scholarly journals A case of COVID-19 with superficial thrombophlebitis caused by an indwelling peripheral venous catheter

2021 ◽  
Author(s):  
Hiroaki Tachi ◽  
Midori Hanazawa ◽  
Takashi Matsuda ◽  
Kei Shimizu ◽  
Yusuke Yamamoto
Keyword(s):  
Thrombus Formation ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Hypercoagulable State ◽  
Indwelling Catheters ◽  
Peripheral Venous Catheter ◽  
Superficial Thrombophlebitis ◽  
Vascular Ultrasonography ◽  
Ventilator Management

Abstract Background: COVID-19 is caused by SARS-CoV-2 infection, and cytokine storm and microthrombus formation affect the severity of the disease, which is often complicated by venous thrombosis due to a systemic hypercoagulable state. On the other hand, indwelling peripheral venous catheters can cause catheter-related bloodstream infections and venous thrombus formation, albeit less frequently. Case presentation: A 53-year-old man was admitted to the hospital with severe COVID-19. He had bilateral pneumonia and required ventilator management but recovered after steroid and anticoagulation. On the 26th day after onset, redness, swelling, and pain developed around the insertion site of the catheter placed in the cephalic vein of the left forearm. Vascular ultrasonography revealed a thrombus in this vein accompanied by inflammation in the surrounding tissues. Catheter-related bloodstream infection was suspected and vancomycin was administered; however, blood cultures were negative, leading to the diagnosis of non-infectious superficial thrombophlebitis. The skin findings improved after removal of the peripheral venous catheter. Conclusions: This case suggested that catheter placement in peripheral veins during COVID-19 treatment increases the risk of thrombus formation. Although anticoagulant therapy is able to control the systemic hypercoagulable state caused by COVID-19, indwelling catheters can induce a local hypercoagulable state, leading to superficial thrombophlebitis.

scholarly journals Risk factors for peripheral venous catheter failure: A prospective cohort study of 5345 patients

2021 ◽  
pp. 112972982110150
Author(s):  
Ya-mei Chen ◽  
Xiao-wen Fan ◽  
Ming-hong Liu ◽  
Jie Wang ◽  
Yi-qun Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Goodness Of Fit ◽  
Insertion Site ◽  
Healthcare Providers ◽  
Venous Catheter ◽  
Goodness Of Fit Test ◽  
Peripheral Venous Catheter ◽  
Independent Risk Factors

Purpose: The objective of this study was to determine the independent risk factors associated with peripheral venous catheter (PVC) failure and develop a model that can predict PVC failure. Methods: This prospective, multicenter cohort study was carried out in nine tertiary hospitals in Suzhou, China between December 2017 and February 2018. Adult patients undergoing first-time insertion of a PVC were observed from catheter insertion to removal. Logistic regression was used to identify the independent risk factors predicting PVC failure. Results: This study included 5345 patients. The PVC failure rate was 54.05% ( n = 2889/5345), and the most common causes of PVC failure were phlebitis (16.3%) and infiltration/extravasation (13.8%). On multivariate analysis, age (45–59 years: OR, 1.295; 95% CI, 1.074–1.561; 60–74 years: OR, 1.375; 95% CI, 1.143–1.654; ⩾75 years: OR, 1.676; 95% CI, 1.355–2.073); department (surgery OR, 1.229; 95% CI, 1.062–1.423; emergency internal/surgical ward OR, 1.451; 95% CI, 1.082–1.945); history of venous puncture in the last week (OR, 1.298, 95% CI 1.130–1.491); insertion site, number of puncture attempts, irritant fluid infusion, daily infusion time, daily infusion volume, and type of sealing liquid were independent predictors of PVC failure. Receiver operating characteristic curve analysis indicated that a logistic regression model constructed using these variables had moderate accuracy for the prediction of PVC failure (area under the curve, 0.781). The Hosmer-Lemeshow goodness of fit test demonstrated that the model was correctly specified (χ2 = 2.514, p = 0.961). Conclusion: This study should raise awareness among healthcare providers of the risk factors for PVC failure. We recommend that healthcare providers use vascular access device selection tools to select a clinically appropriate device and for the timely detection of complications, and have a list of drugs classified as irritants or vesicants so they can monitor patients receiving fluid infusions containing these drugs more frequently.

scholarly journals Care of Peripheral Venous Catheter Sites: Advantages of Transparent Film Dressings Over Tape and Gauze

2014 ◽  
Vol 19 (4) ◽  
pp. 256-261 ◽  
Author(s):  
Stéphanie F. Bernatchez
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
The United States ◽  
Central Venous ◽  
Term Care ◽  
Peripheral Venous Catheter ◽  
Care Facilities ◽  
Review Current ◽  
Peripheral Venous Line

AbstractPeripheral intravenous (PIV) catheters are the most commonly used catheters in hospitals, with up to 70% of patients requiring a peripheral venous line during their hospital stay. This represents 200 million PIV catheters used per year in acute-care hospitals in the United States alone. These medical devices are also used in other health care settings, such as long-term care facilities and nursing homes, and common indications include the administration of medications, nutrients, and fluids. These catheters require proper maintenance and care to avoid complications such as phlebitis, infiltration, occlusion, local infection, and bloodstream infection. Recently it has been suggested that PIV catheter use may lead to a higher rate of complications than previously thought. This is important because some studies have claimed that the rate of bloodstream infections due to PIV catheters is actually comparable to the rates observed with central venous catheters, rather than much lower as previously thought. Moreover, catheter-related infections are now seen as largely preventable. Our goal was to review the current literature and provide an overview of the various approaches used to manage PIV catheter sites as well as review current recommendations.

scholarly journals Peripheral Venous Catheter-related Bloodstream Infections in Hospitalized Children

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Itay Berger ◽  
Tal Cohen ◽  
Eyal Rahmani ◽  
Itzhak Levy ◽  
Alexander Lowenthal ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
Hospitalized Children ◽  
Peripheral Venous Catheter

scholarly journals Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Meggiolaro Marco ◽  
Erik Roman-Pognuz ◽  
Baritussio Anna ◽  
Scatto Alessio
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Insertion Site ◽  
Venous Catheter ◽  
Air Bubbles ◽  
Left Internal Jugular Vein ◽  
Central Venous ◽  
Occlusive Dressing ◽  
Vascular Ultrasonography

Central venous catheterization is of common practice in intensive care units; despite representing an essential device in various clinical circumstances, it represents a source of complications, sometimes even fatal, related to its management. We report the removal of a central venous catheter (CVC) that had been wrongly positioned through left internal jugular vein. The vein presented complete thrombosis at vascular ultrasonography. An echocardiogram performed 24 hours after CVC removal showed the presence, apparently unjustified, of microbubbles in right chambers of the heart. A neck-thorax CT scan showed the presence of air bubbles within the left internal jugular vein, left innominate vein, and left subclavian vein. A vascular ultrasonography, focused on venous catheter insertion site, disclosed the presence of a vein-to-dermis fistula, as portal of air entry. Only after air occlusive dressing, we documented echographic disappearance of air bubbles within the right cardiac cavity. This report emphasizes possible air entry even many hours after CVC removal, making it mandatory to perform 24–72-hour air occlusive dressing or, when inadequate, to perform a purse string.

Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments

2017 ◽  
Vol 97 (3) ◽  
pp. 260-266 ◽  
Author(s):  
M. Guembe ◽  
M.J. Pérez-Granda ◽  
J.A. Capdevila ◽  
J. Barberán ◽  
B. Pinilla ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Nationwide Study ◽  
Peripheral Venous Catheter

scholarly journals Comparison of alcohol, povidone-iodine and octenidine dihydrochloride as skin disinfectants to reduce bacterial count prior to peripheral venous catheter insertions in newborn infants

2011 ◽  
Vol 51 (5) ◽  
pp. 277 ◽  
Author(s):  
Lily Rundjan ◽  
Rinawati Rohsiswatmo ◽  
Sarah Rafika ◽  
Enty Enty ◽  
Lucky H. Moehario
Keyword(s):  
Povidone Iodine ◽  
Newborn Infants ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Bacterial Count ◽  
Peripheral Venous Catheter ◽  
Skin Bacteria ◽  
Skin Disinfection ◽  
Octenidine Dihydrochloride ◽  
Before And After

AbstractBackground Vascular access may increase the risk of bloodstream infections, especially in newborn infants with weak immune systems and requiring invasive supportive care. Skin disinfection prior to peripheral venous catheter insertion lowers the risk of infection. However, antiseptics chosen for this task should be effective and safe for newborn infants.Objective To compare the effectiveness of 70% alcohol (BD alcohol swabs ®), 10% povidone-iodine (Pharma-RSUPNCM), and octenidine (Octenisept ®) as antiseptics for reducing skin bacteria for pre-invasive procedures in neonates.Methods Infants aged less than 28 days, regardless of gestational age, at the Neonatal Unit of Cipto Mangunkusumo Hospital (RSUPNCM) were included in our study. Infants were divided into three groups, each tested with different skin antiseptics (alcohol, povidone-iodine or octenidine). Skin swabs were performed before and after application of skin antiseptic, followed by inoculation onto blood agar plates. Colony-forming units were counted after 18 hours of incubation at 37ºC.Results Ninety subjects were divided into 3 groups of 30, each group using either 70% alcohol swabs, 10% povidone-iodine, or octenidine as skin antiseptic. Skin swabs were taken before and after antiseptic application and drying, as well as 5 minutes after application. The mean reductions in CFU/cm2 (%) after antiseptic application (and fully dried) were 97.54% for povidone-iodine, 97.52% for octenidine, and 89.07% for alcohol. There were no significant differences in mean CFU reductions among the three antiseptics groups (P=0.299). Furthermore, 5 minutes after application, there were still no significant differences in the three antiseptic groups (P=0.289).Conclusions Although octenidine showed a significant bacterial count reduction after application, it was not significantly different from those of alcohol or povidone-iodine. [Paediatr Indones. 2011;51:277-81].

scholarly journals Multidisciplinary Central-Line Bundle Audit Rounding: A Strategy to Reduce CLABSIs

2020 ◽  
Vol 41 (S1) ◽  
pp. s323-s323
Author(s):  
Elizabeth Reed ◽  
Elizabeth Mitchell ◽  
Kimberly Barton ◽  
Kelley Boston ◽  
Luis Ostrosky-Zeichner
Keyword(s):  
Insertion Site ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Just In Time ◽  
Multidisciplinary Rounds ◽  
Improve Compliance ◽  
Insertion Sites ◽  
Dressing Change ◽  
Hospital Acquired

Background: Central venous catheter (CVC) maintenance bundle elements, including labeling IV tubing and dressings, consistently changing them, intact dressings, and dry healthy insertion sites, together have been shown to reduce risks of developing central-line–associated bloodstream infections (CLABSIs).1,2 CLABSIs are a significant, but preventable, cause of mortality among critically ill patients.3 In the last 12 months, the 16-bed medical intensive care unit (MICU) at a large, urban, academic facility had 2,621 central-line days, presenting many opportunities for CLABSI prevention. During that time, weekly observations assessed compliance with CVC maintenance bundle elements. Interventions: Multidisciplinary rounds were conducted to monitor nursing staff adherence to CVC maintenance bundle elements. The following bundle elements observed during rounds: (1) Is central-line dressing occlusive/intact? (2) Is CVC insertion site healthy with no redness/drainage? (3) Is CVC dressing labeled with insertion date? (4) Date/time of last dressing change adheres to policy? (4) All CVC tubing is labeled with date/time? (5) All CVC tubing dates adhere to policy? (6) If stopcock is present, is cap present over unused port? “Just-in-time” staff coaching was employed when noncompliance was observed. Findings were sent to leadership for manager follow-up. Staff were informed about products available within the hospital, which can improve dressing adherence and mitigate insertion-site bleeding. Education was provided to staff defining exact requirements for CVC dressings. The acronym “IDOL” was used to help remind staff of these fundamentals: (1) Intact dressing borders are well adhered, with <50% of the white border detached. (2) Drainage should be within the chlorhexidine square. (3) Occlusive means no bubbles, kinks, or wrinkles in the dressing. (4) Labeling is required and must include insertion date, date/time of change, and initials. Results: In the first 2 months of rounds, overall compliance averaged 85%. Compliance increased to an average of 91% during the subsequent 10 months. Early on, most fallouts were found with dressings not occlusive or intact and excessive drainage from insertion sites. Initially, 71% of sites were without excess drainage, and 57% of dressings were occlusive or intact. These measures increased to 83% and 89%, respectively, after the interventions. A 50% decrease in the number of CLABSIs was observed during the observation period, compared to the previous 12-month period. Conclusions: Consistent use of bundles has been shown to significantly improve patient outcomes with regard to hospital-acquired infections (HAIs).3 Frequent observations, education to define staff expectations, and holding staff accountable have all helped improve compliance with maintenance bundle elements. Preventing CLABSIs is not only important for patient safety and quality of care. Regulatory and accrediting agencies are now increasing their focus on infections and are tying them to reimbursement.Funding: NoneDisclosures: None

A Multicenter Intervention to Prevent Catheter-Associated Bloodstream Infections

2006 ◽  
Vol 27 (7) ◽  
pp. 662-669 ◽  
Author(s):  
David K. Warren ◽  
Sara E. Cosgrove ◽  
Daniel J. Diekema ◽  
Gianna Zuccotti ◽  
Michael W. Climo ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Relative Rate ◽  
Femoral Vein ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Evidence Based ◽  
Process Of Care ◽  
Standard Data ◽  
Relative Ratio

Background.Education-based interventions can reduce the incidence of catheter-associated bloodstream infection. The generalizability of findings from single-center studies is limited.Objective.To assess the effect of a multicenter intervention to prevent catheter-associated bloodstream infections.Design.An observational study with a planned intervention.Setting.Twelve intensive care units and 1 bone marrow transplantation unit at 6 academic medical centers.Patients.Patients admitted during the study period.Intervention.Updates of written policies, distribution of a 9-page self-study module with accompanying pretest and posttest, didactic lectures, and incorporation into practice of evidence-based guidelines regarding central venous catheter (CVC) insertion and care.Measurements.Standard data collection tools and definitions were used to measure the process of care (ie, the proportion of non-tunneled catheters inserted into the femoral vein and the condition of the CVC insertion site dressing for both tunneled and nontunneled catheters) and the incidence of catheter-associated bloodstream infection.Results.Between the preintervention period and the postintervention period, the percentage of CVCs inserted into the femoral vein decreased from 12.9% to 9.4% (relative ratio, 0.73; 95% confidence interval [CI], 0.61-0.88); the total proportion of catheter insertion site dressings properly dated increased from 26.6% to 34.4% (relative ratio, 1.29; 95% CI, 1.17-1.42), and the overall rate of catheter-associated bloodstream infections decreased from 11.2 to 8.9 infections per 1,000 catheter-days (relative rate, 0.79; 95% CI, 0.67-0.93). The effect of the intervention varied among individual units.Conclusions.An education-based intervention that uses evidence-based practices can be successfully implemented in a diverse group of medical and surgical units and reduce catheter-associated bloodstream infection rates.

Sign in / Sign up

Export Citation Format

Share Document