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Long-term Catheter (long-term + catheter)
Selected AbstractsExchanging dual-lumen central venous catheters: How I do itJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 2 2007I Chaitowitz Summary The management of a blocked long-term central venous catheter has traditionally been removal and re-siting, even when device failure is not associated with venous thrombosis or sepsis. It is not possible to ,railroad' a split dual-lumen central venous catheter down a long tortuous s.c. tunnel. Our exchange technique was designed to salvage the tunnel and venous access site in a long-term catheter that has had uncomplicated primary device failure. In this technique we divide the dual-lumen catheter and secure the venous access site and the s.c. tunnel with separate peel-away sheaths. The new catheter is then introduced in the conventional manner through the two peel-away sheaths, which are then removed. The key advantage of the technique is that it preserves one of the few central venous access sites available. This article describes exchange of an internal jugular catheter, but the same technique is applicable to subclavian catheters. [source] A model to quantify encrustation on ureteric stents, urethral catheters and polymers intended for urological useBJU INTERNATIONAL, Issue 4 2000S.K.S. Choong Objective To validate an encrustation model and to quantify encrustation on currently used urological devices and polymers intended for urological use. Materials and methods An encrustation model was validated: (i) to measure the amount of calcium leaching from the glass model and from the polymer used; (ii) to determine whether the use of a single-source or pooled urine produced similar results; (iii) to determine in vitro encrustation; and (iv) to compare the results of in vivo implantation of the same materials into the bladders of rodents with the in vitro results. A test polymer (a ureteric stent, a urethral catheter or a biomaterial) and a control silicone polymer were housed separately but received human urine from the same reservoir and under the same conditions (pH 6.0 and 37 °C) for 5 days. The amount of calcium encrustation on each polymer was measured using atomic absorption spectroscopy. Each experiment was repeated at least four times and the results expressed as an encrustation index, defined as the ratio of encrustation of the test and reference polymers. Results The amount of calcium leaching from the glass model and polymers tested was insignificant. The use of a single-source or pooled urine gave the same results in the encrustation model. The in vitro results correlated with in vivo implantation of disks into the bladders of rats. Among the commonly used ureteric stents tested, the Cook C-Flex ureteric stents encrusted least. Hydrogel-coated ureteric stents encrusted more than uncoated stents. The Bard polytetrafluoroethylene short-term urethral catheter encrusted more than the Bard hydrogel-coated long-term catheter. A plasma-activated surface modification of a synthetic biomaterial with hyaluronic acid encrusted less than silicone, a long-term biomaterial widely regarded as the ,gold standard'. Conclusion This validated encrustation model is the first to quantify encrustation on currently available ureteric stents and urethral catheters. A novel coating for a biomaterial was identified using the encrustation model, and which encrusted less than silicone. [source] Long-term pericardial catheterization is associated with minimum foreign-body responseCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2007Carlo R. Bartoli BS Abstract Objectives: The goals of this study were to assess the feasibility and to characterize the foreign-body response of a long-term catheter in the pericardium. Background: Long-term access to the normal pericardial space provides opportunities for diagnostic sampling and therapeutic intervention. Methods: After thoracotomy, in 7 anesthetized canines, the pericardium was opened and a 5 French silicone vascular access catheter was advanced 10 cm into the pericardial sac toward the apex of the heart. A hydraulic coronary balloon occluder was implanted (N = 6). Pericardium was sealed with Prolene suture. Catheters were tunneled to the nape of the neck, attached to a subcutaneous vascular access port, and buried in the fascia. Animals underwent multiple experimental coronary artery occlusions across months. At sacrifice, we assessed the histopathological response of pericardium and epicardium to chronically indwelling silicone catheters. Results: Post-mortem examinations were performed at 213 days post-operatively (mean, range = 96,413, N = 6), with one animal maintained for longer-term study. At sacrifice, all catheters were bidirectionally patent and completely mobile in the pericardium without evidence of tissue overgrowth around the intrapericardial segment. Adhesion tissue was found only at the site of catheter entry through the pericardium. Microscopic histopathological examination at catheter entry site, surrounding pericardium, and myocardium revealed minimum chronic inflammation. Conclusions: This subcutaneous system provides dependable, chronic access to the normal pericardial space for drug delivery and sampling. The presence of a chronic silicone catheter in the pericardium does not precipitate clinically significant pathologic changes even after repeated ischemic events. © 2007 Wiley-Liss, Inc. [source] Septicaemia due to glucose non-fermenting, Gram-negative bacilli other than Pseudomonas aeruginosa in childrenACTA PAEDIATRICA, Issue 3 2002S Ladhani Bloodstream infections due to non-fermenting Gram-negative bacilli other than Pseudomonas aeruginosa (NF-GNB) are uncommon in children but their incidence is reported to be increasing. The aim of this study was to determine the characteristics of such infections in children in a London teaching hospital. All paediatric patients with positive NF-GNB blood cultures and clinical evidence of sepsis between July 1995 and June 2000 were included in the study. A total of 10278 blood cultures was performed, of which 356 (3.5%) represented clinically significant episodes of bacteraemia. Of these, 12 (0.1%) were due to NF-GNB. Nine of the 12 (75%) patients were receiving haemodialysis for end-stage renal failure (ESRF). Only one patient was receiving immunosuppressive therapy and none was neutropenic or had any malignancy. An intravascular catheter was identified as the focus of infection in all 12 cases. Stenotrophomonas maltophilia was the most common organism isolated (67%). Six patients were successfully treated with antibiotics alone. Four others received antibiotics, but also required line removal, and two patients responded to line removal without the need for antibiotics. Conclusion: An association was found between ESRF and NF-GNB infections, possibly related to the requirement for long-term catheters for dialysis. Antibiotic treatment alone was only successful in half the cases of catheter-related NF-GNB septicaemia, while removal of the infected catheter ensured complete cure in the cases where antibiotic treatment alone did not suffice. [source] | ||||||||||