Anatomic Site-Specific Complication Rates for Central Venous Catheter Insertions

2018 ◽  
Vol 35 (9) ◽  
pp. 869-874 ◽  
Author(s):  
Jacob Bell ◽  
Munish Goyal ◽  
Sallie Long ◽  
Anagha Kumar ◽  
Joseph Friedrich ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Complication Rate ◽  
Venous Catheter ◽  
Complication Rates ◽  
Central Venous ◽  
Site Specific ◽  
Mechanical Complications ◽  
Significant Difference ◽  
Insertion Techniques ◽  
Delayed Complications

Background: Central venous catheter (CVC) complication rates reflecting the application of modern insertion techniques to a clinically heterogeneous patient populations are needed to better understand procedural risk attributable to the 3 common anatomic insertion sites: internal jugular, subclavian, and femoral veins. We sought to define site-specific mechanical and duration-associated CVC complication rates across all hospital inpatients. Methods: A retrospective chart review was conducted over 9 months at Georgetown University Hospital and Washington Hospital Center. Peripherally inserted central catheters and tunneled or fluoroscopically placed CVC’s were excluded. Mechanical complications (retained guidewire, arterial injury, and pneumothorax) and duration-associated complications (deep vein thrombosis or pulmonary embolism, and central line-associated bloodstream infections) were identified. Results: In all, 1179 CVC insertions in 801 adult patients were analyzed. Approximately 32% of patients had multiple lines placed. Of 1179 CVCs, 73 total complications were recorded, giving a total rate of one or more complications occurring per CVC of 5.9%. There was no statistically significant difference between site-specific complications. A total of 19 mechanical complications were documented, with a 1.5% complication rate of one or more mechanical complications occurring. A total of 54 delayed complications were documented, with a 4.4% complication rate of 1 or more delayed complications occurring. There were no statistically significant differences between anatomic sites for either total mechanical or total delayed complications. Conclusions: These results suggest that site-specific CVC complication rates may be less common than previously reported. These data further inform on the safety of modern CVC insertion techniques across all patient populations and clinical settings.

scholarly journals Effect of Central Venous Catheter Care Bundle Implementation on Outcomes of Critically Ill Patients

2020 ◽  
Vol 2 (1) ◽  
pp. 12
Author(s):  
Gehan A. F. Atia
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Catheter ◽  
Care Bundle ◽  
Central Venous ◽  
Significant Difference ◽  
Post Test ◽  
Catheter Care

Context: Central venous access device (CVAD) bundles for insertion and maintenance demonstrate a reduction in the frequency of complications and bloodstream infection when implemented with compliance monitoring, with the reported success of CVAD bundles. Aim: This study aimed to examine the effect of central venous catheter care bundle implementation on outcomes of critically ill patients. Methods: Quasi-experimental research (pre/post-test design) used to achieve the aim of this study. The study conducted at general and surgical intensive care units affiliated to Menoufia University and teaching hospital. Two study samples recruited in this study. All nurses working at the ICUs, as mentioned above, were recruited in this study. They were 6o critical care nurses. A convenient sample of all available critically ill patients at the time of the study was subjected to treatment via a central venous catheter. Four study tools used to collect the data of this study. These are a structured interview questionnaire, CVC nurses’ knowledge assessment questionnaire, nurses’ compliance assessment checklists, and patient complications assessment records. Results: The study result showed a highly statistically significant difference between pre and post-test knowledge scores of studied nurses regarding assisting line insertion, removal, maintenance, care, and infection control practices. Besides, a highly statistically significant difference between pre and post-test scores of nurses’ compliance to central venous catheter care practices of assisting in CVC insertion, blood sample withdrawal, medication and fluid administration, CVP measurements, CVC removal, and the management of central venous line complications. The study also revealed a highly statistically significant difference between the study and control group patients regarding the central venous catheter complications. However, signs of infection were the most frequent complications in both groups. Conclusion. The study concluded that a statistically significant difference between pre and post nurses’ knowledge and compliance with the CVC care bundle. The patients’ outcomes were also improved significantly after the implementation of the CVC care bundle compared to the controls. The study recommended the adoption of the current care bundle that should be disseminated and updated following the international organizations’ recommendation for implementing evidence-based practices for successful central line-associated bloodstream infection (CLABSI) prevention.

scholarly journals Comparison of mechanical complications of central venous catheter according to the insertion site in an intensive care unit of Bangladesh

2020 ◽  
Vol 10 (2) ◽  
pp. 115-119
Author(s):  
Debasish Kumar Saha ◽  
Suraiya Nazneen ◽  
ASM Areef Ahsan ◽  
Madhurima Saha ◽  
Kaniz Fatema ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Insertion Site ◽  
Venous Catheter ◽  
Arterial Puncture ◽  
Central Venous ◽  
Femoral Site ◽  
Mechanical Complications ◽  
Catheter Tip

Background: Central venous catheter (CVC) insertion is very common in intensive care unit (ICU). CVC is usually inserted in subclavian, internal jugular and femoral veins. However, CVC insertion may lead to significant mechanical complications. Our aim was to detect the occurrence of CVC related mechanical complications according to different insertion site. Methods: This prospective observational study was carried out during the period of May 2016 to July 2019 in Department of Critical Care Medicine, BIRDEM General Hospital, Dhaka, enrolling 349 adult patients requiring new CVC insertion in ICU. Results: Among 349 study subjects, 167 CVC were inserted through subclavian vein, 88 through internal jugular and 94 through femoral vein. There was no significant difference among three groups (subclavian / internal jugular / femoral) in terms of age, gender distribution, presence of co-morbid illness.Total mechanical complicationsin study population was 43 (12.3 %) including pneumothorax (14, 4.0%), arterial puncture (10, 2.9%), hemorrhage (11, 3.2%), catheter tip malposition (6, 1.7%), hemothorax (1, 0.3%) and lost guidewire (1, 0.3%). Pneumothorax was more with internal jugular (9.1%) than subclavian (3.6 %) route, which was statistically significant (p=0.007). Although hemorrhage and arterial puncture events were higher with femoral site than subclavian or internal jugular, which were not significant. Catheter tip malposition occurred in 4 (2.4%) patients with subclavian insertion and 2 (2.3%) patients with internal jugular site, no such event in femoral site. Hemothorax and lost guidewire occurred in only 1 patient with subclavian and internal jugular site respectively. Site-wise total mechanical complications were higher in internal jugular (17.0%) followed bysubclavian (10.8%) site and femoral site (10.6%). Conclusion: In this study, though not statistically significant, CVC related mechanical complications occurred more in subclavian site than in internal jugular or femoral insertion site. Birdem Med J 2020; 10(2): 115-119

1175: DO CENTRAL VENOUS CATHETER MECHANICAL COMPLICATION RATES DIFFER BY PROVIDER TYPE?

2016 ◽  
Vol 44 (12) ◽  
pp. 369-369
Author(s):  
Jared Katz ◽  
Zachary Winchester ◽  
Jake Bell ◽  
Anagha Kumar ◽  
Munish Goyal
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Mechanical Complication ◽  
Complication Rates ◽  
Provider Type ◽  
Central Venous

scholarly journals Needleless Closed System Does Not Reduce Central Venous Catheter-Related Bloodstream Infection: A Retrospective Study

2013 ◽  
Vol 98 (1) ◽  
pp. 88-93 ◽  
Author(s):  
Mitsuru Ishizuka ◽  
Hitoshi Nagata ◽  
Kazutoshi Takagi ◽  
Keiichi Kubota
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Closed System ◽  
Venous Catheter ◽  
Time Interval ◽  
Central Venous ◽  
Significant Difference ◽  
Group 2 ◽  
Colorectal Cancer Patients ◽  
Catheter Related Bloodstream Infection

Abstract The needleless closed system (NCS) has been disseminated in several clinical fields to prevent central venous catheter–related bloodstream infection (CVC-RBSI), in place of the conventional Luer cap system (LCS). The purpose of this study is to examine whether NCS is really superior to conventional LCS for prevention of CVC-RBSI. Between May 2002 and December 2008, 1767 patients received CVC in our department. The time interval from insertion to development of CVC-RBSI was compared retrospectively between selected patients who were treated using the conventional LCS (group 1, n = 89, before June 2006) and the NCS (group 2, n = 406, June 2006 and after). Kaplan-Meier analysis revealed no significant difference in the time interval from insertion to development of CVC-RBSI between the two groups. NCS does not reduce CVC-RBSI in adult colorectal cancer patients who undergo CVC insertion.

Ipsilateral vocal fold paralysis: An unusual complication of internal jugular tunnelled dialysis catheter insertion

2019 ◽  
Vol 21 (1) ◽  
pp. 116-119 ◽  
Author(s):  
Sreekanth Koduri ◽  
Alvin Kok Heong Ng ◽  
Debajyoti Roy ◽  
Edmund Chiu Kit Wong
Keyword(s):  
Central Venous Catheter ◽  
Vocal Fold ◽  
Venous Catheter ◽  
Vocal Fold Paralysis ◽  
Catheter Insertion ◽  
Unusual Complication ◽  
Complication Rates ◽  
Dialysis Catheter ◽  
Central Venous Catheter Insertion ◽  
Central Venous

Background: Central venous catheters are extensively used in critical care units and in dialysis centres to gain access to the blood stream for the purpose of invasive monitoring, drug administration, parenteral nutrition and to perform renal replacement therapy. One of the common areas of central venous catheter insertion is right internal jugular vein due to its anatomical continuity with the superior vena cava. The complication rates of central venous catheter insertion can be more than 15%, including early and late complications. Case report: We present an unusual complication of recurrent laryngeal nerve palsy, leading to right vocal fold paralysis, following insertion of a right internal jugular tunnelled dialysis catheter. The vocal fold paralysis improved over next 8 months with conservative management alone. Conclusion: This case illustrates an unusual complication of central venous catheter insertion and the importance of recognizing the possibility of such complications, to prevent them from happening and also to manage them appropriately.

scholarly journals Evaluation of Demographic and Clinical Characteristics of the Patients Undergoing Surgery With Ultrasound in Internal Jugular Vein Cannulation Requiring Central Venous Catheter

2020 ◽  
Vol 23 (4) ◽  
pp. 512-523
Author(s):  
Hossein Hemmati ◽  
◽  
Jalal Aboutalebi ◽  
Mohaya Farzin ◽  
Ghazaleh Hemmati ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Ethics Committee ◽  
Medical Sciences ◽  
Central Venous ◽  
Internal Jugular Vein Cannulation ◽  
Vein Cannulation ◽  
Significant Difference

Background and Aim This study aimed to investigate the demographic and clinical information of patients undergoing surgery with ultrasound in internal jugular vein cannulation. Methods & Materials After the approval of the plan in the ethics committee of Guilan University of Medical Sciences, this study was performed in the general surgery department of Razi Hospital in 2018 on 100 patients in need of central venous catheter implantation. The neck type (distance between the two designated areas) was entered in a special form made by the researcher and after the completion of the design, it was examined and statistically analyzed. Ethical Considerations This research ethically approved by the Ethics Committee of Guilan University of Medical Sciences (Code: IR.GUMS.REC.1396.20) Results The mean age of the studied patients was 58.72±16.09 years. The anatomical and sonographic margins between the two Land Mark areas were higher in men VS women, but there was no statistically significant difference (P>0.05). However, there was no statistically significant difference between the other variables. (P>0.05). Conclusion The findings of this study show that catheterization of the internal jugular vein under the guidance of ultrasound was less access time and fewer complications.

scholarly journals Central venous catheter based closed thoracic drainage in the treatment of tuberculous pleuritis

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Ling Song ◽  
Yueling Zhang ◽  
Qiong Jia
Keyword(s):  
Quality Of Life ◽  
Treatment Group ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Control Group ◽  
Central Venous ◽  
Thoracic Drainage ◽  
Significant Difference ◽  
Tuberculous Pleurisy

Objective: To explore the clinical effect of central venous catheter closed thoracic drainage in the treatment of tuberculous pleurisy. Methods: One hundred and four patients with tuberculous pleurisy who were admitted to Binzhou People’s Hospital from August 2016 to August 2017 were divided into a control group and a treatment group according to random number table method, 52 each. The control group was treated with conventional pleural puncture and drainage, while the treatment group was treated with closed central venous catheter based thoracic drainage. The clinical efficacy, improvement time of clinical symptoms, total volume of drainage, pleural thickness, and improvement of quality of life and occurrence of adverse reactions were compared between the two groups. Results: Pleural effusion, fever and chest tightness of the treatment group disappeared earlier (P<0.05); the hospitalization time in the treatment group was less than that in the control group (P<0.05); the total amount of drainage in the treatment group was lower than that in the control group (P<0.05); the pleural thickness of the treatment group was higher than that in the control group (P<0.05); the quality of life score in the treatment group was significantly higher than that in the control group (P<0.05). The total effective rates of the treatment group and the control group were 93.5% and 85%, respectively, with a significant difference (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group, with a significant difference (P<0.05). Conclusion: Central venous catheter based closed thoracic drainage is more effective than conventional thoracic puncture and drainage in the treatment of tuberculous pleurisy. It can accelerate the improvement of clinical symptoms, improve the quality of life of patients, and reduce the incidence of complications. It is worth popularizing and applying. doi: https://doi.org/10.12669/pjms.35.4.63 How to cite this:Song L, Zhang Y, Jia Q. Central venous catheter based closed thoracic drainage in the treatment of tuberculous pleuritis. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.63 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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