VENOUS ACCESS SYSTEMS АS MEDICAL CARE QUALITY INDICATORS: COMPARATIVE ANALYSIS OF PERIPHERALLY INSERTED CENTRAL CATHETERS AND IMPLANTABLE VENOUS PORT SYSTEMS

2017 ◽  
Vol 4 (2) ◽  
pp. 123-130
Author(s):  
M. Yu. Rykov ◽  
A. A. Petrash ◽  
T. H. Men
Keyword(s):  
Comparative Analysis ◽  
Medical Care ◽  
Quality Indicators ◽  
Venous Access ◽  
Care Quality ◽  
Peripherally Inserted Central Catheters ◽  
Venous Port ◽  
Port Systems ◽  
Central Catheters

Spontaneous Catheter Separation from the Implanted Venous Port and Its Migration to the Venous Heart: Clinical Case

2018 ◽  
Vol 5 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Lyudmila V. Olkhova ◽  
Vladimir E. Popov
Keyword(s):  
Clinical Case ◽  
Care Delivery ◽  
Venous Access ◽  
Cerebellar Hemisphere ◽  
Clinical State ◽  
Venous Port ◽  
Silicone Catheter ◽  
Oncological Diseases ◽  
Left Cerebellar Hemisphere ◽  
Port Systems

Background. Currently, vascular access is one of the most important aspects in specific and accompanying treatment of cancer patients regardless of their age and sex. Partially implanted venous catheters previously described by Hickman were widely applied all over the world. The introduction of completely implanted venous port-systems revolutionized health care delivery and improved the quality of life in patients with oncological diseases. A fully implanted venous port consists of a silicone catheter which distal tip is connected to a port tank implanted subcutaneously. Such a design allows providing safe and multiple adequate vascular accesses regardless of the patient’s clinical state.Case Report. We present a clinical case of a 10-year-old patient diagnosed with medulloblastoma of the cerebellopontine angle and the left cerebellar hemisphere. The case described spontaneous detachment of an implanted venous port catheter and its migration to the venous heart in a patient who underwent chemotherapy by venous access provided through implantation of the venous port.Conclusion. Our clinical case demonstrated a rare and potentially extremely dangerous noninfectious complication associated with the use of venous port-systems. Implanted systems require washing 1–2 times per month with heparinized solutions or solutions containing taurolidine when they are not used. Periodic chest radiographs can reveal integrity alterations of the system. Any implanted system should be removed when it is not used, or it should be monitored on a regular basis.

The upper arm approach for placement of peripherally inserted central catheters for protracted venous access.

1992 ◽  
Vol 158 (2) ◽  
pp. 427-429 ◽  
Author(s):  
J C Andrews ◽  
M V Marx ◽  
D M Williams ◽  
I Sproat ◽  
S C Walker-Andrews
Keyword(s):  
Venous Access ◽  
Upper Arm ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters

Comparison of Outcomes of Extended Dwell/Midline Peripheral Intravenous Catheters and Peripherally Inserted Central Catheters in Children

2016 ◽  
Vol 21 (3) ◽  
pp. 158-164 ◽  
Author(s):  
Jill Anderson ◽  
Angela Greenwell ◽  
Jill Louderback ◽  
Barbara J. Polivka ◽  
Jodi Herron Behr
Keyword(s):  
Decision Tree ◽  
Care Facility ◽  
Venous Access ◽  
Peripherally Inserted Central Catheters ◽  
Included Patient ◽  
Category Type ◽  
Catheter Size ◽  
Venous Access Device ◽  
Record Review ◽  
Central Catheters

Abstract Background: Insertion of extended dwell/midline peripheral intravenous (EPIVs) catheters is not common practice in pediatric hospitals. An interdisciplinary team in 1 pediatric hospital developed a venous access decision tree based on current standards that included EPIVs. The purpose of this evaluation was to assess the process and pediatric patient outcomes associated with use of EPIVs and with peripherally inserted central catheters (PICCs). Methods: A retrospective record review over 22 months was conducted for 375 patients who received either a PICC (67.5%) or EPIV (32.5%). Data collected included patient demographic characteristics, diagnosis category, type and purpose of the line, insertion and removal dates, catheter size, placement location, and complications encountered. Results: EPIVs were inserted with a 1.9F or 3F catheter, whereas PICCs generally used a 3F or 4F catheter. EPIVS were more commonly inserted in children younger than age 1 year, whereas children aged ≥ 11 years more often had a PICC inserted. EPIVs remained in place an average of 9 days compared with 20 days for PICC lines. Significantly more complications occurred during the placement of PICCs, whereas EPIVs had more complications during use such as leakage, dislodging, and infiltration. Conclusions: EPIVs were a successful alternative to PICC or peripherally inserted venous catheters for children in an inpatient acute-care facility who need 30 days or fewer of nonvesicant intravenous therapy. The venous access decision tree provided useful guidance in determining the appropriate venous access device for pediatric patients and the decision tree was adhered to by the vascular access team.

scholarly journals Dealing with Failures of Assumptions in Analyses of Medical Care Quality Indicators with Large Databases Using Clustering

2021 ◽  
Vol 11 (4) ◽  
pp. 835-849
Author(s):  
Kenneth Pietz ◽  
Laura A. Petersen ◽  
LeChauncy D. Woodard
Keyword(s):  
Medical Care ◽  
Quality Indicators ◽  
Care Quality ◽  
Large Databases

Sharp Recanalization of a Chronically Occluded Superior Vena Cava in a Patient with Multiple Prior Peripherally Inserted Central Catheters

2019 ◽  
Vol 24 (2) ◽  
pp. 21-26
Author(s):  
Omar Shwaiki ◽  
Sarah Khoncarly ◽  
James J. Buchino ◽  
Janice McDaniel
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Collateral Flow ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Sharp Recanalization ◽  
Central Catheters

Highlights Recurrent central venous access can lead to central venous occlusions. Collateral flow can be used adventitiously for PICC tip placement. Sharp recanalization can be used to reconstitute patency of an occluded SVC.

Placement of central venous port catheters and peripherally inserted central catheters in the routine clinical setting of a radiology department: analysis of costs and intervention duration learning curve

2017 ◽  
Vol 58 (12) ◽  
pp. 1468-1475 ◽  
Author(s):  
Roman Rotzinger ◽  
Bernhard Gebauer ◽  
Dirk Schnapauff ◽  
Florian Streitparth ◽  
Gero Wieners ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Learning Curve ◽  
Radiology Department ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Central Venous Port ◽  
Venous Port ◽  
Large Patient ◽  
Central Catheters ◽  
Port Catheters

Background Placement of central venous port catheters (CVPS) and peripherally inserted central catheters (PICC) is an integral component of state-of-the-art patient care. In the era of increasing cost awareness, it is desirable to have more information to comprehensively assess both procedures. Purpose To perform a retrospective analysis of interventional radiologic implantation of CVPS and PICC lines in a large patient population including a cost analysis of both methods as well as an investigation the learning curve in terms of the interventions’ durations. Material and Methods All CVPS and PICC line related interventions performed in an interventional radiology department during a three-year period from January 2011 to December 2013 were examined. Documented patient data included sex, venous access site, and indication for CVPS or PICC placement. A cost analysis including intervention times was performed based on the prorated costs of equipment use, staff costs, and expenditures for disposables. The decrease in intervention duration in the course of time conformed to the learning curve. Results In total, 2987 interventions were performed by 16 radiologists: 1777 CVPS and 791 PICC lines. An average implantation took 22.5 ± 0.6 min (CVPS) and 10.1 ± 0.9 min (PICC lines). For CVPS, this average time was achieved by seven radiologists newly learning the procedures after performing 20 CVPS implantations. Total costs per implantation were €242 (CVPS) and €201 (PICC lines). Conclusion Interventional radiologic implantations of CVPS and PICC lines are well-established procedures, easy to learn by residents, and can be implanted at low costs.

scholarly journals Use of totally implantable venous port systems in children hematology clinic

2020 ◽  
Vol 7 (2) ◽  
pp. 35-41
Author(s):  
A. V. Lyanguzov ◽  
S. L. Kalinina ◽  
O. Yu. Sergunina ◽  
S. V. Ignatyev ◽  
O. M. Tselousova ◽  
...  
Keyword(s):  
Perioperative Complications ◽  
Central Venous Access ◽  
Venous Access ◽  
Infectious Complications ◽  
Central Vein ◽  
Pediatric Hematology ◽  
Retrospective Assessment ◽  
Venous Port ◽  
Peripheral Venous Access ◽  
Port Systems

Relevance. Reliable and long-term venous access is one of the most important condition for a successful leukemia therapy in children. Safe and convenient access to a central vein allows to provide chemotherapy, adjuvant treatment, parenteral nutrition and blood transfusion. It decreases the likelihood of phlebitis development and reduction of the peripheral venous network in comparison with peripheral venous access. The use of totally implantable venous port systems reduces risks of severe complications associated with re-catheterization of the central vein thus it improves patient’s quality of life.The purpose of the study is a retrospective assessment of the experience of use and analysis of the complications of totally implantable venous port systems in children with diseases of the blood system.Materials and methods. The data of 61 patients of the pediatric hematology clinic with venous port systems have been analyzed.Results. Perioperative complications developed in 3 (4.9 %) patients Median time of using of port systems was 679 catheter-days. Delayed complications requiring removal of the device developed in 8 (13.1 %) patients. Infectious complications were the reason for device removal in 3 (2.9 %) patients, mechanical complications in 5 (8.2 %) patients. No thrombotic complications were found.Conclusions. The use of venous port systems in children with hematologic diseases for a long period of time is an effective and safe way for central venous access providing.

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