scholarly journals Performing central venous catheters in neonates and small infants undergoing cardiac surgery using a wireless transducer for ultrasound guidance: a prospective, observational pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Judith Schiefer ◽  
Paul Lichtenegger ◽  
Daniel Zimpfer ◽  
Doris Hutschala ◽  
Lorenz Kuessel ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Venous Catheter ◽  
Needle Insertion ◽  
Catheter Insertion ◽  
Success Rates ◽  
Central Venous ◽  
Clear Trend ◽  
Congenital Cardiac Disease ◽  
Survey Results ◽  
Cannulation Success

Abstract Background Neonates and small infants with congenital cardiac disease undergoing cardiac surgery represent major challenges facing paediatric anaesthesia and perioperative medicine. Aims. We here aimed to investigate the success rates in performing ultrasound (US) guided central venous catheter insertion (CVC) in neonates and small infants undergoing cardiac surgery, and to evaluate the practicability and feasibility of thereby using a novel wireless US transducer (WUST). Methods Thirty neonates and small infants with a maximum body weight of 10 kg and need for CVC before cardiac surgery were included in this observational trial and were subdivided into two groups according to their weight: < 5 kg and ≥ 5 kg. Cannulation success, failure rate, essential procedure related time periods, and complications were recorded and the clinical utility of the WUST was assessed by a 5-point Likert scale. Results In total, CVC-insertion was successful in 27 (90%) of the patients and the first attempt was successful in 24 (78%) of patients. Success rates of CVC were 80% < 5 kg and 100% ≥5 kg. Comparing the two groups we found a clear trend towards longer needle insertion time in patients weighing < 5 kg (33 [28–69] vs. 24 [15–37]s, P = .07), whereas, the total time for catheter insertion and the duration of the whole procedure were similar in both groups (199 [167–228] vs. 178 [138–234] and 720[538–818] vs. 660 [562–833]s. In total, we report 3 (10%) cases of local hematoma as procedure-related complications. Assessments of the WUST revealed very good survey results for all parameters of practicability and handling (all ratings between 4.5 and 5.0). Conclusion Although difficulties in CVC-placement seem to relate to vessel size and patient’s weight, US guided CVC-insertion represents a valuable, fast, and safe intervention in neonates and small children undergoing cardiac surgery. Using the WUST is feasible for this clinical application and may aid in efforts aiming to optimize perioperative care. Trial registration Wireless US-guided CVC placement in infants; Clinicaltrials.gov: NCT04597021; Date of Registration: 21October, 2020; retrospectively registered.

Use of Ultrasound Guidance Improves Central Venous Catheter Insertion Success Rates Among Junior Residents

2012 ◽  
Vol 31 (10) ◽  
pp. 1519-1526 ◽  
Author(s):  
Kelly L. Dodge ◽  
Catherine A. Lynch ◽  
Christopher L. Moore ◽  
Brian J. Biroscak ◽  
Leigh V. Evans
Keyword(s):  
Central Venous Catheter ◽  
Ultrasound Guidance ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous Catheter Insertion ◽  
Success Rates ◽  
Central Venous ◽  
Junior Residents

Subclavian Central Venous Catheter Insertion: Angiointerventional Technique

1991 ◽  
Vol 8 (01) ◽  
pp. 78-81 ◽  
Author(s):  
Charitha Fernando ◽  
Louis Juravsky ◽  
Joseph Yedlicka ◽  
David Hunter ◽  
Wilfrido Castañeda-Zúñiga ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous Catheter Insertion ◽  
Central Venous

The value of real-time ultrasound-guidance for definite placement of a right supraclavicular subclavian central venous catheter

2021 ◽  
pp. 112972982199853
Author(s):  
Jens M Poth ◽  
Stefan F Ehrentraut ◽  
Se-Chan Kim
Keyword(s):  
Ultrasound Guidance ◽  
Venous Catheter ◽  
Needle Insertion ◽  
Major Surgery ◽  
Axillary Vein ◽  
Central Venous ◽  
Supraclavicular Fossa ◽  
The Right ◽  
High Index Of Suspicion ◽  
Insertion Process

Central venous catheters (CVC) are widely used in critically ill patients and in those undergoing major surgery. Significant adverse events, such as pneumothorax and hemothorax, can be caused by needle insertion during CVC insertion. CVC misplacement is less often described, yet equally important, as it can lead to deleterious complications. Here, we describe a case in which misplacement of a guidewire following infraclavicular puncture of the right axillary vein was detected by continuous ultrasound employing the right supraclavicular fossa view. Utilizing this ultrasound view, the insertion approach to the vessel was changed and correct CVC placement could be achieved. While ultrasound guidance is widely accepted for vessel puncture, this case demonstrates the value of continuous ultrasound guidance for the entire process of CVC insertion: vessel puncture, correct guidewire advancement, catheter placement, and exclusion of complications such as pneumothorax. It also shows that there should be a high index of suspicion for guidewire misplacement, even after successful venipuncture. In conclusion, ultrasound protocols covering the complete CVC insertion process should be implemented into current clinical practice.

scholarly journals Body surface infrared thermometry in patients with central venous cateter-related infections

2015 ◽  
Vol 13 (3) ◽  
pp. 364-369 ◽  
Author(s):  
José Henrique Silvah ◽  
Cristiane Maria Mártires de Lima ◽  
Maria do Rosário Del Lama de Unamuno ◽  
Marco Antônio Alves Schetino ◽  
Luana Pereira Leite Schetino ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Central Venous Catheter ◽  
Body Surface ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous ◽  
Infrared Thermometer ◽  
The Mean ◽  
Body Surface Temperature ◽  
Insertion Area

Objective To evaluate if body surface temperature close to the central venous catheter insertion area is different when patients develop catheter-related bloodstream infections.Methods Observational cross-sectional study. Using a non-contact infrared thermometer, 3 consecutive measurements of body surface temperature were collected from 39 patients with central venous catheter on the following sites: nearby the catheter insertion area or totally implantable catheter reservoir, the equivalent contralateral region (without catheter), and forehead of the same subject.Results A total of 323 observations were collected. Respectively, both in male and female patients, disregarding the occurrence of infection, the mean temperature on the catheter area minus that on the contralateral region (mean ± standard deviation: -0.3±0.6°C versus-0.2±0.5ºC; p=0.36), and the mean temperature on the catheter area minus that on the forehead (mean ± standard deviation: -0.2±0.5°C versus-0.1±0.5ºC; p=0.3) resulted in negative values. Moreover, in infected patients, higher values were obtained on the catheter area (95%CI: 36.6-37.5ºC versus 36.3-36.5ºC; p<0.01) and by temperature subtractions: catheter area minus contralateral region (95%CI: -0.17 - +0.33ºC versus -0.33 - -0.20ºC; p=0.02) and catheter area minus forehead (95%CI: -0.02 - +0.55ºC versus-0.22 - -0.10ºC; p<0.01).Conclusion Using a non-contact infrared thermometer, patients with catheter-related bloodstream infections had higher temperature values both around catheter insertion area and in the subtraction of the temperatures on the contralateral and forehead regions from those on the catheter area.

Hemodialysis Reliable Outflow (HeRO) graft creation in upper extremities abandoned due to stent obstruction via recanalization and HeRO outflow component insertion across stent interstices

2021 ◽  
pp. 112972982110480
Author(s):  
Brendan C Cline ◽  
Adam Zuchowski ◽  
Shawn M Gage ◽  
Jonathan G Martin ◽  
James Ronald ◽  
...  
Keyword(s):  
Venous Catheter ◽  
Graft Patency ◽  
Upper Extremities ◽  
Success Rates ◽  
Technical Success ◽  
Central Venous ◽  
Kaplan Meier ◽  
Venous Recanalization ◽  
Brachiocephalic Veins ◽  
Graft Implantation

Background: The purpose of this study was to assess the feasibility and outcomes of recanalization and subsequent HeRO graft outflow component insertion across stent interstices in patients with an otherwise abandoned upper extremity. Methods: Over a 10-year period, 15 patients underwent central venous recanalization by interventional radiology across the interstices of one or more occluded stents for the purpose of subsequent HeRO graft creation. A tunneled central venous catheter was left across the stent and occlusions with tip in right atrium. On a later date, the catheter was used for rapid guidewire access for HeRO graft implantation in the OR by vascular surgery. Procedural and clinical outcomes were determined by retrospective review. Primary and secondary HeRO graft patency rates were estimated with the Kaplan-Meier technique. Results: The technical success rates of recanalization across stent interstices was 100% (15/15). Between one and four overlapping stent walls were traversed. The technical success of the patients who underwent attempted HeRO graft implantation with outflow component traversing across stent interstices was 91% (11/12). No major complications were encountered with either recanalization or HeRO graft implantation. The primary and secondary HeRO patency rates at 12 months were 64% and 80%, respectively. Conclusion: HeRO graft insertion across stent interstices is feasible and can provide effective permanent AV access; thus, the presence of stents across the subclavian and brachiocephalic veins should not be considered a contraindication.

Fatal Cardiac Tamponade After Central Venous Catheter Insertion: What Is the Safe Length of Guide-Wire?

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 299A
Author(s):  
Rakesh Vadde ◽  
Meenakshi Ghosh ◽  
Saurav Pokharel ◽  
Setu Patolia ◽  
Dharani Narendra ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cardiac Tamponade ◽  
Guide Wire ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous Catheter Insertion ◽  
Central Venous
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