Complications of nutritional support

2013 ◽  
pp. 171-180
Author(s):  
Daniel Marks ◽  
Marcus Harbord
Keyword(s):  
Central Venous Catheter ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Right Atrium ◽  
Nutritional Support ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip ◽  
Central Catheters

Venous catheter-related problems Other complications of parenteral nutrition Problems with enteral tubes Re-feeding syndrome ● Above all else, ‘if the gut works, use it’. Only consider IV feeding if patients are likely to be without enteral nutrition for 〉5d. ● Central venous catheter feeding (i.e. catheter tip in SVC, IVC, or right atrium) preferred to avoid thrombophlebitis from hyperosmolar feeds. Well-managed central catheters can be left ...

Distance of the internal central venous catheter tip from the right atrium is positively correlated with central venous thrombosis

2016 ◽  
Vol 23 (3) ◽  
pp. 269-273 ◽  
Author(s):  
David H. Ballard ◽  
Navdeep S. Samra ◽  
Karen Mathiesen Gifford ◽  
Robert Roller ◽  
Bruce M. Wolfe ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Thrombosis ◽  
Right Atrium ◽  
Venous Catheter ◽  
Central Venous ◽  
Central Venous Thrombosis ◽  
Catheter Tip ◽  
The Right

scholarly journals Central Venous Catheter Tip in the Right Atrium: A Risk Factor for Neonatal Cardiac Tamponade

2001 ◽  
Vol 21 (7) ◽  
pp. 461-464 ◽  
Author(s):  
Jonathan C Darling ◽  
Simon J Newell ◽  
Omar Mohamdee ◽  
Orhan Uzun ◽  
Catherine J Cullinane ◽  
...  
Keyword(s):  
Risk Factor ◽  
Central Venous Catheter ◽  
Cardiac Tamponade ◽  
Right Atrium ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip ◽  
The Right

A bedside rescue method for retrieving retained guidewires: The ‘Suck Out’ technique

2020 ◽  
pp. 112972982094345
Author(s):  
Maryanne Z A Mariyaselvam ◽  
Vikesh Patel ◽  
Adam Sawyer ◽  
James A Richardson ◽  
Jonathan Dean ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Patient Harm ◽  
Central Venous ◽  
Exact Test ◽  
The United Kingdom ◽  
Catheter Tip ◽  
Never Event ◽  
Benchtop Model

Background: Central venous catheter guidewire retention is classed as a ‘never event’ in the United Kingdom, with the potential for significant patient harm. If the retained guidewire remains within the central venous catheter lumen, bedside techniques may facilitate guidewire retrieval. However, these techniques may be ineffective if the guidewire has already passed below skin level. We investigated a novel ‘suck out’ technique for bedside guidewire retrieval and compared this against traditional retrieval methods. Methods: Simulation 1: in a benchtop model, seven different central venous catheters had their corresponding guidewire placed in the last 2 cm of the catheter tip which was immersed horizontally in fluid. A 50-mL syringe was attached to the distal lumen central venous catheter hub and suction applied for 5 s, and the distance of guidewire retraction was recorded. Simulation 2: a central venous catheter guidewire was intentionally retained within the catheter at either 5 cm above or below skin level in a pigskin model. Simple catheter withdrawal, catheter clamping withdrawal and the ‘suck out’ method were compared for efficacy using Fisher’s exact test. Results: Simulation 1: retained guidewires were retracted by 13 cm on average. Simulation 2: when guidewires were retained 5 cm above skin level, all retrieval methods were 100% effective; however, when retained 5 cm below skin level, simple catheter withdrawal was ineffective, clamping and withdrawal was only 10% effective and the ‘suck out’ technique was 90% effective (p < 0.001). Conclusion: The ‘suck out’ technique can effectively retract guidewires retained within central venous catheter lumens and demonstrates superiority over traditional methods of retained guidewire extraction in simulated models.

Precision in Central Venous Catheter Tip Placement: A Review of the Literature

2010 ◽  
Vol 15 (3) ◽  
pp. 112-125 ◽  
Author(s):  
Russell Hostetter ◽  
Nadine Nakasawa ◽  
Kim Tompkins ◽  
Bradley Hill
Keyword(s):  
Central Venous Catheter ◽  
Selection Criteria ◽  
Weighted Average ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip ◽  
Tip Position ◽  
Landmark Technique ◽  
The Ideal

Abstract Background: Long term venous catheters have been used to deliver specialized therapies since 1968. The ideal tip position of a central venous catheter provides reliable venous access with optimal therapeutic delivery, while minimizing short-and long-term complications. Ideal position limits have evolved and narrowed over time, making successful placement difficult and unreliable when depending exclusively on the landmark technique. Objective: To review and analyze contemporary literature and calculate an overall accuracy rate for first attempt placement of a PICC catheter in the ideal tip position. Methods: Key PICC placement terms were used to search the database PubMED-indexed for MEDLINE in June and October, 2009. The selection of studies required: a patient cohort without tip placement guidance technology; a documented landmark technique to place catheter tips; data documenting initial catheter placement and, that the lower third of the SVC and the cavo-atrial junction (CAJ) were included in the placement criteria. With few exceptions, articles written between 1993 and 2009 met the stated selection criteria. A composite of outcomes associated with tip placement was analyzed, and an overall percent proficiency of accurate catheter tip placement calculated. Results: Nine studies in eight articles met the selection criteria and were included for analysis. Rates of first placement success per study ranged from 39% to 75%, with the majority (7/9) being single center studies. The combined overall proficiency of these studies calculated as a weighted average was 45.87%.

ECG-guided central venous catheter positioning: does it detect the pericardial reflection rather than the right atrium?

2004 ◽  
Vol 21 (8) ◽  
pp. 600-605 ◽  
Author(s):  
W. Schummer ◽  
C. Schummer ◽  
A. Müller ◽  
J. Steenbeck ◽  
J. Fuchs ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Right Atrium ◽  
Venous Catheter ◽  
Central Venous ◽  
The Right
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