scholarly journals EXPRESS: Pediatric Subcutaneous Treprostinil Site Maintenance and Pain Control Strategies from the Pediatric Pulmonary Hypertension Network (PPHNet)

2021 ◽  
pp. 204589402199445
Author(s):  
Emma Olson Jackson ◽  
Anna Brown ◽  
Julia McSweeney ◽  
Claire Parker
Keyword(s):  
Pulmonary Hypertension ◽  
Pain Management ◽  
Pain Control ◽  
Control Strategies ◽  
Management Strategies ◽  
Venous Catheter ◽  
Perceived Effectiveness ◽  
Central Venous ◽  
Life Threatening ◽  
Pulmonary Arterial

Pulmonary arterial hypertension (PAH) is a chronic, progressive and life-threatening disease in children with diverse causes of PAH. The most severe cases of PAH require aggressive treatments with systemic administration of continuous prostacyclin therapy, including treprostinil and epoprostenol. The successful use of continuous subcutaneous (SubQ) treprostinil therapy eliminates the need for an indwelling central venous catheter and its associated risks. However, pain at the SubQ infusion site, an expected side effect of this therapy, is often a deterrent to its widespread use. Effective SubQ treprostinil site maintenance and pain management is essential to achieve success with this therapy, but strategies surrounding site maintenance and pain control vary significantly between pediatric pulmonary hypertension (PH) treatment centers. In an attempt to standardize practice, a survey on the use of SubQ treprostinil and site maintenance and pain management strategies, as well as its perceived effectiveness, was disseminated to 13 pediatric PH centers of the Pediatric Pulmonary Hypertension Network (PPHNet). Responses to the survey were collected and analyzed and were developed into a set of formalized strategies to facilitate knowledge sharing and standardization of practice.

scholarly journals Inadvertent Insertion of Hemodialysis Catheter into Brachiocephalic Trunk During Cannulation of Internal Jugular Vein: Management Strategies

2022 ◽  
Author(s):  
Chinmaya Nanda ◽  
Vinit Garg ◽  
Ajmer Singh ◽  
Yatin Mehta
Keyword(s):  
Intensive Care Unit ◽  
Jugular Vein ◽  
Management Strategies ◽  
Venous Catheter ◽  
Central Venous Catheter Insertion ◽  
Endovascular Technique ◽  
Central Venous ◽  
Hemodialysis Catheter ◽  
Brachiocephalic Trunk ◽  
Life Threatening

AbstractCentral venous catheter insertion is a commonly performed procedure in the operating room and intensive care unit. It is associated with many complications, some of which may be life-threatening. We report here an accidental insertion of a hemodialysis catheter into the brachiocephalic trunk, which was successfully removed by an endovascular technique.

scholarly journals International survey: real-world pain management strategies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Hagen ◽  
A Georgescu
Keyword(s):  
Pain Management ◽  
Real World ◽  
Pain Control ◽  
Online Survey ◽  
Management Strategies ◽  
Pain Medication ◽  
International Survey ◽  
Nationally Representative ◽  
Online Panels ◽  
Control Pain

Abstract Background Pain is a nearly universal experience, but little is known about how people treat pain. This international survey assessed real-world pain management strategies. Methods From 13-31 January, 2020, an online survey funded by GSK Consumer Healthcare was conducted in local languages in Australia, Brazil, Canada, China, Colombia, France, Germany, India, Italy, Japan, Saudi Arabia, Malaysia, Mexico, Poland, Russia, Spain, Sweden, UK, and USA. Adults were recruited from online panels of people who agreed to participate in surveys. Quotas ensured nationally representative online populations based on age, gender, and region. Results Of 19,000 people (1000/country) who completed the survey, 18,602 (98%) had ever experienced physical pain; 76% said they would like to control their pain better. Presented with 17 pain-management strategies and asked to select the ones they use in the order of use, respondents chose an average of 4 strategies each. The most commonly selected strategies were pain medication (65%), rest/sleep (54%), consult a doctor (31%), physical therapy (31%), and nonpharmacologic action (eg, heat/cold application; 29%). Of those who use pain medication, 56% take some other action first. Only 36% of those who treat pain do so immediately; 56% first wait to see if it will resolve spontaneously. Top reasons for waiting include a desire to avoid medication (37%); willingness to tolerate less severe pain (33%); concerns about side effects (21%) or dependency (21%); and wanting to avoid a doctor's visit unless pain is severe or persistent (21%). Nearly half (42%) of those who take action to control pain have visited ≥1 healthcare professional (doctor 31%; pharmacist 18%; other 17%) about pain. Conclusions This large global survey shows that people employ a range of strategies to manage pain but still wish for better pain control. Although pain medication is the most commonly used strategy, many people postpone or avoid its use. Key messages More than three-quarters (76%) of respondents across countries seek better pain control. Pain medication and rest/sleep consultation are the most common pain management strategies. More than half of respondents (56%) wait to see if pain will resolve spontaneously before taking any action, and 56% of those who use pain medication try some other approach first.

scholarly journals EXPRESS: Pulmonary Hypertension Associated With Neurofibromatosis Type 2

2021 ◽  
pp. 204589402110295
Author(s):  
Hirohisa Taniguchi ◽  
Tomoya Takashima ◽  
Ly Tu ◽  
Raphaël Thuillet ◽  
Asuka Furukawa ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Neurofibromatosis Type ◽  
Pulmonary Vascular Remodeling ◽  
Life Threatening ◽  
History Of ◽  
Pulmonary Arterial ◽  
First Time

Although precapillary pulmonary hypertension (PH) is a rare but severe complication of patients with neurofibromatosis type 1 (NF1), its association with NF2 remains unknown. Herein, we report a case of a 44-year-old woman who was initially diagnosed with idiopathic pulmonary arterial hypertension (IPAH) and treated with PAH-specific combination therapy. However, a careful assessment for a relevant family history of the disease and genetic testing reveal that this patient had a mutation in the NF2 gene. Using immunofluorescence and Western blotting, we demonstrated a decrease in endothelial NF2 protein in lungs from IPAH patients compared to control lungs, suggesting a potential role of NF2 in PAH development. To our knowledge, this is the first time that precapillary PH has been described in a patient with NF2. The altered endothelial NF2 expression pattern in PAH lungs should stimulate work to better understand how NF2 is contributing to the pulmonary vascular remodeling associated to these severe life-threatening conditions.

Life-threatening complications of pulmonary hypertension

ESC CardioMed ◽  
2018 ◽  
pp. 2497-2500
Author(s):  
Marion Delcroix ◽  
Catharina Belge
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Coronary Artery ◽  
Pulmonary Arterial Hypertension ◽  
Severe Disease ◽  
Right Heart Failure ◽  
Artery Dissection ◽  
Life Threatening ◽  
Pulmonary Arterial ◽  
Arterial Dilation

Pulmonary arterial hypertension is a severe disease with a 1-year mortality of over 10%. Since it is a rare disease, it is usually managed in expert centres. However, life-threatening complications can occur at any moment and place and should be adequately taken care of to prevent avoidable deaths. Therefore, based on an analysis of the causes of death, this chapter describes the most important complications and their management: right heart failure, arrhythmias, haemoptysis, pericardial effusion, pulmonary arterial dilation with as a consequence left main coronary artery compression, and pulmonary artery dissection, as well as treatment-related adverse events.

scholarly journals Presumed prenatal closure of foramen ovale and persistent pulmonary hypertension of the newborn

2019 ◽  
Vol 30 (2) ◽  
pp. 281-283
Author(s):  
Katharina Stock ◽  
Miriam Michel ◽  
Elisabeth Schermer ◽  
Elisabeth Ralser ◽  
Ursula Kiechl-Kohlendorfer ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Management Strategies ◽  
Left Ventricular ◽  
Left Ventricular Failure ◽  
Persistent Pulmonary Hypertension ◽  
Foramen Ovale ◽  
Severe Pulmonary Hypertension ◽  
Ventricular Failure ◽  
Life Threatening ◽  
Echocardiographic Findings

AbstractPrenatal closure of foramen ovale without CHD is a rarely reported entity. Therefore, clinical and echocardiographic findings are poorly defined in these patients. We report a patient with prenatal closure of foramen ovale that presented with severe pulmonary hypertension of the newborn and left ventricular failure. Judicious management strategies were utilised to successfully treat both life-threatening conditions.

Central Venous Catheter Securement: Using the Healthcare and Technology Synergy Model to Take a Closer Look

2015 ◽  
Vol 20 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Denise Macklin ◽  
Paul L. Blackburn
Keyword(s):  
Central Venous Catheter ◽  
Health Care Providers ◽  
Venous Catheter ◽  
Clinical Settings ◽  
Care Providers ◽  
Central Venous ◽  
Bacterial Migration ◽  
Life Threatening ◽  
Delay Of Treatment ◽  
Catheter Replacement

Abstract Proper securement provides a safe vascular access device environment for both patients and health care providers. Successful securement protects central venous catheters from several sources of failure until the end of therapy by preventing central venous catheter movement during all phases of care. Movement causes vein trauma, bacterial migration, distal tip location variation, loss of dressing integrity, and even total dislodgement. Any of these events can have serious consequences, including catheter-related bloodstream infection, thrombosis, delay of treatment, catheter replacement, and potential hemorrhage, all of which can be life-threatening events, and increase costs. We review patient issues, practice issues, and the types of securement currently used in clinical settings.

scholarly journals Classification of Pulmonary Hypertension

2014 ◽  
Vol 13 (1) ◽  
pp. 17-20
Author(s):  
Rogerio Souza ◽  
Gerald Simonneau
Keyword(s):  
Pulmonary Hypertension ◽  
Task Force ◽  
Management Strategies ◽  
Pathological Findings ◽  
Clinical Classification ◽  
Current Classification ◽  
Pulmonary Arterial ◽  
Current Classification System ◽  
Group 1

Classification of pulmonary hypertension groups patients with similar pathological findings, hemodynamic profiles, and management strategies. Minor modifications have been made to the current classification system, particularly within Group 1 pulmonary arterial hypertension. This article summarizes the published conclusions of the Fifth World Symposium of Pulmonary Hypertension task force that addressed the updated clinical classification of pulmonary hypertension.

Life-Threatening Mediastinal Hematoma Caused by Extravascular Infusion Through a Triple-Lumen Central Venous Catheter

2004 ◽  
Vol 99 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Matthias Hohlrieder ◽  
Rosmarie Oberhammer ◽  
Ingo H. Lorenz ◽  
Josef Margreiter ◽  
Gabriele Kühbacher ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Central Venous ◽  
Mediastinal Hematoma ◽  
Life Threatening
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