scholarly journals The risk of fatal bleeding complications in jugular catheterization in patients with coagulopathy: A retrospective analysis of death cases in closed claims and the Medical Accident Investigating System in Japan

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261636
Author(s):  
Yasuhiro Otaki ◽  
Naofumi Fujishiro ◽  
Yasuaki Oyama ◽  
Naoko Hata ◽  
Daisuke Kato ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Insertion Site ◽  
Bleeding Complications ◽  
Central Venous ◽  
Error Type ◽  
Safety Research ◽  
Venous Catheterization ◽  
Medical Accident ◽  
Death Cases ◽  
Closed Claim

Background To prevent recurrence of medical accidents, the Medical Accident Investigating System was implemented in October 2015 by the Japan Medical Safety Research Organization (Medsafe Japan) to target deaths from medical care that were unforeseen by the administrator. Medsafe Japan analyzed the 10 cases of central venous catheterization-related deaths reported in the system and published recommendations in March 2017. However, the particular emphasis for the prevention of central venous catheterization-related deaths is unclear. Methods This study aimed to identify the recommendation points that should be emphasized to prevent recurrence of central venous catheterization-related deaths. We assessed central venous catheterization in 8530 closed-claim cases between January 2002 and December 2016 covered by the medical insurer Sompo-Japan. Moreover, we compared central venous catheterization-related death in closed-claim cases with death in reported cases. Results The background, error type, anatomic insertion site, and fatal complication data were evaluated for 37 closed-claim cases, of which 12 (32.4%) were death cases. Of the 12 closed-claim cases and 10 reported cases, 9 (75.0%) closed-claim cases and 9 (90.0%) reported cases were related to vascular access. Among these, 5 closed-claim cases (41.7%) and 7 reported cases (77.8%) were related to internal jugular vein catheterization (p = 0.28). Coagulopathy was observed in 3 (60.0%) of 5 closed-claim cases and 6 (85.7%) of 7 reported cases. Conclusions The risk of internal jugular catheterization in patients with coagulopathy must be carefully considered.

Intravascular Complications of Central Venous Catheterization by Insertion Site

2015 ◽  
Vol 373 (13) ◽  
pp. 1220-1229 ◽  
Author(s):  
Jean-Jacques Parienti ◽  
Nicolas Mongardon ◽  
Bruno Mégarbane ◽  
Jean-Paul Mira ◽  
Pierre Kalfon ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Insertion Site ◽  
Central Venous ◽  
Venous Catheterization

Bleeding complications of central venous catheterization in septic patients with abnormal hemostasis

2014 ◽  
Vol 32 (7) ◽  
pp. 737-742 ◽  
Author(s):  
David R. Vinson ◽  
Dustin W. Ballard ◽  
Luke G. Hance ◽  
YunYi Hung ◽  
Adina S. Rauchwerger ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Bleeding Complications ◽  
Central Venous ◽  
Venous Catheterization

Bleeding Complications of Central Venous Catheterization in Septic Patients With Abnormal Hemostasis

2013 ◽  
Vol 62 (4) ◽  
pp. S134
Author(s):  
D.R. Vinson ◽  
L.G. Hance ◽  
D.G. Mark ◽  
D.W. Ballard ◽  
Y.Y. Hung ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Bleeding Complications ◽  
Central Venous ◽  
Venous Catheterization

scholarly journals Ultrahangvezérelt centrálisvéna-biztosítás korrigálatlan coagulopathiában

2015 ◽  
Vol 156 (27) ◽  
pp. 1085-1090
Author(s):  
Géza Reusz ◽  
Csilla Langer ◽  
Tibor Hevessy ◽  
Ákos Csomós
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Central Venous Catheterization ◽  
Central Venous Access ◽  
Venous Access ◽  
Bleeding Complications ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Venous Catheterization ◽  
Clopidogrel Therapy

Introduction: Correction of coagulopathy prior to central venous catheterization is a standard practice. Before ultrasound-guided procedures, routine correction of coagulopathy is controversial as mechanical complications are rare. Aim: To evaluate the safety of ultrasound-guided central venous access in critically ill patients with coagulopathy. Method: In this retrospective study the authors included all ultrasound-guided central venous catheterizations performed in their Intensive Care Unit between February 2011 and January 2013. They defined coagulopathy as INR or APTT ratio above 1.5, platelet count below 100 G/l, and anticoagulation or clopidogrel therapy. Data obtained from ultrasound register and patient records were used. Results: 310 ultrasound-guided central venous catheterizations were performed. Coagulopathy was observed in 134 cases (43.2%) and corrected in 10 cases prior to catheterization. There were no bleeding complications (complication rate in uncorrected coagulopathy: 0%, 95% confidence interval: 0-3.0%). Conclusions: Coagulopathy is common in critically ill patients, but its routine correction prior to ultrasound-guided central venous catheterization seems unnecessary. Orv. Hetil., 2015, 156(27), 1085–1090.

scholarly journals Objective Assessment Metrics for Central Line Simulators: An Exploration of Causal Factors

2020 ◽  
Vol 64 (1) ◽  
pp. 2008-2012
Author(s):  
Jessica M. Gonzalez-Vargas ◽  
Dailen C. Brown ◽  
Jason Z. Moore ◽  
David C. Han ◽  
Elizabeth H. Sinz ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Objective Assessment ◽  
Central Line ◽  
Expert Interviews ◽  
Central Venous ◽  
Patient Case ◽  
Causal Factors ◽  
Venous Catheterization ◽  
Assessment Metrics ◽  
Automated Feedback

The Dynamic Haptic Robotic Trainer (DHRT) was developed to minimize the up to 39% of adverse effects experienced by patients during Central Venous Catheterization (CVC) by standardizing CVC training, and provide automated assessments of performance. Specifically, this system was developed to replace manikin trainers that only simulate one patient anatomy and require a trained preceptor to evaluate the trainees’ performance. While the DHRT system provides automated feedback, the utility of this system with real-world scenarios and expertise has yet to be thoroughly investigated. Thus, the current study was developed to determine the validity of the current objective assessment metrics incorporated in the DHRT system through expert interviews. The main findings from this study are that experts do agree on perceptions of patient case difficulty, and that characterizations of patient case difficulty is based on anatomical characteristics, multiple needle insertions, and prior catheterization.

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