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Venous Catheterization (venous + catheterization)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Anesthesia & Pain Management	23%
Oncology & Radiotherapy	17%

Kinds of Venous Catheterization

central venous catheterization

Selected Abstracts

Incidence of Deep Venous Thrombosis Associated with Femoral Venous Catheterization

ACADEMIC EMERGENCY MEDICINE, Issue 5 2000
Nabeela Z. Mian MD
ABSTRACT Objective: To determine in adult medical patients the incidence of deep venous thrombosis (DVT) resulting from femora] venous catheterization (FVC). Methods: A prospective, observational study was performed at a 420-bed community teaching hospital. Hep-arin-coated 7-Fr 20-cm femoral venous catheters were inserted unilaterally into a femoral vein. Each contra-lateral leg served as a control site. Age, gender, number of FVC days. DVT risk factors, administration of DVT prophylaxis, and DVT formation and site were tabulated for each patient. Venous duplex sonography was performed bilaterally on each patient within 7 days of femoral venous catheter removal. Results: Catheters were placed in 29 men and 13 women. Femoral DVT was identified by venous duplex sonography in 11 (26.2%) of the FVC legs and none (0%) in the control legs. Posterior tibial and popliteal DVT was identified in both the FVC and control legs of 1 patient. DVT formation at the site of FVC insertion was highly significant (p = 0.005). There were no statistically significant associations with age (p = 0.42), gender (p = 0.73), number of DVT risk factors (p = 0.17), number of FVC days (p = 0.89), or DVT prophylaxis (p , 099). Conclusion: Placement of femoral catheters for central venous access is associated with a significant incidence of femoral DVT as detected by venous duplex sonography criteria at the site of femoral venous catheter placement. Physicians must be aware of this risk when choosing this vascular access route for adult medical patients. Further studies to assess the relative risk for DVT and its clinical sequelae when using the femoral vs other central venous catheter routes are indicated. Key words: deep venous thrombosis; femoral vein; catheterization; pulmonary embolism. [source]

Central Venous Catheterization,Right Internal Jugular Vein Approach

ACADEMIC EMERGENCY MEDICINE, Issue 4 2008
Jon Van Roo MD
No abstract is available for this article. [source]

Incidence of Deep Venous Thrombosis Associated with Femoral Venous Catheterization

Simultaneous onset of acute inflammatory response, sepsis-like symptoms and intestinal mucosal injury after cancer chemotherapy

INTERNATIONAL JOURNAL OF CANCER, Issue 2 2003
Eiichi Tsuji
Abstract Chemotherapy is 1 method for the treatment of cancer, but serious side effects can sometimes limit the dosage given. Mild fever and diarrhea are common side effects of cancer chemotherapy. Gastrointestinal injury induced by chemotherapeutic agents may result in bacterial/endotoxin translocation from the gut into the systemic circulation. An experimental study was therefore conducted to clarify the effect of systemic chemotherapeutic agents on gastrointestinal barrier function. Male Wistar rats were divided into a 5-fluorouracil (5-FU) group (100 mg/kg/day for 4 days; n = 27) and a control group (n = 5). All rats were fasted and central venous catheterization was performed for total parenteral nutrition and blood sampling. Intestinal tissue was also sampled for pathological examination. Plasma levels of interleukin-6 (IL-6) and tumor necrosis factor , (TNF,) were determined by ELISA, bacterial translocation was quantified by lymph node culture and plasma endotoxin content of portal blood was measured by the Limulus -amebocyte-lysate test. In the 5-FU group on day 4, a proportion of rats exhibited severe watery diarrhea (73.9%) and occasional vomiting (86.2%). The levels of plasma TNF, and IL-6 were seen to increase, peaking at day 6 (IL-6, 350.0 ± 67.8 pg/ml; TNF,, 26.1 ± 3.2 pg/ml). The pathological findings also changed on day 4. On day 6, 90% of the rats in the 5-FU group showed dramatic sepsis-like manifestations, whereas the control group did not. Within the 5-FU group, only at day 6 was bacterial translocation in the rat mesenteric lymph nodes or significantly elevated levels of endotoxin evident. These results suggest that bacterial/endotoxin translocation might cause sepsis-like manifestations after systemic chemotherapy. © 2003 Wiley-Liss, Inc. [source]

Vascular catheterization is difficult in infants with Down syndrome

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2009
D. S. SULEMANJI
Background: Our aim was to compare difficulties in vascular access interventions in infants with and without Down Syndrome (DS) undergoing congenital heart surgery. Methods: The anesthesia records of infants with DS undergoing congenital heart surgery (Group DS, n=61) were reviewed and matched with records of infants without DS (Group ND, n=61). Vascular cannulation sites, the experience of the anesthesiologists performing each procedure, the number of clinicians who attempted each procedure until it was successfully performed, and the number of attempts for each catheterization were recorded. Results: The rate of unsuccessful peripheral venous cannulation in any of the four extremities was higher in Group DS (P=0.026). The success rate of radial artery cannulation was lower in Group DS (P=0.048). Although the total number of attempts for arterial cannulation was higher in Group DS, the difference was not statistically significant (P=0.058). However, in Group DS, the clinician who was able to cannulate the artery successfully required a significantly higher number of attempts at cannulation (P=0.011). For central venous catheterization, cannulation site and the number of attempts required before success was achieved were similar in both groups. The specialist-to-resident ratio was higher in Group DS (P=0.037). Conclusion: Our results indicate a trend toward clinicians having more difficulty performing arterial and peripheral venous catheterizations in infants with DS compared with performing the same procedure in infants without DS. Anesthesiologists should be prepared for catheterization difficulties in this patient population. In infants with DS, we recommend that catheterizations be performed by more experienced physicians. [source]

Neonatal ascites and hyponatraemia following umbilical venous catheterization

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2002
MS Mohan
Abstract: The complications associated with umbilical venous catheterization in neonates range from pericardial effusion, portal hypertension, and peritoneal perforation with ascites, to Wharton's jelly embolism. The case of a term neonate who developed ascites and severe hyponatraemia (serum sodium 119 mmol/L) most probably following peritoneal perforation by an umbilical venous catheter is reported. The presenting feature was convulsions associated with dilutional hyponatraemia, probably following absorption of a large quantity of ascitic fluid across the peritoneum. Conservative management was associated with gradual recovery over 24 h. The case highlights that, irrespective of the route, excessive administration of salt-free fluids can lead to dilutional hyponatraemia with adverse consequences. The present case illustrates the importance of confirming intravascular positioning of umbilical catheters by ensuring free flow of blood on aspiration, to prevent/detect inadvertent peritoneal perforation. Ideally, echocardiographic confirmation of optimal intravascular placement of such catheters is preferred as radiographic confirmation is reported to be unreliable. [source]

External jugular venous catheterization with a Groshong catheter for central venous access,

JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2008
Mitsuru Ishizuka MD
Abstract Background The Groshong catheter (GC) is commonly used as a peripherally inserted central catheter (PICC), and the external jugular vein (EJV) is not a common route for central venous access (CVA). Therefore, external jugular venous catheterization (EJVC) using a GC is rare. However, our experience has shown that this procedure is safe and simple for CVA. Purpose To assess the utility of EJVC using the GC for CVA. Methods CVA was done using a GC via the EJV with a single puncture employing the maximal barrier precaution technique. Results Between March 2005 and June 2007, we attempted to perform EJVC using a GC via the EJV for 331 patients. Among of these patients, 301 patients received successful catheterization (success rate: 301/331,=,90.9%). The total period of catheter insertion was 4601 days, and the mean insertion period was 15.1 days (range 2,147 days). The main complications of catheter insertion were malposition (8/301; 2.7%) and, oozing or hematoma formation (8/301; 2.7%). There were no severe complications such as nerve injury, pneumothorax or arterial bleeding. Conclusions Our experience demonstrates that EJVC using the GC is acceptable for CVA. J. Surg. Oncol. 2008;98:67,69. © 2008 Wiley-Liss, Inc. [source]

Influence of orientations of guidewire tip on the placement of subclavian venous catheters

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2005
H-P. Park
Background:, The role of a J-type guidewire tip has been known to prevent vascular or cardiac wall damage. We hypothesized that the course of the guidewire may be influenced by the initial orientations of the J-type guidewire tip during the subclavian approach. The purpose of this study was to investigate the influence of the direction of the needle bevel and J-wire tip on successful placement of subclavian catheters. Methods:, A total of 140 adult patients of either sex were studied. Patients were randomly divided by the direction of the needle bevel (neutral vs. downward) and the direction of the J-wire tip (upward vs. downward). Under general anesthesia, right infraclavicular subclavian catheterization was attempted using the Seldinger technique. Results:, There was no statistically significant difference among the successful and unsuccessful placements in relation to factors including sex, body mass index, and needle bevel direction. The success rate was high when the J-wire tip was directed downward (P = 0.001). Conclusion:, These data suggest that the orientation of the J-wire tip downward can increase successful placement rates of right subclavian venous catheterization. [source]

Thoracentesis in pericardial and pleural effusion caused by central venous catheterization: a less invasive neonatal approach

PEDIATRIC ANESTHESIA, Issue 4 2004
Maria Serenella Pignotti MD
Summary An 840 g infant developed a rapid onset of shock-like symptoms. Pericardial and pleural effusions from an indwelling central catheter were diagnosed via echocardiography. A thoracentesis was promptly performed with immediate clinical improvement. The fluid withdrawn from the pleural space was analysed as hyperalimentation. The infant survived because of early diagnosis and aggressive therapeutic intervention. A pericardial effusion should be drained if there is cardiovascular compromise and because pericardiocentesis represents a high risk technique, attempts should be made to rectify the extravasation via thoracentesis. [source]

Septic arthritis in patients followed-up in neonatal intensive care unit

PEDIATRICS INTERNATIONAL, Issue 6 2002
Sevki Kabak
Abstract Background: Septic arthritis is an uncommon, but serious disorder in neonates. Most patients survive with permanent handicaps. Due to the rarity of this condition in neonates and paucity of signs and symptoms, the diagnosis of septic arthritis in newborns is more difficult than in older children. Methods: Septic arthritis or suppurative arthritis is an infection of the joint by a variety of microorganisms, including bacteria, viruses, mycobacteria and fungi. Purulent synovial fluid, positive culture and positive Gram stain were accepted as a gold standard for exact diagnosis. Fourteen neonates who were followed-up in a neonatal intensive care unit, with septic arthritis, were included in a study based on a review of medical reports and a long-term clinical and radiological follow-up. Clinical symptoms, bacteriology, risk factors and outcomes are discussed. Results: Staphylococcus aureus was the predominant causative organism. Risk factors for septic arthritis were prematurity (4/14), umbilical catheterization or venous catheterization (3/14), sepsis (3/14), perinatal asphyxia (2/14) and difficult birth (1/14). All cases of septic arthritis in neonates were improved without squealae except in two patients. One patient died and one patient had severe squealae. In these two patients, the duration of disease from clinical onset to initiation of therapy was long. Conclusion: The most important prognostic factor in predicting a favorable outcome in neonatal septic arthritis is early diagnosis and therapy. When appropriate treatment is delayed, catastrophic sequelae are inevitable. Early diagnosis of the condition and rapid removal of pus are mandatory for the survival of the joint. Long-term follow-up may reveal effects of epiphyseal damage, early degenerative changes and limitation of the range of motion. [source]

Iatrogenic vertebral artery injury

ACTA NEUROLOGICA SCANDINAVICA, Issue 6 2005
J. Inamasu
Iatrogenic vertebral artery injury (VAI) results from various diagnostic and therapeutic procedures. The objective of this article is to provide an update on the mechanism of injury and management of this potentially devastating complication. A literature search was conducted using PubMed. The iatrogenic VAIs were categorized according to each diagnostic or therapeutic procedure responsible for the injury, i.e., central venous catheterization, cervical spine surgery, chiropractic manipulation, diagnostic cerebral angiography, percutaneous nerve block, and radiation therapy. The incidence, mechanisms of injury, and reparative procedures were discussed for each type of procedure. The type of VAI depends largely on the type of procedure. Laceration was the dominant type of acute injury in central venous catheterization and cervical spine surgery. Arteriovenous fistulae and pseudoaneurysms were the delayed complications. Arterial dissection was the dominant injury type in chiropractic manipulation and diagnostic cerebral angiography. Inadvertent arterial injection caused seizures or stroke in percutaneous nerve block. Radiation therapy was responsible for endothelial injury which in turn resulted in delayed stenosis and occlusion of the vertebral artery (VA). The proximal VA was the most vulnerable portion of the artery. Although iatrogenic VAIs are rare, they may actually be more prevalent than had previously been thought. Diagnosis of iatrogenic VAI may not always be easy because of its rarity and deep location, and a high level of suspicion is necessary for its early detection. A precise knowledge of the surgical anatomy of the VA is essential prior to each procedure to prevent its iatrogenic injury. [source]

Paradoxical embolization of a fractured guidewire: Successful retrieval from left atrium using a snare device

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 1 2002
Ivan P. Casserly
Abstract In adults, paradoxical embolization of catheters or guidewire fragments related to central venous catheterization is a rare phenomenon. Reports of successful percutaneous retrieval of foreign bodies from the left atrium is also rare. We describe the successful percutaneous retrieval of a fractured guidewire that had undergone paradoxical embolization to the left atrium in an adult patient. Cathet Cardiovasc Intervent 2002;57:34,38. © 2002 Wiley-Liss, Inc. [source]

Ultrasonographic Investigation of the Effect of Inguinal Compression on the Cross-sectional Area of the Femoral Vein

ACADEMIC EMERGENCY MEDICINE, Issue 1 2008
Jin-Tae Kim MD
Abstract Objectives:, The reverse Trendelenburg position increases the cross-sectional area (CSA) of the femoral vein, making it easier to cannulate, although this position is potentially harmful in hypovolemic patients. The authors hypothesized that compression above the femoral vein increases the CSA of the femoral vein during emergency cannulation. Methods:, Ultrasound was used to measure the CSA of the femoral vein of 20 healthy volunteers. The following five measurements were made inferior to the inguinal crease: 1) in the horizontal supine position (control), 2) with inguinal compression 2 cm above the inguinal crease (at the point of arterial pulsation and its medial side), 3) in the Trendelenburg position 15°, 4) in the Trendelenburg position 15° plus inguinal compression, and 5) in the reverse Trendelenburg position 15°. Results:, Femoral vein CSA was increased by 35% by inguinal compression in the horizontal supine position (p < 0.001) and was decreased by the Trendelenburg position (p < 0.001). However, inguinal compression increased the CSA by 66% in the Trendelenburg position (p < 0.001). The reverse Trendelenburg position also increased the CSA of the femoral vein by 50% (p < 0.001). Conclusions:, Inguinal compression presents an alternative method for increasing the CSA of the femoral vein for venous catheterization in normal patients. [source]

What steps should be considered in the patient who has had a negative cervical exploration for primary hyperparathyroidism?

CLINICAL ENDOCRINOLOGY, Issue 5 2009
Barney Harrison
Summary The key to cure of the patient with persistent primary hyperparathyroidism is a clear understanding of the investigations, operative procedure and pathology related to the initial procedure. Reinvestigation and subsequent surgery should be performed in a specialist unit. A logical pathway of increasingly sophisticated localization studies (MIBI, ultrasound, CT/MRI, selective venous catheterization for PTH) will usually guide the surgeon to the missing parathyroid gland/s. Improved preoperative localization can facilitate the use of a minimally invasive small incision approach. The surgeon must have a detailed knowledge of the nuances of parathyroid embryology and a meticulous surgical technique, not only to identify and safely remove the retained gland/s but also do so without causing unnecessary morbidity. Results of re-operation (84,98% cure) from centres of excellence are highly commendable, yet the use of ,new' technology (that includes intra-operative PTH) has not translated into improved outcomes in all cases. Some parathyroid glands are extremely difficult to find! Re-operative parathyroid surgery is a challenge, sometimes easy, and on other occasions extremely difficult. [source]