A Five-Year Data Report of Long-Term Central Venous Catheters Focusing on Early Complications

Background. Long-term venous access has become the standard practice for the administration of chemotherapy, fluid therapy, antibiotics, and parenteral nutrition. The most commonly used methods are percutaneous puncture of the subclavian and internal jugular veins using the Seldinger technique or surgical cutdown of the cephalic vein. Methods. This study is based on a quality registry including all long-term central venous catheter insertion procedures performed in patients >18 years at our department during a five-year period. The following data were registered: demographic data, main diagnosis and indications for the procedure, preoperative blood samples, type of catheter, the venous access used, and the procedure time. In addition, procedural and early postoperative complications were registered: unsuccessful procedures, malpositioned catheters, pneumothorax, hematoma complications, infections, nerve injuries, and wound ruptures. The Seldinger technique using anatomical landmarks at the left subclavian vein was the preferred access. Fluoroscopy was not used. Results. One thousand one hundred and one procedures were performed. In eight (0.7%) cases, the insertion of a catheter was not possible, 23 (2.1%) catheters were incorrectly positioned, twelve (1.1%) patients developed pneumothorax, nine (0.8%) developed hematoma, and three (0.27%) developed infection postoperatively. One (0.1%) patient suffered nerve injury, which totally recovered. No wound ruptures were observed. Conclusions. We have a high success rate of first-attempt insertions compared with other published data, as well as an acceptable and low rate of pneumothorax, hematoma, and infections. However, the number of malpositioned catheters was relatively high. This could probably have been avoided with routine use of fluoroscopy during the procedure.

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JUGULAR CENTRAL VENOUS CATHETER PLACEMENT THROUGH A MODIFIED SELDINGER TECHNIQUE FOR LONG-TERM VENOUS ACCESS IN CHELONIANS

Journal of Zoo and Wildlife Medicine ◽

10.1638/2015-0143.1 ◽

2016 ◽

Vol 47 (1) ◽

pp. 286-290 ◽

Cited By ~ 5

Author(s):

Mariana A. Pardo ◽

Stephen Divers

Keyword(s):

Central Venous Catheter ◽

Venous Catheter ◽

Venous Access ◽

Catheter Placement ◽

Seldinger Technique ◽

Central Venous ◽

Central Venous Catheter Placement

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Vias para Nutrição Artificial na Criança (II): Acessos Parentéricos

Acta Médica Portuguesa ◽

10.20344/amp.5313 ◽

2014 ◽

Vol 27 (6) ◽

pp. 767

Author(s):

José Estevão-Costa

Keyword(s):

Parenteral Nutrition ◽

Central Venous Catheterization ◽

Venous Catheter ◽

Venous Access ◽

The Body ◽

Central Catheter ◽

Maintenance Care ◽

Central Venous ◽

Venous Catheterization

Parenteral nutrition is crucial when the use of the gastrointestinal tract is not feasible. This article addresses the main techniques for parenteral access in children, its indications, insertion details and maintenance, and complications. The type of venous access is mainly dictated by the expected duration of parenteral nutrition and by the body weight/stature. The peripheral access is viable and advantageous for parenteral nutrition of short duration (< 2 weeks); a tunneled central venous catheter (Broviac) is usually necessary in long-term parenteral nutrition (> 3 weeks); a peripherally introduced central catheter is an increasingly used alternative. Parenteral<br />accesses are effective and safe, but the morbidity and mortality is not negligible particularly in cases of short bowel syndrome. Most complications are related to the catheter placement and maintenance care, and can be largely avoided when the procedures are carried out by experienced staff under strict protocols.<br /><strong>Keywords:</strong> Child; Parenteral Nutrition; Catheterization, Central Venous; Catheterization, Peripheral.

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Ultrasound-guided percutaneous right brachiocephalic vein cannulation in a 5-year-old patient with bilaterally occluded internal jugular veins due to previous access by venous cut-down: A case report

The Journal of Vascular Access ◽

10.1177/11297298211011883 ◽

2021 ◽

pp. 112972982110118

Author(s):

Filiz Uzumcugil

Keyword(s):

Venous Access ◽

Term Treatment ◽

Brachiocephalic Vein ◽

Central Vein ◽

Ultrasound Guided ◽

Central Venous ◽

Jugular Veins ◽

Assessment Protocol ◽

Long Term Treatment

The open surgical venous cut-down technique is widely performed in cases of long-term treatment including administration of chemotherapy, parenteral nutrition, or replacement therapies. However, it has been recommended to avoid this technique considering the resultant unpredictable alterations in the veins draining the relevant site, especially in patients who may need central venous cannulation (CVC) during disease progression. We aimed to report on CVC in a 5-year-old child who had previously undergone bilateral internal jugular venous access by the open venous cut-down technique, in order to highlight the importance of performing the Rapid Central Vein Assessment protocol prior to any intervention and considering to abandon the use of the open surgical venous cut-down technique by gaining experience with ultrasound-guided percutaneous techniques.

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Central venous thrombosis in patients receiving long-term parenteral nutrition

Applied Physiology Nutrition and Metabolism ◽

10.1139/h07-153 ◽

2008 ◽

Vol 33 (1) ◽

pp. 32-38 ◽

Cited By ~ 8

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.

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Central Venous Catheter Placement Using the Seldinger Technique

Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists ◽

10.1093/med/9780190081416.003.0006 ◽

2021 ◽

pp. 55-64

Author(s):

Kirk Lalwani ◽

Philip W. Yun

Keyword(s):

Central Venous Catheter ◽

Central Venous Access ◽

Venous Catheter ◽

Venous Access ◽

Catheter Placement ◽

Seldinger Technique ◽

Central Venous ◽

Rapid Infusion ◽

Patient Factors ◽

Central Venous Catheter Placement

Chapter 6 covers central venous catheter placement, which is often performed for major procedures or in critical pediatric patients. Indications include hemodynamic monitoring, administration of hyperosmolar medications, hemodialysis, and rapid infusion of fluids. Internal jugular, subclavian, and femoral veins are commonly used for central venous access. In the pediatric patient, factors that influence the site of placement include age, likely duration of use, operator expertise, and the need for sedation. After the site of placement is determined, optimal positioning of the patient and meticulous technique are paramount to increase the chance for success. The Seldinger technique is the preferred method for catheterizing the vein following needle venipuncture and is outlined step-by-step in this chapter.

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PORT-A-CATH catheter rupture: case report

International Journal of Medical and Surgical Sciences ◽

10.32457/ijmss.v8i4.1742 ◽

2022 ◽

pp. 1-7

Author(s):

Manuel de la O Escamilla ◽

Rodrigo Gómez-Álvarez ◽

Héctor Vergara Miranda ◽

Jorge Adrián Garza-Cerna

Keyword(s):

Case Report ◽

Radical Mastectomy ◽

Venous Catheter ◽

Venous Access ◽

Progressive Increase ◽

Brachiocephalic Vein ◽

Seldinger Technique ◽

Patient Reports ◽

The Right

Introduction: The modern management of cancer treatment requires access to the venous system repeatedly for the passage of drugs, fluids and blood components. Peripheral veins are rapidly damaged by repeated punctures and by fluids that pass through them. To solve this problem, long-term vascular accesses avoid repeated punctures. One type of long-term venous access is the Port-A-Cath, which is an implantable device usually in the chest with a central venous catheter. Case report: Next, the case of a 34-year-old female with a diagnosis of breast cancer in the right breast is presented. It is treated with a radical mastectomy, and after the procedure a port-a-cath is placed in the left subclavian route for future treatments. The first cycle of chemotherapy is performed, later the patient reports pain at the catheter placement site with increased volume and progressive increase in pain. The patient goes to her health center for an evaluation, they decide to take a chest X-ray showing the migration of the catheter. The management used was through the seldinger technique at the femoral puncture site with a 6 Fr Amplatz GooseNeck Snare Guide, with which it was possible to extract the foreign body at the level of the left brachiocephalic vein. Conclusion: The implantation of a Port-A-Cath catheter is associated with some risks in the process. Catheter and patient care should be maintained to decrease the incidence of complications.

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