chest Compression in an Infant Model of Prolonged Cardiopulmonary Resuscitation

ACADEMIC EMERGENCY MEDICINE, Issue 10 2000
Michele L. Dorfsman MD
Abstract. Objective: Previous experiments in the authors swine lab have shown that cardiopulmonary resuscitation (CPR) using two-thumb chest compression with a thoracic squeeze (TT) produces higher blood and perfusion pressures when compared with the American Heart Association (AHA)-recommended two-finger (TF) technique. Previous studies were of short duration (1-2 minutes). The hypothesis was that TT would be superior to TF during prolonged CPR in an infant model. Methods: This was a prospective, randomized crossover experiment in a laboratory setting. Twenty-one AHA-certified rescuers performed basic CPR for two 10-minute periods, one with TT and the other with TF. Trials were separated by 2-14 days, and the order was randomly assigned. The experimental circuit consisted of a modified manikin with a fixed-volume arterial system attached to a neonatal monitor via an arterial pressure transducer. The arterial circuit was composed of a 50-mL bag of normal saline solution (air removed) attached to the manikin chest plate and connected to the transducer with a 20-gauge intravenous catheter and tubing. Rescuers were blinded to the arterial pressure tracing. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded in mm Hg, and pulse pressures (PPs) were calculated. Data were analyzed with two-way repeated-measures analysis of variance. Sphericity assumed modeling, with Greenhouse-Geisser and Huynh-Feldt adjustments, was applied. Results: Marginal means for TT SBP (68.9), DBP (17.6), MAP (35.3), and PP (51.4) were higher than for TF SBP (44.8), DBP (12.5), MAP (23.3), and PP (32.2). All four pressures were significantly different between the two techniques (p , 0.001). Conclusion: In this infant CPR model, TT chest compression produced higher MAP, SBP, DBP, and PP when compared with TF chest compression during a clinically relevant duration of prolonged CPR. [source]

Fallacies of High-Speed Hemodialysis

HEMODIALYSIS INTERNATIONAL, Issue 2 2003
Zbylut J. Twardowski
Chronic hemodialysis sessions, as developed in Seattle in the 1960s, were long procedures with minimal intra- and interdialytic symptoms. Financial and logistical pressures related to the overwhelming number of patients requiring hemodialysis created an incentive to shorten dialysis time to four, three, and even two hours per session in a thrice weekly schedule. This method spread rapidly, particularly in the United States, after the National Cooperative Dialysis Study suggested that time of dialysis is of minor importance as long as urea clearance multiplied by dialysis time and scaled to total body water (Kt/Vurea) equals 0.95,1.0. This number was later increased to 1.3, but the assumption remained unchanged that hemodialysis time is of minimal importance as long as it is compensated by increased urea clearance. Patients accepted short dialysis as a godsend, believing that it would not be detrimental to their well-being and longevity. However, Kt/Vurea measures only removal of low molecular weight substances and does not consider removal of larger molecules. Besides, it does not correlate with the other important function of hemodialysis, namely ultrafiltration. Whereas patients with substantial residual renal function may tolerate short dialysis sessions, the patients with little or no urine output tolerate short dialyses poorly because the ultrafiltration rate at the same interdialytic weight gain is inversely proportional to dialysis time. Rapid ultrafiltration is associated with cramps, nausea, vomiting, headache, fatigue, hypotensive episodes during dialysis, and hangover after dialysis; patients remain fluid overloaded with subsequent poor blood pressure control, left ventricular hypertrophy, diastolic dysfunction, and high cardiovascular mortality. Short, high-efficiency dialysis requires high blood flow, which increases demands on blood access. The classic wrist arteriovenous fistula, the access with the best longevity and lowest complication rates, provides "insufficient" blood flow and is replaced with an arteriovenous graft fistula or an intravenous catheter. Moreover, to achieve high blood flows, large diameter intravenous catheters are used; these fit veins "too tightly," so predispose the patient to central-vein thrombosis. Longer hemodialysis sessions (5,8 hrs, thrice weekly), as practiced in some centers, are associated with lower complication rates and better outcomes. Frequent dialyses (four or more sessions per week) provide better clinical results, but are associated with increased cost. It is my strong belief that a wide acceptance of longer, gentler dialysis sessions, even in a thrice weekly schedule, would improve overall hemodialysis results and decrease access complications, hospitalizations, and mortality, particularly in anuric patients. [source]

The three-way stopcock may be a weak component of total intravenous anaesthesia

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009
A. ZECHA-STALLINGER
Background: An intravenous line is needed to administer anaesthesia, particularly when total intravenous anaesthesia (TIVA) is performed. A disadvantage of TIVA is that the intravenous concentration of anaesthetics cannot be easily measured compared with volatile anaesthetics. If a three-way stopcock is accidentally unscrewed, TIVA drugs cannot reach the patient's veins, thus resulting in inadequate anaesthesia levels, possibly resulting in awareness. We therefore measured the required torque to open five different brands of three-way stopcocks in an attempt to make an intravenous-line including all elements safer. Methods: The torque required to open one, two or three three-way stopcocks being connected in a perpendicular manner was measured with a biaxial servo hydraulic material testing machine. Results: The force required to open three-way stopcocks connected with an intravenous catheter ranged in five different stopcock models from 5.03±0.75 to 2.21±0.51 N respectively; with two three-way stopcocks from 2.68±0.42 to 1.31±0.59 N, respectively, and with three three-way stopcocks from 1.29±0.27 to 0.82±0.05 N, respectively. Conclusion: Turning a three-way stopcock to become loose with possibly leaking drugs requires minimal amounts of force and decreases significantly if not connected in-line. [source]

Ascites in infants with severe sepsis , treatment with peritoneal drainage

PEDIATRIC ANESTHESIA, Issue 12 2006
ANDRZEJ PIOTROWSKI MD PhD
Summary Background:, Ascites in neonates and infants is usually caused by cardiac failure and urinary or biliary tract obstruction. The objective of this study was to characterize our experience with ascites as a complication of sepsis. Methods:, We retrospectively collected and analyzed data of patients treated in the intensive care unit (ICU) of the university-based children's hospital, in whom ascites developed during nosocomial sepsis. Ten infants admitted to the ICU in the first 2 days of life developed sepsis on the mean 31.5 (±21.9) postnatal day. Gram-negative bacteria were the causative organism in nine cases, and Staphylococcus hemolyticus in one. Because of sepsis, reintubation and mechanical ventilation were necessary. All patients received broad spectrum antibiotics (including meropenem and ciprofloxacin), blood transfusions, catecholamines and intravenous immunoglobulin preparations. Ascites was observed on the median 13.5 day of sepsis (range 3,36), and severely compromised gas exchange. Continuous peritoneal drainage was applied by means of an intravascular catheter placed in the right lower abdominal quadrant. Results:, The mean drained fluid volume was 44.7 (±20.4) ml·kg,1·day,1, drainage was continued for a median of 5.5 (range 1,56) day, and enabled significant reduction of ventilator settings 24 h after its implementation. No severe complications related to drainage occurred; six of 10 babies survived. Conclusions:, Ascites can develop in infants with sepsis and cause respiratory compromise. Continuous drainage of ascitic fluid by means of an intravenous catheter is relatively safe and can improve gas exchange. [source]

A leaking Biovalve intravenous catheter

ANAESTHESIA, Issue 6 2000
J. C. J. Wright
First page of article [source]

A possible role of central serotonin in L-tryptophan-induced GH secretion in cattle

ANIMAL SCIENCE JOURNAL, Issue 3 2010
Etsuko KASUYA
ABSTRACT To clarify the role of serotonin (5-HT) in the regulatory mechanism of L-tryptophan (TRP)-induced growth hormone (GH) secretion in cattle, changes in 5-HT concentrations in the cerebrospinal fluid (CSF) in the third ventricle (3V) and GH in plasma before and after the peripheral infusion of TRP were determined simultaneously. The direct effect of TRP on GH release from the dispersed anterior pituitary cells was also assessed. A chronic cannula was placed in 3V by stereotaxic surgery, then CSF and blood were withdrawn under physiological conditions. TRP (38.5 mg/kg BW) was infused through an intravenous catheter from 12.00 to 14.00 hours and CSF and blood sampling were performed from 11.00 to 18.00 hours at 1-h intervals. The concentration of 5-HT in CSF was determined by high-performance liquid chromatography with electrochemical detection. GH, melatonin (MEL), and cortisol (CORT) concentrations were measured by radio-immunoassay and enzyme-immunoassay. Concentrations of 5-HT were increased by TRP infusion. The TRP infusion significantly increased GH release. On the other hand, TRP did not stimulate GH release from the bovine pituitary cells. MEL and CORT concentrations were not altered by TRP infusion. These results suggest that TRP induced GH release via the activation of serotonergic neurons in cattle. [source]

Fallacies of High-Speed Hemodialysis

Predisposing factors to phlebitis in patients with peripheral intravenous catheters: A descriptive study

JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2008
Esin Uslusoy BSN, MS (Research Assistant)
Abstract Purpose: The purpose of this study was to investigate the predisposing factors in the development of phlebitis in peripheral intravenous (IV) catheterization sites in patients treated with a variety of IV infusion solutions and drugs. Data sources: Systematic observation of 568 IV sites inserted for fluid infusion and drug administration in 355 patients in the Department of General Surgery of a University Hospital in Turkey. A data collection tool was based on standards established by the Infusion Nurses Society. Patients' infusion sites were monitored every 24 h during treatment and for 48 h after discontinuation of the IV. Conclusions: In contrast to the usual findings in the literature, the authors found that infusion through an infusion pump and insertion of catheters in the veins around the elbow increased the risk of phlebitis. Also, the number of times infusions were started led to an increased rate of phlebitis. However, conflicting results were obtained about the relation between phlebitis, gender, and catheter size. Implications for practice: Phlebitis causes sepsis, pain, additional diagnostic investigations, and treatments, and may lead to increased duration of hospitalization, patient's stress level, and financial burden, as well as increasing staff workload. Advanced practice nurses need to be aware of the factors that increase the likelihood of phlebitis and take appropriate measures to prevent it. [source]

COMPARISON OF SIX NON-INVASIVE SUPPLEMENTAL OXYGEN TECHNIQUES IN DOGS AND CATS

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue S1 2004
MH Engelhardt
Objective: To determine the amount of time required to reach the highest concentrations of oxygen at the patient's face and to determine what these highest concentrations of oxygen were with various non-invasive methods of providing supplemental oxygen using a commercial oxygen content analyzer. Procedure: Three healthy cats and 3 healthy dogs were each individually given supplemental oxygen by 6 different means, each done at 2 rates (5 L and 15 L per minute). The methods tested were: 1) Plastic sheet over conventional cage door (PSCD); 2) Blow-by where the tubing delivering the oxygen was held 8 cm from the face (BB); 3) Large plastic bag covering the patient (BAG); 4) Anesthesia induction chamber (AIC); 5) Synder oxygen cage (SOC); and 6) Crowe Oxygen E-Collar (COC). Prior to the testing, the commercial oxygen content analyzer (Mini-Ox) was calibrated. Results: Significant repeatable differences were consistently observed between the 6 methods of oxygen delivery. Results of both 5 L and 15 L/min oxygen flow rates consistently indicated that the highest oxygen concentrations were achieved with the anesthesia induction chamber and large plastic bag with oxygen concentrations reaching approximately 95% and 90%, respectively between 5 to 15 min. The BAG method had the advantage of allowing additional room for patient manipulation and the ability to place intravenous catheters while continuing to give supplemental oxygen. The plastic sheet covering a conventional cage door provided oxygen concentrations of 50% and 60% at 15 and 45 min, respectively. The Crowe Oxygen E-Collar achieved oxygen concentrations of 70% in 1.5 min. Blow-by was found to be the simplest method. It increased FiO2 to 40% within 2 min. The Synder oxygen cage was able to achieve 45% oxygen concentration within 30 min with an oxygen flow rate of 15 L/min. It was able to achieve 60% at 45 min (similar to the plastic bag on the cage). Conclusion: The order of effectiveness of providing non-invasive oxygen supplementation, from the highest to the lowest concentrations, was AIC, BAG, COC, PSCD, SOC, and BB. The fastest to the slowest increases in oxygen concentrations followed the same order at both 5 L and 15 L/min oxygen flow rate and they were BB, COC, AIC, BAG, PSCD, and SOC. SOC was the most inefficient means of providing oxygen while AIC, BAG and COC were the most efficient. [source]

Simple, reliable replacement of pilot balloons for a variety of clinical situations

PEDIATRIC ANESTHESIA, Issue 6 2010
PETE G. KOVATSIS md
Summary When a pilot balloon fails or is an impediment to an intubation, such as via a pediatric laryngeal mask, options are generally limited to a tracheal tube exchange. Simple and effective solutions are described to replace a pilot balloon in a variety of clinical situations by using equipment that is readily available in operating rooms. Equipment such as intravenous catheters or epidural clamp connectors provides reliable, light weight, and streamlined substitutions for pilot balloons when connected to the pilot-cuff inflation line. [source]

Superior vena cava syndrome related to indwelling intravenous catheters in patients with cystic fibrosis

PEDIATRIC PULMONOLOGY, Issue 7 2006
Susan Garwood MD
Abstract Patients with cystic fibrosis (CF) often need long-term implanted vascular-access devices for intravenous antibiotics for chronic lower respiratory tract infections. These devices are not without complications, including infection, occlusion, and vascular thrombosis. Such thrombosis can result in superior vena cava (SVC) syndrome due to the position of the catheter proximal to the right atrium. SVC syndrome in CF patients, however, is rarely reported in the literature, suggesting that its incidence is uncommon. We describe three patients with SVC syndrome as a consequence of implanted vascular-access devices. Pediatr Pulmonol. 2006; 41: 683,687. © 2006 Wiley-Liss, Inc. [source]

Flow Visualization Study of a Novel Respiratory Assist Catheter

ARTIFICIAL ORGANS, Issue 6 2009
Stephanus G. Budilarto
Abstract Respiratory assist using intravenous catheters may be a potential therapy for patients with acute and acute-on-chronic lung failure. An important design constraint is respiratory catheter size, and new strategies are needed that enable size reduction while maintaining adequate gas exchange. Our group is currently developing a percutaneous respiratory assist catheter (PRAC) that uses a rotating bundle of hollow fiber membranes to enhance CO2 removal and O2 supply with increasing bundle rotation rate. In this study, particle image velocimetry (PIV) was used to analyze the fluid flow patterns and velocity fields surrounding the rotating fiber bundle of the PRAC. The goal of the study was to assess the rotational flow patterns within the context of the gas exchange enhancement that occurs with increasing fiber bundle rotation. A PRAC prototype was placed in a 1-in. internal diameter test section of an in vitro flow loop designed specifically for PIV studies. The rotation rate of the PRAC was varied between 500 and 7000 rpm, and PIV was used to determine the velocity fields in the primary (r -,) and secondary (r - z) flow planes. The secondary flow exhibited time-varying and incoherent vortices that were consistent with the classical Taylor vortices expected for Taylor numbers (Ta) corresponding to the rotation speeds studied (2200 < Ta < 31 000). In the primary flow, the tangential velocity exhibited boundary layers of less than ½ mm adjacent to the fiber bundle and vessel wall. The estimated shear stress associated with the Taylor vortices was approximately 11 dyne/cm2 at 7000 rpm and was over 10 times smaller than the shear stress in the primary flow boundary layers. [source]

Infective endocarditis in Greece: a changing profile.

CLINICAL MICROBIOLOGY AND INFECTION, Issue 6 2004
Epidemiological, microbiological, therapeutic data
Abstract The epidemiology, and clinical and microbiological spectrum, of infective endocarditis (IE) in Greece was analysed in a prospective 4-year study in a tertiary hospital and a heart surgery centre in Athens. In total, 101 cases of IE (71 men, 30 women, aged 54.4 ± 17.1 years) were studied, with a follow-up period of 3 months. Seventy-seven cases were definite and 24 possible; 59 involved native valves (native valve endocarditis; NVE), 31 prosthetic valves (prosthetic valve endocarditis; PVE), of which nine were early and 22 late, and 11 permanent pacemakers (pacemaker endocarditis; PME). There was a predominant involvement of aortic (48/101) and mitral (40/101) valves. Seven patients had rheumatic valvular disease, two had mitral valve prolapse, and eight had a previous history of IE. Thirteen and six patients had undergone dental and endoscopic procedures, respectively. In 13 patients, intravenous catheters were used within the 3 months before diagnosis of IE. There were three intravenous drug users among the patients. Staphylococcus aureus was the most important pathogen, isolated in 22% of cases, followed by viridans streptococci (19%) and coagulase-negative staphylococci (16%). Enterococcus spp. were responsible for 3%, HACEK group for 2%, and fungi for 6% of cases. Viridans streptococci were the leading cause of NVE (29%), Staphylococcus epidermidis of PVE (16%), and S. aureus of PME (54.5%). Six of 22 S. aureus and ten of 16 S. epidermidis isolates were methicillin-resistant. Surgical intervention, including total pacemaker removal, was performed in 51.5% of patients. Overall mortality was 16%, but was 29% with PVE, and was significantly higher with medical than with combined surgical and medical therapy (24.5% vs. 8%). Compared with previous studies, there were changing trends in the epidemiology, microbiology, treatment and prognosis of IE in Greece. [source]