scholarly journals Methods and difficulties of different ways in gaining central line access: a literature review

2021 ◽  
Author(s):  
Muhammad A. Alkholy ◽  
Jumanah T. Albarakati ◽  
Mustafa M. Rawas ◽  
Lujain O. Rayes ◽  
Manal A. Alghamdi ◽  
...  
Keyword(s):  
Literature Review ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Web Of Science ◽  
Central Line ◽  
Central Vein ◽  
Central Catheter ◽  
Ultrasound Guided ◽  
Search Terms ◽  
Determining Factors

The central line is one of the vital techniques in medicine and it is widely used for critically ill patients’ resuscitation. Proper knowledge of the proper techniques and understanding how to choose the perfect central vein for each patient is considered a vital skill for physicians. In this study, we reviewed the literature to provide a simple guide for physicians. PubMed, Medline, Web of Science, Embase, Google Scholar, and Scopus using the following search terms (“Central line” or “central catheter”) and (“method” or “procedure” or “complication”). We included any study that reports the methods and difficulties of different ways of gaining central line access. Based on our results, the proper choice of the central line and the site of insertion are the determining factors for the success of the procedure and decreasing the risk of complications. The ultrasound-guided approach is considered the best option to avoid any injury of the vital structures.

scholarly journals Risks in Management of Enteral Nutrition in Intensive Care Units: A Literature Review and Narrative Synthesis

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 82
Author(s):  
Magdalena Hoffmann ◽  
Christine Maria Schwarz ◽  
Stefan Fürst ◽  
Christina Starchl ◽  
Elisabeth Lobmeyr ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Clinical Practice ◽  
Literature Review ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Rapid Review ◽  
Narrative Synthesis ◽  
Safety Issues

Critically ill patients in the intensive care unit (ICU) have a high risk of developing malnutrition, and this is associated with poorer clinical outcomes. In clinical practice, nutrition, including enteral nutrition (EN), is often not prioritized. Resulting from this, risks and safety issues for patients and healthcare professionals can emerge. The aim of this literature review, inspired by the Rapid Review Guidebook by Dobbins, 2017, was to identify risks and safety issues for patient safety in the management of EN in critically ill patients in the ICU. Three databases were used to identify studies between 2009 and 2020. We assessed 3495 studies for eligibility and included 62 in our narrative synthesis. Several risks and problems were identified: No use of clinical assessment or screening nutrition assessment, inadequate tube management, missing energy target, missing a nutritionist, bad hygiene and handling, wrong time management and speed, nutritional interruptions, wrong body position, gastrointestinal complication and infections, missing or not using guidelines, understaffing, and lack of education. Raising awareness of these risks is a central aspect in patient safety in ICU. Clinical experts can use a checklist with 12 identified top risks and the recommendations drawn up to carry out their own risk analysis in clinical practice.

scholarly journals Use of heparin in patients with severe COVID-19: What is the evidence?

2021 ◽  
Vol 10 (6) ◽  
pp. e28910615820
Author(s):  
Vitória Ribeiro Dantas Marinho ◽  
Camila Vilar Oliveira Villarim ◽  
Laura Cristina Costa e Silva ◽  
André Luiz Costa e Silva ◽  
Irami Araújo-Neto ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Web Of Science ◽  
Pulmonary Thromboembolism ◽  
Cytokine Release ◽  
Beneficial Effects ◽  
Heparin Administration ◽  
Rapid Spread ◽  
New Research ◽  
D Dimer

The rapid spread of coronavirus disease (COVID-19) worldwide urges the need for studies on the illness and its management. The COVID-19 infection leads to hypercoagulation due to inflammatory cytokine release and D-dimer increase in critically ill patients, resulting in pulmonary thromboembolism (PE) and venous thromboembolism (VTE) evolving to sepsis and death. The study evaluated the currently existing evidence on heparin administration in patients with severe COVID-19. An integrative literature review was done by searching for scientific studies in the PubMed, Scopus, Embase, and Web of Science databases. The analyzed studies showed that heparin use in critically ill patients could efficiently prevent thrombotic events and reduce the exacerbated inflammatory process. However, further investigation on the effect on patients is still needed. The use of heparin in critically ill COVID-19 patients has been prescribed increasingly by doctors. But its use has not yet had its outcomes well established in the literature. Therefore, deeper investigations and new research development are needed to clarify potential beneficial effects.

scholarly journals Fluid Removal With Ultrasound Guided Protocol Improves the Efficacy and Safety of Dehydration in Post-Resuscitated Critically Ill Patients

Shock ◽  
2018 ◽  
Vol 50 (4) ◽  
pp. 401-407 ◽  
Author(s):  
Luhao Wang ◽  
Chunfang Qiu ◽  
Xiangdong Guan ◽  
Minying Chen ◽  
Juan Chen ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Efficacy And Safety ◽  
Ultrasound Guided ◽  
Fluid Removal

Sepsis associated with central vein catheters in critically ill patients

1988 ◽  
Vol 14 (3) ◽  
pp. 227-231 ◽  
Author(s):  
P. Collignon ◽  
N. Soni ◽  
I. Pearson ◽  
T. Sorrell ◽  
P. Woods
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Central Vein

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.

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