Central venous catheter malposition in surgical patients: a retrospective observational study

2013 ◽  
Vol 30 ◽  
pp. 241-241 ◽  
Author(s):  
P. Solorzano ◽  
A. Salazar ◽  
N. Brogly ◽  
R. Schiraldi ◽  
E. Guasch ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Observational Study ◽  
Venous Catheter ◽  
Surgical Patients ◽  
Retrospective Observational Study ◽  
Central Venous ◽  
Catheter Malposition

Temporary Central Venous Catheter Utilization Patterns in a Large Tertiary Care Center Tracking the “Idle Central Venous Catheter”

2012 ◽  
Vol 33 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Sheri Chernetsky Tejedor ◽  
David Tong ◽  
Jason Stein ◽  
Christina Payne ◽  
Daniel Dressler ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Observational Study ◽  
Dwell Time ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Care Facility ◽  
Venous Catheter ◽  
Retrospective Observational Study ◽  
Central Venous ◽  
Tertiary Care Facility

Objectives.Although central venous catheter (CVC) dwell time is a major risk factor for catheter-related bloodstream infections (CR-BSIs), few studies reveal how often CVCs are retained when not needed (“idle”). We describe use patterns for temporary CVCs, including peripherally inserted central catheters (PICCs), on non-ICU wards.Design.A retrospective observational study.Setting.A 579-bed acute care, academic tertiary care facility.Methods.A retrospective observational study of a random sample of patients on hospital wards who have a temporary, nonimplanted CVC, with a focus on on daily ward CVC justification. A uniform definition of idle CVC-days was used.Results.We analyzed 89 patients with 146 CVCs (56% of which were PICCs); of 1,433 ward CVC-days, 361 (25.2%) were idle. At least 1 idle day was observed for 63% of patients. Patients had a mean of 4.1 idle days and a mean of 3.4 days with both a CVC and a peripheral intravenous catheter (PIV). After adjusting for ward length of stay, mean CVC dwell time was 14.4 days for patients with PICCs versus 9.0 days for patients with non-PICC temporary CVCs (other CVCs; P< .001). Patients with a PICC had 5.4 days in which they also had a PIV, compared with 10 days in other CVC patients (P< .001). Patients with PICCs had more days in which the only justification for the CVC was intravenous administration of antimicrobial agents (8.5 vs 1.6 days; P = .0013).Conclusions.Significant proportions of ward CVC-days were unjustified. Reducing “idle CVC-days” and facilitating the appropriate use of PIVs may reduce CVC-days and CR-BSI risk.Infect Control Hosp Epidemiol 2012;33(1):50-57

Supradiaphragmatic central venous catheter malposition detection using the parasternal long-axis echocardiographic view and dextrose 50% contrast solution: A pilot study

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110517
Author(s):  
Mohd Jazman Che Rahim ◽  
Shaik Farid Abdull Wahab ◽  
Mohd Hashairi Fauzi ◽  
Chandran Nadarajan ◽  
Siti Azrin Ab Hamid
Keyword(s):  
Pilot Study ◽  
Central Venous Catheter ◽  
Blood Sugar ◽  
Venous Catheter ◽  
Capillary Blood ◽  
Brachiocephalic Vein ◽  
Central Venous ◽  
Perfect Agreement ◽  
Catheter Malposition ◽  
Contrast Solution

Background Contrast-enhanced ultrasonography (CEUS) using saline was studied to detect supradiaphragmatic central venous catheter malposition. Commonly used echocardiographic views are apical 4-chamber (A4c) and subcostal views. However, this standard method is not feasible in certain situations. We explored the feasibility of the right ventricle inflow parasternal long axis (RVI-PLAX) echocardiographic view and dextrose 50% (D50%) contrast solution for detecting supradiaphragmatic central venous catheter malposition. Method This pilot study screened 60 patients who underwent ultrasound-guided supradiaphragmatic central venous catheter insertion. We compared the investigators' guidewire's J-tip detection, D50% rapid atrial swirl sign (RASS) findings on the RVI-PLAX view and the central venous catheter tip on chest radiograph. We also compared the mean capillary blood sugar level before and after the 5 ml D50% flush. Results No guidewire J-tips were detected from the RVI-PLAX view. The first and second investigators’ diagnosis of central venous catheter malposition detected on RVI-PLAX CEUS achieved an almost perfect agreement (κ = 1.0 (95% confidence interval (CI): 0.90 to 1.0), p < .0001). The RVI-PLAX CEUS was not able to detect two central venous catheter malpositions (one atrial malposition and one left brachiocephalic vein venous catheter malposition). The capillary blood sugar was significantly elevated (8.96 mmol/L vs. 9.75 mmol/L) after D50% flush ( p < 0.005) with no complications reported within 30 minutes after the D50% flush. Conclusion RVI-PLAX view should not be used for guidewire detection. CEUS using D50% and RVI-PLAX view are potentially useful tools in detecting central venous catheter malposition. Further studies comparing them with conventional methods are needed.

Central Venous Catheter Malposition Presenting as Chest Pain

CHEST Journal ◽  
1986 ◽  
Vol 89 (2) ◽  
pp. 309-312 ◽  
Author(s):  
John G. Webb ◽  
S.Douglas Simmonds ◽  
Clifford Chan-Yan
Keyword(s):  
Chest Pain ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Malposition

Competence of the Internal Jugular Vein Valve Is Damaged by Cannulation and Catheterization of the Internal Jugular Vein

2000 ◽  
Vol 93 (2) ◽  
pp. 319-324 ◽  
Author(s):  
Xianren Wu ◽  
Wolfgang Studer ◽  
Thomas Erb ◽  
Karl Skarvan ◽  
Manfred D. Seeberger
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Color Doppler ◽  
Venous Catheter ◽  
Color Doppler Ultrasound ◽  
Surgical Patients ◽  
Venous Cannulation ◽  
Central Venous ◽  
Distal Site

Background Experimental results suggest that the competence of the internal jugular vein (IJV) valve may be damaged when the IJV is cannulated for insertion of a central venous catheter. It has further been hypothesized that the risk of causing incompetence of the proximally located valve might be reduced by using a more distal site for venous cannulation. The present study evaluated these hypotheses in surgical patients. Methods Ninety-one patients without preexisting incompetence of the IJV valve were randomly assigned to undergo distal or proximal IJV cannulation (&gt; or = 1 cm above or below the cricoid level, respectively). Color Doppler ultrasound was used to study whether new valvular incompetence was present during Valsalva maneuvers after insertion of a central venous catheter, immediately after removal of the catheter, and, in a subset of patients, several months after catheter removal, when compared with baseline findings before cannulation of the IJV. Results Incompetence of the IJV valve was frequently induced both by proximal and distal cannulation and catheterization of the IJV. Its incidence was higher after proximal than after distal cannulation (76% vs. 41%; P &lt; 0.01) and tended to be so after removal of the catheter (47% vs. 28%; P = 0.07). Valvular incompetence persisting immediately after removal of the catheter did not recover within 8-27 months in most cases. Conclusions Cannulation and catheterization of the IJV may cause persistent incompetence of the IJV valve. Choosing a more distal site for venous cannulation may slightly lower the risk of causing valvular incompetence but does not reliably avoid it.

scholarly journals Central venous catheter-related complications in children with oncological/hematological diseases: an observational study of 418 devices

2005 ◽  
Vol 16 (4) ◽  
pp. 648-654 ◽  
Author(s):  
G. Fratino ◽  
A.C. Molinari ◽  
S. Parodi ◽  
S. Longo ◽  
P. Saracco ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Observational Study ◽  
Venous Catheter ◽  
Central Venous ◽  
Hematological Diseases
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