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Vascular Access Catheter (vascular + access_catheter)

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Medical Sciences100%

Selected Abstracts

Catheter-related Infections via Temporary Vascular Access Catheters: A Randomized Prospective Study

ARTIFICIAL ORGANS, Issue 3 2010
Hajime Nakae
Abstract Temporary vascular access catheters (VACs) are important devices used in acute blood purification therapies. The aim of this study was to determine whether a catheterization duration of 2 weeks increased the risk of nosocomial complications when compared with a 1-week duration. Fifty-six patients with 90 double lumen VACs were randomly chosen, and received either 1- or 2-week catheterizations from operators experienced in the placement of such catheters at three sites such as the internal jugular, subclavian, or femoral vein. The characteristics of the VACs, including the sites, procedures, and lengths, were similar in both groups. No significant difference in the rate of catheter colonization was observed between the groups (14.6% vs 26.2%, P = 0.1371). No significant difference in the rate of catheter-related bloodstream infections was observed between the groups (2.1% vs 4.8%, P = 0.5967). Two-week indwelling did not increase the risk of infection compared with 1-week indwelling at any of the sites in critically ill patients. [source]

Effective interventions with chlorhexidine gluconate (CHG) to decrease hemodialysis (HD) tunneled catheter-related infections

HEMODIALYSIS INTERNATIONAL, Issue 1 2005
N. Redman
Purpose:,Identify practices to reduce HD catheter access related bacteremias (ARB). Methods:,Data was collected per the CDC Dialysis Surveillance Network protocol. ARB was defined as a patient with a positive blood culture with no apparent source other than the vascular access catheter. ARB's were calculated in events per 100 patient months with 3 cohorts. Cohort 1 was observed for 12 months, Cohort 2 for the subsequent 10 months, and Cohort 3 for the final 10 months. Cohort 1 had weekly transparent dressing changes, cleansing of the skin and 5 minute soaking of the connection lines with 10% povidone-iodine (PI) solution, and HCW use of clean gloves and face shield without a mask. Cohort 2 changes consisted of thrice weekly gauze dressing changes, skin cleansing with ChloraPrep, a 2% CHG/70% isopropyl alcohol applicator, masks on the patients, adding a face mask to the shield, and application of 10% PI ointment to the exit site. Cohort 3 changes included weekly application of BioPatch (BioP), an antimicrobial dressing with CHG, sterile glove use, and replacing the PI line soaks with 4% CHG. Results:,The catheter-associated ARB rate per 100 patient months was 7.9 (17ARB/216 patient months) in Cohort 1, 8.6 (13/151) in Cohort 2, and 4.7 (5/107) in Cohort 3(p = 0.31 compared with Cohorts 1 and 2 combined). During the last 2 months, in Cohort 3, 9 catheter lumen cracks occurred, with one of the patients having a bacteremia. Conclusions:,Addition of CHG line soaks and BioP reduced tunneled catheter infections, although this is not statistically significant. The increased number of catheter lumen cracks raises concern with the use of CHG line soaks. Further investigation with use of CHG line soaks and the BioP for decreasing ARB is needed. [source]

Long-term pericardial catheterization is associated with minimum foreign-body response

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2007
Carlo 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]

Risk of nerve damage from vascular access catheters

ANAESTHESIA, Issue 6 2006
K. R. Vege
No abstract is available for this article. [source]

Catheter-related Infections via Temporary Vascular Access Catheters: A Randomized Prospective Study

ARTIFICIAL ORGANS, Issue 3 2010
Hajime Nakae
Abstract Temporary vascular access catheters (VACs) are important devices used in acute blood purification therapies. The aim of this study was to determine whether a catheterization duration of 2 weeks increased the risk of nosocomial complications when compared with a 1-week duration. Fifty-six patients with 90 double lumen VACs were randomly chosen, and received either 1- or 2-week catheterizations from operators experienced in the placement of such catheters at three sites such as the internal jugular, subclavian, or femoral vein. The characteristics of the VACs, including the sites, procedures, and lengths, were similar in both groups. No significant difference in the rate of catheter colonization was observed between the groups (14.6% vs 26.2%, P = 0.1371). No significant difference in the rate of catheter-related bloodstream infections was observed between the groups (2.1% vs 4.8%, P = 0.5967). Two-week indwelling did not increase the risk of infection compared with 1-week indwelling at any of the sites in critically ill patients. [source]