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Peripheral Veins (peripheral + vein)

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Medical Sciences	100%

Selected Abstracts

Continuous glucose monitoring by intravenous microdialysis

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2010
O. ROOYACKERS
Background: The conflicting results from studies over tight glucose control in intensive care unit (ICU) patients ask for a continuous on-line real-time glucose monitoring in future. Here, intravenous microdialysis was tested in ICU patients and healthy volunteers. Primary aims were technical feasibility and accuracy. Methods: A microdialysis catheter was inserted into a peripheral vein. ICU patients (n=10) were studied for up to 5 days. Healthy volunteers (n=6) were studied on one occasion. Recordings were monitored during 70 min each 24-h period to allow for an estimate of variability over time. Microdialysis glucose and lactate were compared with plasma glucose and whole blood lactate. Results are presented as medians (quartiles) of the differences between microdialysis and plasma concentrations over each of the 70-min recording periods. Results: Out of the included ICU patients, no exclusions or early terminations were due to failure of the microdialysis catheter. The concordance was highly variable. The difference of medians over the recording periods differed by ,34% (,40, ,16) in patients and ,22% (,31, ,15) for the volunteers. In contrast, the overall variability within the individual measurement periods was low. Conclusion: Technical feasibility was good, but the accuracy was not sufficient and the variability between the recording periods was high without calibrations. The non-availability of suitable peripheral veins was a problem in many patients screened but not included in the study. Intravenous microdialysis to obtain continuous on-line real-time glucose monitoring is technically feasible, but accuracy needs to be improved. [source]

Administration of 5% human serum albumin in critically ill small animal patients with hypoalbuminemia: 418 dogs and 170 cats (1994,2008)

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 2 2010
Fabio Viganó DVM, SCMPA
Abstract Objectives , To describe the administration of 5% human serum albumin (HSA) in 588 critically ill hypoalbuminemic dogs and cats, and report outcome to discharge, changes in albumin concentration, and adverse effects during hospitalization. Design , Retrospective clinical study. Setting , Private emergency and general veterinary center. Animals , Client-owned dogs and cats. Interventions , None. Measurements and Main Results , The medical records of 588 critically ill hypoalbuminemic animals (418 dogs and 170 cats) were reviewed. All animals had hypoalbuminemia (serum albumin <20 g/L [2.0 mg/dL]) at admission, received an infusion of 5% HSA, and received no other colloid infusion. The HSA solution was administered through a peripheral vein at 2 mL/kg/h for 10 h/d (total volume 20 mL/kg/d) until albumin reached 20 g/L. The number of days of HSA infusion (median and range) was 4 days (2,11 d) for dogs and 3 days (2,7 d) for cats. Three hundred and sixteen dogs (75.6%) survived to discharge; 56 of 418 (13.4%) died in hospital. One hundred and twenty-three cats (72.3%) survived to discharge; 21 of 170 (12.4%) died in hospital. Severe hypersensitivity reactions such as anaphylaxis, angioedema, and urticaria were not noted. Interruption of albumin infusion and specific treatment of reactions were not required in any animal. Conclusions , In this study, administration of 5% HSA appeared to be safe in a large group of critically ill, hypoalbuminemic dogs and cats. The results should be interpreted with caution due to the retrospective, descriptive nature of the study, the absence of control groups and the lack of follow-up data, as well as the potentially life-threatening complications of HSA administration. [source]

Spontaneous labor increases nitric oxide synthesis during the early neonatal period

PEDIATRICS INTERNATIONAL, Issue 4 2001
Akihiko Endo
AbstractBackground: This paper aimed to assess the influence of spontaneous labor upon endogenous nitric oxide (NO) and endothelin 1 (ET-1) during transition to extrauterine life. Methods: The serum levels of NO metabolites (the sum of nitrites and nitrates (NOx)) and the plasma level of ET-1 were determined in 53 healthy full-term infants (spontaneous labor group; n=40, cesarean delivery group; n=13). In both groups, blood samples were obtained from a cord vein at birth and from a peripheral vein at 5 days of age. Results: The differences in serum NOx concentrations between the spontaneous labor group and the elective cesarean group were not significant at birth. By the age of 5 days, serum NOx concentrations had risen significantly in the spontaneous labor group to become significantly higher in the elective cesarean group. Conclusion: It is speculated that spontaneous labor might enhance endogenous NO synthesis at 5 days of age. [source]

Clinical practice of obtaining blood cultures from patients with a central venous catheter in place: an international survey

CLINICAL MICROBIOLOGY AND INFECTION, Issue 7 2009
M. E. Falagas
Abstract Several aspects of the procedure for obtaining blood cultures are rather controversial. An international survey among 386 experts was performed to investigate the clinical practice of obtaining blood cultures from patients with a central venous catheter (CVC). Among respondents, 64.5% obtain one set of blood cultures from the CVC and one set from the peripheral vein (PV). Other participants answered ,two sets from PV', ,two sets from CVC', ,one from PV', ,one from CVC' and ,other' (9.1%, 4.1%, 8.3%, 7%, and 7%, respectively). Clinicians who, according to the survey, demonstrated that they know the diagnostic performance characteristics of cultures more often obtain one culture from the CVC and one from the PV (73.9% vs. 61.7%, p 0.037). [source]

Reversible Cardiac Arrest After Polidocanol Sclerotherapy of Peripheral Venous Malformation

DERMATOLOGIC SURGERY, Issue 2 2002
Massimiliano M. Marrocco-Trischitta MD
background. Polidocanol sclerotherapy is a well-established therapeutic modality for the treatment of venous malformations. Systemic complications are extremely rare. objective. To report a case of cardiac complication after polidocanol injection of peripheral venous malformation. methods. A case report and a review of the English language literature using a published MEDLINE search strategy. results. A patient undergoing polidocanol sclerotherapy for a symptomatic venous malformation of the right inferior limb developed cardiac arrest shortly after injection of the sclerosing agent which was promptly reversed. conclusion. Systemic complications following sclerotherapy may occur even when the sclerosant is injected in peripheral veins or venous malformations. Clinicians should be alerted to the possibility of uncommon but life-threatening adverse effects. [source]

Transillumination by light-emitting diode facilitates peripheral venous cannulations in infants and small children

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2010
K. HOSOKAWA
Background: Transillumination facilitates the visualization of peripheral veins in infants and children. The clinical usefulness of light-emitting diode (LED)-powered devices has not been thoroughly studied. Methods: We randomly assigned 136 infants and children weighing <15 kg, undergoing general anesthesia, to red LED-powered transillumination (TM group, n=67) vs. the usual method (UM group, n=69) of peripheral venous cannulations. Venous puncture was performed following anesthesia induction with sevoflurane and nitrous oxide. The primary and secondary study endpoints were the rate of successful cannulations at initial attempt, and the duration of insertion attempts, respectively. Results: The median score of the estimated cannulation difficulty before attempted puncture was similar in both groups. The success rates at first attempt were 75% and 61% (NS) and mean±SD times to successful venous access were 47±34 and 68±66 s (NS) in the TM and UM groups, respectively. The cannulation procedures were completed significantly earlier in the TM group than in the UM group (hazard ratio, 1.59; 95% confidence interval, 1.03,2.47; P=0.03). In the subgroup of infants and children <2 years old, venous cannulation was successful at first attempt in 73% and 49% in the TM group (n=44) and in the UM group (n=47), respectively (P=0.03). Conclusions: LED-powered transillumination devices facilitated peripheral venous cannulations in small infants and children. [source]

Continuous glucose monitoring by intravenous microdialysis

Circulating adiponectin reflects severity of liver disease but not insulin sensitivity in liver cirrhosis

JOURNAL OF INTERNAL MEDICINE, Issue 3 2005
S. KASER
Abstract. Background., The adipocytokine adiponectin has been proposed to play important roles in the regulation of energy homeostasis, insulin sensitivity and shows anti-inflammatory properties. Aim., In this study we investigated the role of circulating adiponectin in different chronic liver diseases, its regulation by systemic anti-tumour necrosis factor (TNF)- , treatment and its hepatic metabolism. Patients and methods., Plasma adiponectin levels were determined in 87 patients with liver cirrhosis of different aetiologies, seven patients with alcoholic steatohepatitis undergoing systemic anti-TNF- , treatment, in 11 patients with liver cirrhosis receiving transjugular intrahepatic portosystemic shunt implantation and in 21 healthy controls. Results., Adiponectin levels were significantly higher in all subjects with liver cirrhosis of different aetiologies when compared with healthy controls and increased dependent on Child-Pugh classification. In subjects with alcoholic steatohepatitis, systemic anti-TNF- , treatment caused a significant decrease in circulating adiponectin. Adiponectin concentrations were similar in portal, hepatic and peripheral veins. No correlation between adiponectin levels and insulin resistance was found in any patient group. Conclusions., Our data suggest that circulating adiponectin is increased in liver cirrhosis independent of the aetiology of liver disease. We suggest that high adiponectin levels in chronic liver disease might reflect one of the body's anti-inflammatory mechanisms in chronic liver diseases. [source]

Feasibility of prophylaxis and immune tolerance induction regimens in haemophilic children using fully implantable central venous catheters

BRITISH JOURNAL OF HAEMATOLOGY, Issue 5 2008
Maria Elisa Mancuso
Summary Venous access represents the major barrier to the feasibility of prophylaxis and immune tolerance induction (ITI) in haemophilic children. Ports improve treatment feasibility, but their duration is limited by infectious complications. This study aimed at evaluating whether or not ports allow haemophilic children to maintain the treatment regimen in the long term. Children were prospectively followed-up and underwent port removal either for complications or transition to peripheral veins. Of 27 ports (17 used for prophylaxis and 10 for ITI), 25 were removed after a median of 3·3 years. Inhibitor children showed a younger age at port insertion (P = 0·02), an earlier occurrence of infections (P = 0·006) at a higher rate (P = 0·00001) and an earlier removal for infection (P = 0·05) than non-inhibitor patients. Daily port use was associated with earlier infections at a higher rate compared to less frequent use (P = 0·02). Port removal after a median of 0·8 years prevented ITI completion in 50% of children, while it hampered the maintenance of prophylaxis in 27% of patients. This study showed that ports improved the feasibility of prophylaxis in the majority of non-inhibitor children, while they were not suitable for inhibitor children who require a prolonged ITI regimen with daily infusions. [source]

Glucose infusions into peripheral veins in the management of neonatal hypoglycemia , 20% instead of 15%?

ACTA PAEDIATRICA, Issue 3 2010
T Vanhatalo
Abstract Aim: To establish whether peripheral intravenous 20% glucose solutions would cause less local irritation, fewer cannulation changes and less weight gain than 15% glucose in newborn infants. Methods: A total of 121 newborn infants with hypoglycemia were randomized to receive either 20% (group 20%, 60 infants) or 15% (group 15%, 61 infants) glucose infusions, which were initiated at 8 mg/kg/min rates and tapered according to the blood glucose levels. When the cannulation site had to be changed, signs of phlebitis at the previous cannulation site were scored (0,3). Number of cannulation site changes, durations of infusions and the infants' daily weights were recorded. Results: The median durations of infusions in groups 20 and 15% were 4 (range 2,7) days versus 4 (range 2,8) days and the median number of cannulation site changes were 1 (range 0,6) versus 1 (range 0,5), respectively. Thirty-six infants in group 20% and 37 in group 15% developed some phlebitis, median severity scores being 1 (range 0,7) versus 15% 1 (range 0,8). The weights during the treatment were also similar. Conclusion:, 20% and 15% glucose solutions can be infused equally safely into peripheral veins in neonates. [source]

A Pilot Study of Ultrasound Analysis before Pediatric Peripheral Vein Cannulation Attempt

ACADEMIC EMERGENCY MEDICINE, Issue 5 2007
David Schnadower MD
ObjectivesTo determine whether peripheral veins can be detected by ultrasound (US) and to determine vein characteristics, as measured by US, that are associated with successful peripheral venous (PV) catheterization in young children. MethodsThe authors conducted an observational study in the pediatric emergency department (ED), with a convenience sample of children younger than 7 years. They evaluated attempts at PV catheterization in two groups on the basis of the visibility and palpability of the patients' veins: 1) clinically apparent (visible or palpable) and 2) not clinically apparent (nonvisible and nonpalpable). The authors obtained sonographic measurements in a transverse view (vertical diameter, circumference, and area) and in a longitudinal view (maximal uninterrupted length). Practitioners blinded to the US images then attempted to catheterize veins in the usual manner. The proportion of clinically apparent veins and the proportion of veins that were successfully catheterized that were identified by US were assessed, and the association between ultrasonographic vein measurements and success at catheterization, controlling for possible confounders, was determined. ResultsThe authors assessed 120 attempts (90 clinically apparent and 30 not clinically apparent) at PV catheterization in 83 patients. US detected all 90 clinically apparent veins, and cannulation success rate was 62/90 (69%). In the not clinically apparent vein group, the rate of success was only 3/30 (10%), and US detected all successfully catheterized veins. In no instance was cannulation successful when the vein was not detected by US. Maximal vein length in longitudinal view was an independent predictor of cannulation success in multivariate analysis. ConclusionsUltrasound appears to be capable of detecting peripheral veins in children younger than 7 years of age, with lack of US vein visualization likely leading to unsuccessful PV placement. Greater vein length visualization may be a useful predictor of successful PV catheterization. [source]