Long-Term Vascular Access Devices

1997 ◽  
Vol 15 (1) ◽  
pp. 237-262 ◽  
Author(s):  
JANET S. FULTON
Keyword(s):  
Vascular Access ◽  
Interrater Reliability ◽  
Future Research ◽  
Central Venous ◽  
Short Term ◽  
Laboratory Methods ◽  
Vascular Access Devices ◽  
Adults And Children ◽  
Patient Subgroups

Introduced in the 1970s, long-term vascular access devices are used in both adults and children, with about 500,000 devices placed annually. This integrative review of research on dressings to minimize infectious catheter-related complications showed that current practices were adapted from knowledge derived from short-term central venous and peripheral catheters without thorough investigation. Summary and critique of recent, as well as older significant studies, provide guidance for future research. Specifically, future research should demonstrate greater confidence in outcome measures with attention to reliability of laboratory methods, diagnostic criteria, and interrater reliability. Continuing research efforts are needed to capture unique design features of various devices, qualify device performance across prolonged time, examine nuances within patient subgroups, and address underrepresented patients and settings. Confounding and interacting variables require greater attention in study design and analysis.

Advanced vascular access

2019 ◽  
pp. 177-190
Author(s):  
Richard Craig
Keyword(s):  
Vascular Access ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Short Term ◽  
Central Lines ◽  
Venous Access Devices

In this chapter, the use of ultrasound to facilitate cannulation of a vessel is described in detail, including commentaries on equipment, preparation, scanning, and needling technique. Equipment and techniques for the insertion of short-term non-tunnelled central lines, long-term central venous access devices, arterial lines, and intraosseous needles are presented.

Clinical and Engineering Considerations for the Design of Indwelling Vascular Access Devices

2005 ◽  
Vol 10 (1) ◽  
pp. 24-27
Author(s):  
Attilio E. Di Fiore
Keyword(s):  
Vascular Access ◽  
Chemical Resistance ◽  
High Strength ◽  
Diagnostic Techniques ◽  
Bolus Administration ◽  
Invasive Procedures ◽  
Short Term ◽  
Vascular Access Devices ◽  
Tissue Interface

As treatment methods in the clinical setting move toward less invasive procedures, the need for materials that possess high strength, greater maneuverability, better vascular and tissue interface, and better long-term (>30 days) implantation capabilities is in greater demand. Historically, vascular access was deemed a requirement for short-term application such as for the bolus administration of drugs or aspiration of blood for various diagnoses, each time requiring a separate cannulation of the vein or artery. As diagnostic techniques have become more sophisticated and the technology of drug design and infusion has advanced, the need for vascular access devices with good chemical resistance, long-term implantation, and high biocompatibility characteristics have become increasingly important to the patient, clinician, and biomedical designer.

scholarly journals The family of vascular access devices

2009 ◽  
Vol 10 (1_suppl) ◽  
pp. S7-S12 ◽  
Author(s):  
Linda J Kelly
Keyword(s):  
Vascular Access ◽  
Community Care ◽  
Relevant Information ◽  
Clinical Settings ◽  
Short Term ◽  
Vascular Access Devices ◽  
Intravenous Access ◽  
The Family

dequate intravenous access is of paramount importance for patients in both acute and community care. Advances in catheter materials and techniques have resulted in a range of vascular access devices being available for use in clinical settings. This article will present an overview of vascular access devices and provide the most relevant information regarding the indications for the use of each device. For the purpose of this article the devices will be divided into short-term, intermediate-term or long-term devices.

MO783CENTRAL VEIN STENOSIS IN HEMODIALYSIS PATIENTS WITH PAST CENTRAL VEIN MANIPULATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Pedro Reis Pereira ◽  
Círia Sousa ◽  
Natalia Silva ◽  
Jose Francisco ◽  
Mónica Fructuoso ◽  
...  
Keyword(s):  
Vascular Access ◽  
Significant Proportion ◽  
Previous History ◽  
Hemodialysis Patients ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Central Venous ◽  
Short Term ◽  
History Of

Abstract Background and Aims Central vein stenosis (CVS) is frequently observed in hemodialysis patients. Risk factors for CVS include prior ipsilateral central venous catheterization (CVC) and cardiac rhythm device (CRD) insertions. Though it may have clinical manifestations, CVS is often asymptomatic and, therefore, not diagnosed. The aim of this work was to evaluate the prevalence of CVS in a population of hemodialysis patients, as well as underlying risk factors, clinical manifestations and impact in patients’ vascular access. Method We retrospectively evaluated all venous angiographies of prevalent patients in our hemodialysis units from 2013 to 2018. In patients with proved CVS, we evaluated history of prior short term and long term upper ipsilateral CVC and CRD insertions. We also analyzed symptoms associated CVS as well as the rate of loss of vascular access for hemodialysis related to the presence of CVS. Results The prevalence of CVS in prevalent patients in hemodialysis during the period of our study (n=209) was 14%. We identified 31 upper CVS in 29 patients undergoing venous angiography. Left brachiocephalic vein was the most commonly affected site (45.1% of cases), followed by the right brachiocephalic vein (19.3%), left subclavian vein (16.1%), right subclavian vein (12.9%) and superior vena cava (6.4%). The majority of patients with CVS (95%) had previous history of ipsilateral CVC (previous short-term CVC in 40%, pervious short term and long-term CVC in 27% and previous long-term CVC in 33%). Loss of vascular access for hemodialysis due do CVS was observed in 26% of patients with CVS. Conclusion A significant proportion of patients in hemodialysis presents CVS. The majority of patients with CVS had a previous history of ipsilateral central venous catherization. A significant proportion of patients with CVS had a previous history central venous catherization uniquely with short term CVC, highlighting the importance of the risk of vascular lesion, even during short periods of catherization. The presence of CVS is associated with a significant rate of loss hemodialysis vascular access.

scholarly journals The Effectiveness of the Ecological Forest Rangers Policy in Southwest China

Forests ◽  
2021 ◽  
Vol 12 (6) ◽  
pp. 746
Author(s):  
Yifan Wang ◽  
Dengju Wang ◽  
Rong Zhao
Keyword(s):  
Poverty Alleviation ◽  
Southwest China ◽  
Rural Poverty ◽  
Ecological Effect ◽  
Income Growth ◽  
Future Research ◽  
Linkage Mechanism ◽  
Short Term ◽  
Forest Protection

To achieve the dual goal of poverty alleviation and ecological restoration, the policy of ecological forest rangers (EFRs) was implemented in rural poverty-stricken areas in China, where local residents commonly depend on nearby forest resources for livelihoods. This study aimed to analyze the short-term and long-term effectiveness of the EFRs policy in China mainly in poverty alleviation and income growth, with a brief discussion on the ecological effect of the policy. A questionnaire survey was conducted in four counties in the Karst rocky desertification region in southwest China. By combing through the early literature on REDD+, community forestry, leasehold forestry, etc., this paper summarizes the experience and lessons of similar community forest management models, aiming to explain the unsustainability of EFRs policy from the perspective of forest tenure and governance. The findings of the effectiveness analysis of EFRs policy in the four poverty-stricken counties reflect different degrees of effect in rural households with different income levels. We believe that the EFRs policy has played important roles in short-term regional poverty alleviation while its potential for long-term income growth has not been stimulated. For the amendment of EFRs policy, we put forward the following points: (1) It is necessary to redesign the selection and recruitment mechanism, as well as the exit mechanism of EFRs adapting to the local conditions. (2) It is advisable to further improve the local assessment and monitoring system of forest protection quality of EFRs and optimize the establishment of benefit linkage mechanism between protection effectiveness and EFRs remuneration. (3) The EFRs remuneration standards should be dynamically raised to assure the active participation of EFRs in forest protection. Furthermore, there is a need for one more effective integration model of forest protection and rural livelihoods improvement, which is considered as a potential future research direction.

A scoping review of Clinical Studies, Hospital Group Reports and National Strategic Documents on vascular access devices in cancer patients

2021 ◽  
pp. 112972982110414
Author(s):  
Jennifer Clesham ◽  
Helen Reynolds ◽  
Peter J Carr
Keyword(s):  
Cancer Patients ◽  
Vascular Access ◽  
Scoping Review ◽  
Future Research ◽  
Infection Rates ◽  
Vascular Access Devices ◽  
Access Device ◽  
Catheter Related Infection ◽  
Scoping Reviews ◽  
Study Designs

Introduction: The extent of vascular/venous access device (VAD) research output from the Island of Ireland is unknown. The identification of the papers available is important to create a future research agenda. Objectives: The main objective of this study is to answer three questions: What is the number and descriptive quality of reported Vascular Access Device literature from the Island of Ireland? Is the reporting of Catheter Related Infection rates for cancer patients common in Irish Hospital Groups, National Cancer Reports and Publication Outputs? What are the implications for future research in this area? Methods: We used a scoping review and searched selected databases, grey literature and hospital regulatory bodies websites following the Joanna Briggs Institute Guidelines 2017. A data charting form was developed based on a template from the Joanna Briggs Institute and this was used to extract data from the included reports. Results: A total of 660 reports were screened. Sixty-one full text articles were reviewed from which 20 reports were included for data extraction. Of the reports included the following designs were used: nine retrospective study designs, four guidelines, two prospective study designs, two literature reviews and one of the following; survey, case study and cross sectional analysis designs. We did not identify any randomised controlled trials, systematic reviews, meta-analysis, meta-synthesis and scoping reviews. Five studies included catheter related infection rates. Gaps in the research include the collection of data sets and the need to establish a VAD registry; develop core outcomes for VADs; assessment and evaluation of VAD care bundles among cancer patients; and, the inclusion of public and patient involvement in future VAD research. Conclusion: The reporting of VAD outcomes in published literature regarding cancer patients receiving treatment in Ireland is inconsistent and varied with no interventional studies addressing vascular access complications in cancer care.

scholarly journals Diagnosis and management of catheter-related bloodstream infections in patients on home parenteral nutrition

2019 ◽  
Vol 11 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Ashley Bond ◽  
Paul Chadwick ◽  
Trevor R Smith ◽  
Jeremy M D Nightingale ◽  
Simon Lal
Keyword(s):  
Parenteral Nutrition ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Nutrition Support ◽  
Central Venous ◽  
Short Term ◽  
Qualitative And Quantitative ◽  
Central Venous Catheter Removal ◽  
Support Team

Catheter-related bloodstream infections (CRBSIs) commonly arise from a parenteral nutrition catheter hub. A target for a Nutrition Support Team is to have a CRBSI rate of less than 1 per 1000. The diagnosis of CRBSI is suspected clinically by a temperature shortly after setting up a feed, general malaise or raised blood inflammatory markers. It is confirmed by qualitative and quantitative blood cultures from the catheter and peripherally. Treatment of inpatients may involve central venous catheter removal and antibiotics for patients needing short-term parenteral nutrition, but catheter salvage is generally recommended for patients needing long-term parenteral nutrition, where appropriate.

scholarly journals All insects are equal, but some insects are more equal than others

2018 ◽  
Vol 120 (4) ◽  
pp. 852-863 ◽  
Author(s):  
Arnout R.H. Fischer ◽  
L.P.A. (Bea) Steenbekkers
Keyword(s):  
Design Methodology ◽  
Prior Experience ◽  
Future Research ◽  
Valuable Contribution ◽  
Short Term ◽  
Content Type ◽  
Quasi Experimental ◽  
Insects As Food ◽  
Practical Implications

Purpose Lack of acceptance of insects as food is considered a barrier against societal adoption of the potentially valuable contribution of insects to human foods. An underlying barrier may be that insects are lumped together as one group, while consumers typically try specific insects. The purpose of this paper is to investigate the ways in which Dutch consumers, with and without insect tasting experience, are more or less willing to eat different insects. Design/methodology/approach In a quasi-experimental study (n=140), the participants with and without prior experience in eating insects were asked to give their willingness to eat a range of insects, and their attitudes and disgust towards eating insects. Findings Insects promoted in the market were more preferred than the less marketed insects, and a subgroup of preferred insects for participants with experience in eating insects was formed. Research limitations/implications Although well-known insects were more preferred, general willingness to eat remained low for all participants. The results indicate that in future research on insects as food the specific insects used should be taken into account. Practical implications Continued promotion of specific, carefully targeted, insects may not lead to short-term uptake of insects as food, but may contribute to willingness to eat insects as human food in the long term. Originality/value The paper shows substantial differences between consumers who have and who have not previously tasted insects, with higher acceptance of people with experience in tasting insects for the specific insects that are frequently promoted beyond their generally more positive attitude towards eating insects.

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