Open- vs Closed-Tip Valved Peripherally Inserted Central Catheters and Midlines: Findings from a Vascular Access Database

2015 ◽  
Vol 20 (3) ◽  
pp. 169-176 ◽  
Author(s):  
Pietro Antonio Zerla ◽  
Antonio Canelli ◽  
Giuseppe Caravella ◽  
Alessandra Gilardini ◽  
Giuseppe De Luca ◽  
...  
Keyword(s):  
Vascular Access ◽  
Cost Reduction ◽  
Infectious Complications ◽  
Central Venous Catheters ◽  
Blood Component ◽  
Central Venous ◽  
Vascular Access Devices ◽  
Care Workers ◽  
Thrombotic Complications ◽  
Central Catheters

Abstract Today's patients are more complex in terms of comorbidities and other conditions requiring multiple, long-lasting therapies such as chemotherapy, total parenteral nutrition, blood transfusion or blood component infusions, and frequent blood sampling. The use of central venous catheters represents an important aspect of care for many patients. It is essential to inform health care workers of the risks associated with central venous catheters such as systemic and infectious complications, mechanical complications, and/or thrombotic complications. To maintain monitoring of our peripherally inserted central catheter team's activity, we developed and adopted a database in which all the data regarding each catheter are recorded. By doing that, we have improved catheter management, clinical efficiency, as well as achieved a cost reduction. We implanted 1416 vascular access devices in 1341 patients of both sexes (632 male and 709 female) for a total of 135,778 vascular access device-implant days between March 2010 and December 2013 for several indications. We have followed-up total complications and we correlated them with the need for catheter removal. The results were that open-tipped catheters resulted in both more complications and a greater need for removal.

Thrombus and thrombosis in cancer patients with permanent venous catheters

2000 ◽  
Vol 20 (03) ◽  
pp. 143-145
Author(s):  
H. D. Bruhn ◽  
F. Gieseler
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Clinical Studies ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Vascular Lumen ◽  
Additive Risk ◽  
Thrombotic Complications ◽  
Port Systems ◽  
Central Catheters

SummaryCancer patients have additive risk factors for thrombosis especially if permanent central catheters (port systems) are used for the delivery of chemotherapy. In our hospital the rate of thrombotic complications is below 5% for cancer patients receiving chemotherapy via port systems. This is in contrast to clinical studies, which have shown that up to 60% of catheters acquire clots that obstruct more than 50% of the vascular lumen. It is reasonable to believe that complications arising from thrombotic catheter alterations, such as bacterial hosting or micro-emboli, are clinically underestimated. The identification of thrombotic alterations of permanent central venous catheters in cancer patients receiving chemotherapy is substantial for the estimation whether anticoagulation strategies should be used as prophylaxis.

scholarly journals A review of peripherally inserted central catheters and various types of vascular access in very small children and pediatric patients and their potential complications

2021 ◽  
Vol 14 (3) ◽  
pp. 298-309
Author(s):  
Gholamreza Bahoush ◽  
◽  
◽  
Pourya Salajegheh ◽  
Ali Manafi Anari ◽  
...  
Keyword(s):  
Vascular Access ◽  
Pediatric Patients ◽  
Critical Factor ◽  
Process Of Care ◽  
Central Venous ◽  
Small Children ◽  
Appropriate Care ◽  
Comprehensive Search ◽  
Thrombotic Complications ◽  
Central Catheters

Accessing the veins for blood delivery, sampling or nutrition is a critical factor in the process of care and management of pediatric patients. In this regard, the peripherally inserted central catheter (PICC) is one of the main alternatives which could be applied effectively as traditional central venous devices in neonates and adults. Due to their essential role in providing safe central venous entry, PICCs could be applied extensively in patients who are critically ill. The main aims of the present study are to review approximately all relevant publications concerning PICC procedures, any possible complications, and the most appropriate decision for preventing these complications due to their high mortality rate. We carried out a comprehensive search on PubMed, HubMed, EMBASE, MEDLINE, Science Direct, Scopus, MEDLINE, and EMBASE databases for identifying the most relevant publications related to potential complications following the application and insertion of PICCs in hospitalized children and infants. Through appropriate care of catheters, the rate of possible infectious, mechanical and thrombotic complications would decrease considerably compared to those patients who received traditional central venous catheters. However, the process of vascular access in neonatal and children is very challenging. Any delay or denying treatment due to the lack of vascular access is intolerable. In this regard, anesthesiologists must achieve extra knowledge of various vascular devices.

Intravascular Access

2018 ◽  
pp. 269-274
Author(s):  
Jenna Fine ◽  
Ndidi Nwokorie ◽  
Lia H. Lowrie
Keyword(s):  
Cognitive Ability ◽  
Vascular Access ◽  
Central Venous Catheters ◽  
Behavioral Modification ◽  
Peripherally Inserted Central Catheters ◽  
Vascular Access Devices ◽  
Intravascular Catheters ◽  
Control Pain ◽  
Central Catheters ◽  
Intravascular Access

Vascular access is necessary for routine and emergent care of patients for delivery of fluids and medications. The vascular access devices (VADs) discussed here include peripheral intravascular catheters, intraosseous needles, peripherally inserted central catheters (PICC lines), and central venous catheters. VAD insertion can be painful and frightening for children, and their inherently smaller anatomy may also make the procedure more challenging. Children often require behavioral modification as well as medications to control pain and anxiety in order to tolerate placement of VADs. The sedationist must have a good knowledge of the demands of the procedure, the patient’s level of cooperation and cognitive ability, and pharmacologic resources available to aid in the performance of the procedure.

Standards of Care, and Strategies in the Prevention of Infection: A Primer on Central Venous Catheters (Part 2 of a 3-Part Series)

2007 ◽  
Vol 12 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Deborah Richardson
Keyword(s):  
Health Care ◽  
Health Care Worker ◽  
Vascular Access ◽  
Current Knowledge ◽  
Central Venous Catheters ◽  
Standards Of Care ◽  
Preventive Strategies ◽  
Central Venous ◽  
Vascular Access Devices ◽  
Care Worker

Abstract The use of vascular access devices is an inherent component of health care today. The varied situations calling for these devices include: the administration of antibiotics, fluids, pain medications, blood and blood products, and parenteral nutrition; hemodynamic monitoring; and blood sampling. Although these devices are common in the health care environment, they are not without risks. The most common life-threatening complication associated with central venous catheters is infection. Catheter-related bloodstream infection (CRBSI) is caused by colonization of the catheter, contamination of the catheter hub or infusate, and/or contamination of the catheter from the skin of the patient or health care worker. The health care worker, such as the vascular access nurse, can affect CRBSI rates by implementing the most current technologies; maintaining current knowledge related to intravenous therapy; implementing, and maintaining aseptic technique; and incorporating the standards, guidelines, and preventive strategies associated with vascular access nursing. This article provides an overview of central venous catheters (CVCs), the issue of CRBSI and CVCs, practice and technologies developed to prevent or decrease infections, current standards and guidelines, and preventive strategies.

Infectious complications after insertion of peripheral or central venous catheters in patients on parenteral nutrition

2020 ◽  
Vol 40 ◽  
pp. 629
Author(s):  
C.L. Barbosa ◽  
M.F. de Godoy ◽  
M.M. Machado ◽  
L.R. Silva ◽  
C.M. Duarte ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Infectious Complications ◽  
Central Venous Catheters ◽  
Central Venous

Optimizing vascular-access device decision-making in the era of midline catheters

2019 ◽  
Vol 40 (6) ◽  
pp. 674-680 ◽  
Author(s):  
Kelly A. Cawcutt ◽  
Richard J. Hankins ◽  
Teresa A. Micheels ◽  
Mark E. Rupp
Keyword(s):  
Decision Making ◽  
Best Practices ◽  
Vascular Access ◽  
Central Venous Catheters ◽  
Narrative Review ◽  
Central Venous ◽  
Access Device ◽  
Vascular Access Device ◽  
Intravenous Catheters

AbstractThis narrative review addresses vascular access device choice from peripheral intravenous catheters through central venous catheters, including the evolving use of midline catheters. The review incorporates best practices, published algorithms, and complications extending beyond CLABSI and phlebitis to assist clinicians in navigating complex vascular access decisions.

Peripherally inserted central catheter placement in a multidisciplinary intensive care unit: A preliminary study demonstrating safety and procedural time in critically ill subjects

2020 ◽  
pp. 112972982092861
Author(s):  
Ryan J Smith ◽  
Rodrigo Cartin-Ceba ◽  
Julie A Colquist ◽  
Amy M Muir ◽  
Jeanine M Moorhead ◽  
...  
Keyword(s):  
Critically Ill ◽  
Vascular Access ◽  
Critically Ill Patients ◽  
Catheter Placement ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Time Required ◽  
Central Catheters

Objective: Peripherally inserted central catheters are a popular means of obtaining central venous access in critically ill patients. However, there is limited data regarding the rapidity of the peripherally inserted central catheter procedure in the presence of acute illness or obesity, both of which may impede central venous catheter placement. We aimed to determine the feasibility, safety, and duration of peripherally inserted central catheter placement in critically ill patients, including obese patients and patients in shock. Methods: This retrospective cohort study was performed using data on 55 peripherally inserted central catheters placed in a 30-bed multidisciplinary intensive care unit in Mayo Clinic Hospital, Phoenix, Arizona. Information on the time required to complete each step of the peripherally inserted central catheter procedure, associated complications, and patient characteristics was obtained from a prospectively assembled internal quality assurance database created through random convenience sampling. Results: The Median Procedure Time, beginning with the first needle puncture and ending when the procedure is complete, was 14 (interquartile range: 9–20) min. Neither critical illness nor obesity resulted in a statistically significant increase in the time required to complete the peripherally inserted central catheter procedure. Three (5.5%) minor complications were observed. Conclusion: Critical illness and obesity do not delay the acquisition of vascular access when placing a peripherally inserted central catheter. Concerns of delayed vascular access in critically ill patients should not deter a physician from selecting a peripherally inserted central catheter to provide vascular access when it would otherwise be appropriate.

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