Severe cutaneous necrotizing vasculitis with postinfectious glomerulonephritis secondary to peripherally inserted central catheter bloodstream infection

2020 ◽  
pp. 112972982097078
Author(s):  
Francesco Londrino ◽  
Antonio Granata ◽  
Slave Boiceff ◽  
Massimo Guadagni ◽  
Sara Dominijanni ◽  
...  
Keyword(s):  
Term Therapy ◽  
Peripherally Inserted Central Catheter ◽  
Necrotizing Vasculitis ◽  
Central Catheter ◽  
Central Venous ◽  
Safe Alternative ◽  
Postinfectious Glomerulonephritis ◽  
Long Term Therapy ◽  
Central Catheters

Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients particularly in the oncological and hematological field. PICCs are a safe alternative to central venous catheters, mainly for medium- and long-term therapy

Peripherally Inserted Central Catheter Lines in the Behavioral Health Client: A Perspective

2006 ◽  
Vol 11 (3) ◽  
pp. 154-156
Author(s):  
Vera Deacon ◽  
Susan Oliver
Keyword(s):  
Behavioral Health ◽  
Chemotherapeutic Agents ◽  
Treatment Modalities ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Short Term ◽  
Hyperosmolar Solutions ◽  
Central Catheters ◽  
Indications For Use

Abstract Peripherally inserted central catheters (PICCs) are used in many different patient populations. The indications for use vary and include infusions of hyperalimentation, chemotherapeutic agents, hyperosmolar solutions, antibiotics, or long-term rehydration. However, on occasion, there are clients who do not fit the typical criteria for PICC insertion. This includes, but is not limited to, those individuals who are receiving frequent intravenous (IV) “sticks” or even short-term infusions of irritating drugs. The behavioral health client is one who may not be the typical PICC or IV patient but who may benefit from the placement of a PICC for certain treatment modalities.

Percutaneous removal of a precariously placed pericardial peripherally inserted central catheter

2019 ◽  
Vol 20 (6) ◽  
pp. 778-781
Author(s):  
Trevor Tyner ◽  
Noelle McNaught ◽  
Matthew B. Shall ◽  
Mark L. Lessne
Keyword(s):  
Parenteral Nutrition ◽  
Unusual Complication ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Blood Products ◽  
Peripherally Inserted Central Catheters ◽  
Percutaneous Removal ◽  
Essential Function ◽  
Central Catheters

Peripherally inserted central catheters provide access to the central chest veins and allow administration of long-term antibiotics, chemotherapy, blood products, fluids, and parenteral nutrition. Peripherally inserted central catheters provide an essential function and are routinely placed safely, but are not without risks. This case describes an unusual complication of peripherally inserted central catheter perforation into the pericardial space with subsequent successful percutaneous removal.

Peripherally inserted central catheter placement in a multidisciplinary intensive care unit: A preliminary study demonstrating safety and procedural time in critically ill subjects

2020 ◽  
pp. 112972982092861
Author(s):  
Ryan J Smith ◽  
Rodrigo Cartin-Ceba ◽  
Julie A Colquist ◽  
Amy M Muir ◽  
Jeanine M Moorhead ◽  
...  
Keyword(s):  
Critically Ill ◽  
Vascular Access ◽  
Critically Ill Patients ◽  
Catheter Placement ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Time Required ◽  
Central Catheters

Objective: Peripherally inserted central catheters are a popular means of obtaining central venous access in critically ill patients. However, there is limited data regarding the rapidity of the peripherally inserted central catheter procedure in the presence of acute illness or obesity, both of which may impede central venous catheter placement. We aimed to determine the feasibility, safety, and duration of peripherally inserted central catheter placement in critically ill patients, including obese patients and patients in shock. Methods: This retrospective cohort study was performed using data on 55 peripherally inserted central catheters placed in a 30-bed multidisciplinary intensive care unit in Mayo Clinic Hospital, Phoenix, Arizona. Information on the time required to complete each step of the peripherally inserted central catheter procedure, associated complications, and patient characteristics was obtained from a prospectively assembled internal quality assurance database created through random convenience sampling. Results: The Median Procedure Time, beginning with the first needle puncture and ending when the procedure is complete, was 14 (interquartile range: 9–20) min. Neither critical illness nor obesity resulted in a statistically significant increase in the time required to complete the peripherally inserted central catheter procedure. Three (5.5%) minor complications were observed. Conclusion: Critical illness and obesity do not delay the acquisition of vascular access when placing a peripherally inserted central catheter. Concerns of delayed vascular access in critically ill patients should not deter a physician from selecting a peripherally inserted central catheter to provide vascular access when it would otherwise be appropriate.

Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia

2020 ◽  
Vol 21 (6) ◽  
pp. 861-867 ◽  
Author(s):  
Emanuele Iacobone ◽  
Daniele Elisei ◽  
Diego Gattari ◽  
Luigi Carbone ◽  
Giuseppe Capozzoli
Keyword(s):  
Central Venous Catheter ◽  
Transthoracic Echocardiography ◽  
Venous Catheter ◽  
Atrial Arrhythmia ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Bubble Test ◽  
Central Catheters

Introduction: Transthoracic echocardiography with bubble test is an accurate, reproducible, and safe technique to verify the location of the tip of the central venous catheter. The aim of this study is to confirm the effectiveness of this method for tip location in patients with atrial arrhythmia. Methods: Transthoracic echocardiography with bubble test was adopted as a method of tip location in patients with atrial arrhythmia requiring central venous catheter. If bubbles were evident in the right atrium in less than 2 s after simple saline injection, tip placement was assumed as correct. In cases of uncertain visualization of the bubble effect, the test was repeated injecting a saline–air mixture. Tip location was also assessed by post-procedural chest X-ray. Results: In 42 patients with no evident P-wave at the electrocardiography, we placed 34 centrally inserted central catheters and 8 peripherally inserted central catheters. Transthoracic echocardiography with bubble test detected two centrally inserted central catheter malpositions. In four patients with peripherally inserted central catheter, transthoracic echocardiography with bubble test was positive only when repeated with the saline–air mixture. When the transthoracic echocardiography was positive, the mean (±standard deviation) time for onset of the bubble effect was 0.89 ± 0.33 s in patients with centrally inserted central catheter and 1.1 ± 0.20 s in those with peripherally inserted central catheter; such time difference was not statistically significant (p > 0.05). Conclusion: Tip location of central venous catheter by transthoracic echocardiography with bubble test is feasible, safe, and accurate in patients with atrial arrhythmia. This method can also be applied in peripherally inserted central catheters; however, further studies may be needed to confirm its use in this type of catheters.

scholarly journals TUNNELED ADULT PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) FOR CENTRAL VENOUS ACCESS IN PAEDIATRICS: A SINGLE CENTRE EXPERIENCE

2021 ◽  
Vol 1 (2) ◽  
pp. 34-37
Author(s):  
Nurul Nabila Mortadza ◽  
Arvin Rajadurai ◽  
Norhafizah Ehsan ◽  
Ganesan Arthimulam ◽  
Noorshahrizal Nordin ◽  
...  
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Intravenous Access ◽  
Single Centre Experience ◽  
Feasible Option ◽  
Premature Removal

Objective: Long term intravenous access in paediatrics is challenging in terms of ease of procedure, maintenance of catheter and complications. Small calibre of peripheral veins in children make insertion of peripheral long-term access difficult. Our centre adopted the use of tunneled adult Peripherally Inserted Central Catheter (PICC) for central venous access in paediatrics with the hope to improve these challenges. We describe a single institute 3-year experience of this technique. Material & Methods: Retrospective analysis of patients aged less than 12 years old who had tunneled PICC insertions from January 2018 till December 2020. The following data was recorded and studied: indication, reason for removal, duration of PICC, vessel inserted, device type and complications. Results: Eleven adult PICCs were inserted from this technique in 10 children. The average age was 35.7months and weight was 13.2kg. The youngest patient was 3 months old at 6.9kg. Most common indication for insertion was for long term antibiotics (82%) and the remainder were for difficult intravenous access. The procedure was done under local anaesthetic with sedation in 90% of cases. Average duration of PICC was 26.8 days. Out of 11 PICCs only 1 had line related infection that required premature removal of the catheter. 55% completed the intended duration while 27% of PICCs had dislodged. Conclusion: Tunnelled adult PICC for central venous access in paediatrics is a feasible option for long term vascular access and has a lower risk of infection. However, almost a third of the catheters inserted still suffered premature dislodgement.

Atypical use of PICC in Infants and Small Children: A Unicentric Experience

2017 ◽  
Vol 18 (6) ◽  
pp. 535-539 ◽  
Author(s):  
Filippo Bernasconi ◽  
Clelia Zanaboni ◽  
Andrea Dato ◽  
Andrea Dolcino ◽  
Michela Bevilacqua ◽  
...  
Keyword(s):  
Vascular Access ◽  
Pediatric Population ◽  
Conventional Technique ◽  
Term Therapy ◽  
Puncture Site ◽  
Vascular Access Devices ◽  
Small Children ◽  
Long Term Therapy ◽  
Central Catheters

Introduction The peripherally inserted central catheters (PICCs) are vascular access devices (VAD) that are increasingly being used in the pediatric population. If a small vein caliber prevents positioning the catheter in the arm, the following step is to position the same catheter in the supraclavicular area, which can be defined as an off-label use or “atypical” approach, first described by Pittiruti. Materials and methods We retrospectively reviewed PICC positioning with puncture-site in the supra-clavicular area (“atypical” PICC insertion) and then tunneled on the chest. Results Nineteen atypical PICCs were positioned in 18 patients. The median age of patients at the day of implant was 14 months (IQR 3-27 months), and weight 7.5 kg (IQR 4-12 kg). Within this population, 74% of cases scheduled for a typical PICC insertion presented vein caliber too small for this procedure. For this reason, the typical PICC insertion was changed in favor of an atypical PICC procedure. Atypical PICCs were successfully used in 100% of cases without immediate complications. Conclusions Atypical PICC positioning is a safe and useful alternative to the conventional technique when there is need for a central vascular access device (CVAD) for mid- or long-term therapy.

Assessing the Quality of Central Venous Catheter and Peripherally Inserted Central Catheter Videos on the YouTube Video-Sharing Web site

2013 ◽  
Vol 18 (3) ◽  
pp. 177-182 ◽  
Author(s):  
Peter J. Carr ◽  
Evan Alexandrou ◽  
Gavin M. Jackson ◽  
Timothy R. Spencer
Keyword(s):  
Venous Catheter ◽  
Central Venous Catheters ◽  
Evidence Based ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Video Sharing ◽  
Evidence Based Guidelines ◽  
Central Catheters

AbstractBackground: Video sharing networks such as YouTube have revolutionized communication. Whilst access is freely available uploaded videos can contain non peer-reviewed information. This has consequences for the scientific and health care community, when the challenge in teaching is to present clinical procedures that follow empirical methods.Objective: To review 50 central venous catheter and peripherally inserted central catheter videos posted on YouTube. The aim was to appraise these videos using current evidenced-based guidelines.Methods: We searched YouTube using the key words central venous cannulation and peripherally inserted central catheter insertion on September 21, 2012. We consecutively reviewed 50 videos for both procedures.Results: There was poor adherence to evidence-based guidelines in the critiqued videos. There was a difference in adherence with the use of appropriate skin antisepsis in the 2 groups (18% for central venous catheters vs 52% for peripherally inserted central catheters; p = 0.009). And a large proportion in both groups compromised aseptic technique (37% for central venous catheters vs 38% for peripherally inserted central catheter; p = 0.940). The use of ultrasound guidance during procedures was also different between the 2 groups (33% for central venous catheters vs 85% for peripherally inserted central catheters; p = 0.017).Conclusions: This critique of instructional videos related to the insertion of central venous catheters and peripherally inserted central catheters uploaded to YouTube has highlighted poor adherence to current evidence-based guidelines. This lack of adherence to empirical guidelines can pose risks to clinical learning and ultimately to patient safety.

Antithrombotic Therapy for DVT/PE

1997 ◽  
Vol 17 (03) ◽  
pp. 161-162
Author(s):  
Thomas Hyers
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Cost Effective ◽  
Therapeutic Agents ◽  
Great Promise ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
Long Term Therapy

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.

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