Umbilical venous catheterisation: emergency central venous access which saves lives in coarctation of the aorta

2021 ◽  
Vol 14 (11) ◽  
pp. e245789
Author(s):  
Amber Seigel ◽  
Nele Legge ◽  
Gerry Hughes ◽  
Kathryn Browning Carmo
Keyword(s):  
Central Venous Access ◽  
Ductus Arteriosus ◽  
Neurodevelopmental Outcome ◽  
Coarctation Of The Aorta ◽  
Venous Catheter ◽  
Venous Access ◽  
First Line ◽  
Central Venous ◽  
Newborn Period ◽  
Clinical Prognosis

We describe a 9-day-old baby with coarctation of the aorta who required urgent resuscitation including intubation and cardiac compressions. Despite the commencement of prostaglandin E1 (PGE1) to reopen the ductus arteriosus via the intraosseous route, postductal saturations remained unrecordable for a further 45 min. Within 3 min of administration of PGE1 via an umbilical venous catheter (UVC), saturations were recordable at 92%. UVC access was the sentinel intervention that irrevocably altered the clinical prognosis. This baby boy has survived with excellent neurodevelopmental outcome. Clinicians are less familiar with UVCs outside of the newborn period. Our data demonstrate successful placement in neonates up to 28 days of age. We hope this case encourages clinicians to consider the UVC as first-line central venous access in collapsed neonates. In cases of suspected left heart obstruction, we argue that UVCs are the optimal route.

Hybrid angioplasty-catheter placement procedure performed in a hemodialysis patient with central venous obstruction disease. Presentation of a case

2020 ◽  
pp. 112972982098318
Author(s):  
Nikolaos Ptohis ◽  
Panagiotis G Theodoridis ◽  
Ioannis Raftopoulos
Keyword(s):  
Therapeutic Option ◽  
Central Venous Access ◽  
Major Complication ◽  
Venous Catheter ◽  
Venous Access ◽  
Transluminal Angioplasty ◽  
Catheter Placement ◽  
Venous Disease ◽  
Central Venous ◽  
Brachiocephalic Trunk

Obstruction or occlusion of the central veins (Central venous disease, CVD) represents a major complication in hemodialysis patients (HD) limiting central venous access available for a central venous catheter placement. Endovascular treatment with percutaneous transluminal angioplasty (PTA) is the first therapeutic option to restore patency and gain access. This case presents our initial experience of a HD patient with CVD treated with a combination therapy of a balloon PTA to the left brachiocephalic trunk, through the right hepatic vein and standard catheter placement technique to the previously occluded junction of the left internal jugular vein to the left subclavian vein.

scholarly journals Central Venous Catheter induced Atrial Fibrillation-A Case Report

2021 ◽  
Vol 39 (3) ◽  
pp. 200-204
Author(s):  
Masud Ahmed ◽  
Azizun Nessa ◽  
Md Al Amin Salek
Keyword(s):  
Atrial Fibrillation ◽  
Central Venous Catheter ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Cardiac Complications ◽  
Haemodynamic Instability ◽  
Central Venous ◽  
Common Procedure ◽  
Dc Cardioversion

Though a common procedure, central venous access is related to morbidity and mortality of patients. Common cardiac complications caused by central venous catheters include premature atrial and ventricular contractions. But development of atrial fibrillation with haemodynamic instability is quite rare. We are reporting a patient who developed atrial fibrillation with hypotension while inserting central venous catheter through right subclavian vein by landmark technique. Patient was managed with DC cardioversion. Careful insertion of central venous catheter & prompt management of its complication is crucial to avoid catastrophe. J Bangladesh Coll Phys Surg 2021; 39(3): 200-204

scholarly journals Linezolid lock prophylaxis of central venous catheter infection

2008 ◽  
Vol 57 (4) ◽  
pp. 534-535 ◽  
Author(s):  
Jérôme Patrick Fennell ◽  
Martin O'Donohoe ◽  
Martin Cormican ◽  
Maureen Lynch
Keyword(s):  
Central Venous Catheter ◽  
Hospital Admissions ◽  
Blood Stream Infection ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Blood Stream ◽  
Central Venous ◽  
Central Venous Catheter Infection ◽  
The Impact

Central venous catheter (CVC)-related infections are a major problem for patients requiring long-term venous access and may result in frequent hospital admissions and difficulties in maintaining central venous access. CVC-related blood stream infections are associated with increased duration of inpatient stay and cost approximately \#8364;13 585 per patient [Blot, S. I., Depuydt, P., Annemans, L., Benoit, D., Hoste, E., De Waele, J. J., Decruyenaere, J., Vogelaers, D., Colardyn, F. & Vandewoude, K. H. (2005). Clin Infect Dis 41, 1591–1598]. Antimicrobial lock therapy may prevent CVC-related blood stream infection, preserve central venous access and reduce hospital admissions. In this paper, the impact of linezolid lock prophylaxis in a patient with short bowel syndrome is described.

scholarly journals Prevalence of the Use of Central Venous Access Devices Within and Outside of the Intensive Care Unit: Results of a Survey Among Hospitals in the Prevention Epicenter Program of the Centers for Disease Control and Prevention

2003 ◽  
Vol 24 (12) ◽  
pp. 942-945 ◽  
Author(s):  
Michael Climo ◽  
Dan Diekema ◽  
David K. Warren ◽  
Loreen A. Herwaldt ◽  
Trish M. Perl ◽  
...  
Keyword(s):  
Central Venous Access ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Venous Access ◽  
Teaching Hospitals ◽  
Central Venous ◽  
Prevalence Survey ◽  
Icu Patients ◽  
Medical Centers ◽  
Control And Prevention

AbstractObjective:To determine the prevalence of central venous catheter (CVC) use among patients both within and outside the ICU setting.Design:A 1-day prevalence survey of CVC use among adult inpatients at six medical centers participating in the Prevention Epicenter Program of the CDC. Using a standardized form, observers at each Epicenter performed a hospital-wide survey, collecting data on CVC use.Setting:Inpatient wards and ICUs of six large urban teaching hospitals.Results:At the six medical centers, 2,459 patients were surveyed; 29% had CVCs. Among the hospitals, from 43% to 80% (mean, 59.3%) of ICU patients and from 7% to 39% (mean, 23.7%) of non-ICU patients had CVCs. Despite the lower rate of CVC use on non-ICU wards, the actual number of CVCs outside the ICUs exceeded that of the ICUs. Most catheters were inserted in the subclavian (55%) or jugular (22%) site, with femoral (6%) and peripheral (15%) sites less commonly used. The jugular (33.0% vs 16.6%; P < .001) and femoral (13.8% vs 2.7%; P < .001) sites were more frequently used in ICU patients, whereas peripherally inserted (19.9% vs 5.9%; P < .001) and subclavian (60.7% vs 47.3%; P < .001) catheters were more commonly used in non-ICU patients.Conclusions:Current surveillance and infection control efforts to reduce morbidity and mortality associated with bloodstream infections concentrate on the high-risk ICU patients with CVCs. Our survey demonstrated that two-thirds of identified CVCs were not in ICU patients and suggests that more efforts should be directed to patients with CVCs who are outside the ICU.

Practical procedures

2018 ◽  
Author(s):  
James Thomas ◽  
Tanya Monaghan ◽  
Prarthana Thiagarajan
Keyword(s):  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Chest Drain ◽  
Arterial Line ◽  
Tube Insertion ◽  
Central Venous ◽  
Urethral Catheterization ◽  
Arterial Blood Gas ◽  
Arterial Blood

Using this chapterInfiltrating anaesthetic agentsHand hygieneConsentAseptic techniqueSubcutaneous and intramuscular injectionsIntravenous injectionsVenepunctureSampling from a central venous catheterArterial blood gas (ABG) samplingPeripheral venous cannulationFemoral venous catheter insertionCentral venous access: internal jugular veinCentral venous access: subclavian veinCentral venous access: ultrasound guidanceIntravenous infusionsArterial line insertionFine needle aspiration (FNA)Lumbar punctureMale urethral catheterizationFemale urethral catheterizationBasic airway managementOxygen administrationPeak expiratory flow rate (PEFR) measurementInhaler techniqueNon-invasive ventilationPleural fluid aspirationPneumothorax aspirationChest drain insertion (Seldinger)Recording a 12-lead ECGCarotid sinus massageVagal manoeuvresTemporary external pacingDC cardioversionPericardiocentesisNasogastric tube insertionAscitic fluid sampling (ascitic tap)Abdominal paracentesis (drainage)Sengstaken–Blakemore tube insertionBasic interrupted suturingCleaning an open woundApplying a backslabManual handling

scholarly journals Superior Vena Cava Duplication: The Red Herring of Central Line Placement

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Karin Gunther ◽  
Carmen Lam ◽  
David Siegel
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Catheter ◽  
Venous Access ◽  
The United States ◽  
Central Line ◽  
Central Venous ◽  
Central Venous Access Lines

5 million central venous access lines are placed every year in the United States, and it is a common surgical bedside procedure. We present a case of a central venous catheter placement with port for chemotherapy use, during which a duplication of a superior vena cava was discovered on CTA chest after fluoroscopy could not confirm placement of the guidewire. Due to its potential clinical implications, superior vena cava duplication must be recognized when it occurs.

Central venous thrombosis in patients receiving long-term parenteral nutrition

2008 ◽  
Vol 33 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Donald R. Duerksen
Keyword(s):  
Parenteral Nutrition ◽  
Venous Thrombosis ◽  
Vitamin K ◽  
Central Venous Access ◽  
Anticoagulation Therapy ◽  
Venous Catheter ◽  
Venous Access ◽  
Central Venous ◽  
Central Venous Thrombosis

Long-term parenteral nutrition (PN) is administered to patients who are unable to use their gastrointestinal tract to absorb sufficient nutrients and water to maintain their nutritional status. Patients receiving long-term parenteral nutrition are at risk of numerous complications including thrombosis of the central venous catheter used to provide nutrition. Central venous access is essential to the successful delivery of long-term PN. One of the strategies to lessen the frequency of this complication is anticoagulation therapy with warfarin. The effect of warfarin in preventing this complication may be modified by vitamin K intake. Individuals with gastrointestinal failure may receive vitamin K from a variety of sources. This review summarizes the role of warfarin in preventing central venous access thrombosis. It also summarizes potential sources of vitamin K intake in home parenteral nutrition patients, examines the evidence for recommendations regarding vitamin K intake, and considers the potential impact of increased vitamin K intake on home PN patients, particularly on the prevention of central venous thrombosis.

When the course deviates from expected: Misplacement of an epicutaneo-caval catheter in a neonate

2021 ◽  
pp. 112972982110008
Author(s):  
Russell A Kesman ◽  
Amy R Mehollin-Ray ◽  
Regina Lantin-Hermoso ◽  
John Colquitt ◽  
Caraciolo J Fernandes ◽  
...  
Keyword(s):  
Birth Weight ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Extremely Low Birth Weight ◽  
Diagnostic Tools ◽  
Arterial Cannulation ◽  
Radiological Findings ◽  
Central Venous ◽  
Low Birth Weight Infant

Central venous access, a common and essential component of the care of the critically ill neonate, is associated with complications such as infection, thrombosis, and bleeding. Unintentional arterial cannulation of a venous catheter is a rare but potentially dangerous complication. In the report, we describe the accidental cannulation of an artery with an epicutaneo-caval catheter in an extremely low birth weight infant. We discuss the physical and radiological findings that raise the suspicion of an arterial placement of a catheter, the diagnostic tools to confirm the misplacement, the potential complications, and strategies to prevent it.

Cannulation of the popliteal vein as an intraoperative emergency access in prone position: A case report

2021 ◽  
pp. 112972982110080
Author(s):  
Tobias Kammerer ◽  
Tobias Brezina
Keyword(s):  
Prone Position ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Popliteal Vein ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Vein Thrombosis ◽  
Emergency Situations ◽  
Feasible Alternative

Many surgeries have to be performed in the prone position. Access to central vessels is very limited in this position. This requires forward planning with regard to the placement of a central venous catheter. Emergency situations or unexpected intraoperative events in prone position are challenging, as a conventional central venous access is not possible. We describe the cannulation of the popliteal vein in such a case. We report the case of a patient with severe intracerebral hemorrhage who was transferred to our emergency department where his clinical condition rapidly deteriorated. Due to the surgical approach, a prone position was necessary and preoperative central venous cannulation was not possible. We therefore performed an alternative vascular access in prone position using a ultrasound-guided cannulation of the popliteal vein. The cannulation of the popliteal vein described here can be carried out as a quick and easy feasible alternative in emergency situations in prone position. The ultrasound-guided catheter insertion succeeded without any problems and there was no evidence of a deep vein thrombosis after the intervention.

scholarly journals PROVISION OF CENTRAL VENOUS ACCESS DURING ALLOGENEIC HAEMATOPOIETIC STEM CELL TRANSPLANTATION

2019 ◽  
Vol 64 (4) ◽  
pp. 396-411
Author(s):  
M. V. Spirin ◽  
G. M. Galstyan ◽  
M. Yu. Drokov ◽  
L. A. Kuzmina ◽  
G. A. Klyasova ◽  
...  
Keyword(s):  
Conflict Of Interest ◽  
Central Venous Access ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Venous Access ◽  
Haematopoietic Stem Cell ◽  
Central Venous ◽  
Post Transplant ◽  
Antibacterial Coating ◽  
Mechanical Complications

Introduction. The transplantation of allogeneic haematopoietic stem cells (allo-HSCT) is impossible without a central venous catheter (CVC).Aim. To determine an optimal approach to providing venous access during allo-HSCT.Materials and methods. This prospective, non-randomised, single-centre study included 146 patients (70 men and 76 women, median age 37 years) who underwent the fi rst allo-HSCT. Prior to conditioning, one of the following CVCs was placed: Hickman or Leonard tunnelled double-lumen silicone catheters (BardAccessSystem); polyurethane non-tunnelled CVCs without (Certofi x Duo, B. Braun) or with an antibacterial coating (Certofi x Protect Duo, B. Braun). The following complications were recorded: early complications, mechanical complications, catheter-associated thrombosis (CAT), catheterrelated bloodstream infections (CRBSI), as well as catheter exit-site and tunnel infections.Results. A total of 320 CVCs were placed (146 prior to allo-HSCT and 174 in the post-transplant period); 259 of the CVCs were non-tunnelled and 61 were tunnelled. Non-tunnelled CVCs were used for 1–123 days (median 22 days), whereas tunnelled CVCs were implanted for 9–621 days (median 146 days). The use of non-tunnelled CVCs was associated with 2.7 % (1.0/1000 catheter days) of mechanical complications and 9 % of CAT (1.4 / 1000 catheter days). The use of tunnelled CVCs was associated with the following complications: accidental removal — 1 (1.6 %), catheter rupture — 4 (6.5 %), CAT — 5 (8.2 %) patients (0.3 / 1000 catheter days); 18 (29.5 %) patients exhibited catheter obstruction, with CVC function being restored in 14 (77.7 %) patients, whereas in 4 (22.3 %) patients the CVC was removed. The incidence of CRBSI associated with non-tunnelled and tunnelled CVCs was 4.4 and 1.5 per 1000 catheter days, respectively. The study revealed no significant differences in the probability of developing CRBSI between non-tunnelled CVCs with and without antibacterial coating (p = 0.298), as well as between non-tunnelled and tunnelled CVCs in the fi rst 28 days after the catheter placement (p = 0.424). The risk of developing CRBSI when using tunnelled CVCs increased after 150 days of use.Conclusion. Allo-HSCT can be performed using any CVC type. Our study revealed no advantages in employing nontunnelled CVCs with an antibacterial coating compared to those having no coating. Tunnelled CVCs (as opposed to nontunnelled ones) provide the opportunity to employ a single catheter throughout the entire transplantation and post-transplant period. It should be noted that tunnelled CVCs should not be used for more than 150 days, since prolonged use of such CVCs significantly increases the risk of infection.Conflict of interest: the authors declare no conflict of interest.Financial disclosure: the study had no sponsorship.

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