Use of Peripherally Inserted Central Catheter as a Facilitator in the Juvenile Cancer Therapeutic Process

2021 ◽  
Vol 17 ◽  
Author(s):  
Natalia Cristina Liubartas ◽  
Thaís Moura Gascón ◽  
Rosangela Filipini ◽  
Fernando Luiz Affonso Fonseca
Keyword(s):  
Central Venous Catheter ◽  
Medical Records ◽  
Therapeutic Process ◽  
Secondary Data ◽  
Venous Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Cross Sectional ◽  
Non Profit ◽  
Catheter Implantation

Objective: To analyze the characteristics of insertion and maintenance of 163 peripherally inserted central venous catheters in juvenile patients oncological. Methods: This is an observational study of a cross-sectional and longitudinal collection, with quantitative approach of secondary data from patient’s medical records that underwent the procedure for a peripheral insertion central catheter implantation, carried out in a non-profit health institution (HI) in Sao Paulo, Brazil, specialized in the treatment of childhood-juvenile cancer, and which attends children and adolescents from all regions of Brazil. Results: the measurement of the external catheter, when greater than 2 centimeters, negatively influences the period of the segment used (p = 0.007) and is associated with catheter removal for unforeseen causes (p = 0.013); displacement was the main cause of unexpected removal of peripherally inserted central venous catheter. Conclusion: Peripherally inserted central venous catheter is a safe option when the entire therapeutic trajectory is reached.

scholarly journals Guide-wire replacement of a mini-midline catheter with a central venous catheter: A retrospective study on 63 cases

2020 ◽  
pp. 112972982094406
Author(s):  
Lucio Brugioni ◽  
Elisabetta Bertellini ◽  
Mirco Ravazzini ◽  
Marco Barchetti ◽  
Andrea Borsatti ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Guide Wire ◽  
Case Series ◽  
Venous Catheter ◽  
Venous Access ◽  
Late Complications ◽  
Central Catheter ◽  
Central Venous ◽  
Single Lumen ◽  
Thrombotic Complications

Background: Achieving a reliable venous access in a particular subset of patients and/or in emergency settings can be challenging and time-consuming. Furthermore, many hospitalized patients do not meet the criteria for central venous catheter positioning, unless an upgrade of the treatment is further needed. The mini-midline catheter has already showed to be reliable and safe as a stand-alone device, since it is easily and rapidly inserted and can indwell up to 1 month. Methods: In this further case series, we retrospectively evaluated data from 63 patients where a previously inserted mini-midline catheter was upgraded to a central venous catheter (the devices inserted in the arm replaced by peripherally inserted central catheter and others inserted “off-label” in the internal jugular replaced by single lumen centrally inserted central catheter), being used as introducer for the Seldinger guidewire. Results: The guidewire replacement was been made even early (after 1 day) or late (more than 10 days), usually following a need for an upgrade in treatment. No early or late complications were reported. Conclusion: According to the preliminary data we collected, this converting procedure seems to be feasible and risk-free, since neither infectious nor thrombotic complications were reported.

scholarly journals Bedside ultrasound as a screening test for the diagnosis of catheter-related bloodstream infection (CRBI)

2021 ◽  
Author(s):  
Chiara de Sio ◽  
Mario Venafro ◽  
Giampiero Foccillo ◽  
Riccardo Nevola ◽  
Lucio Monaco
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Signs And Symptoms ◽  
Venous Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Roc Curve Analysis ◽  
Suspected Infection ◽  
Intravascular Devices ◽  
A Prospective Study

Abstract Purpose Between 15 and 30% of all nosocomial bacteremias and sepsis are associated with the use of intravascular devices. Catheter-related bloodstream infections (CRBI) are infections in which the organism identified in the blood is also present on the tip of the catheter itself or in a blood sample taken through it. The aim of the study was to evaluate the role of ultrasound in the diagnosis of infections related to the use of central catheters. Methods Between January 2018 and June 2019, we carried out a prospective study on 36 patients with a central catheter, such as a central venous catheter (CVC), a central catheter with peripheral insertion (PICC), or a fully implanted central venous catheter (PORT-a-cath) and who had signs and symptoms of infection. These patients were submitted to an ultrasound of the catheter upon arrival in the ward in case of suspected infection, or at the time of the onset of signs and symptoms of infection (if these arose during hospitalization). Patients with a central catheter but without signs and symptoms of infection were not included in the study. The end point of the study was to evaluate sensitivity (SENS), specificity (SPEC), positive and negative predictive value (PPV-NPV) and overall diagnostic accuracy (ODA) of ultrasound in the diagnosis of CRBI through Receiver Operating Characteristic (ROC) curve analysis. Results US showed a SENS of 94%, a SPEC of 84%, a PPV of 84%, an NPV of 94% and an ODA of 88.8% for the diagnosis of CRBI. Conclusions Preliminary data from our study show that US of intravascular devices has a high SENS and SPEC in the diagnosis of CRBI, and can, therefore, be used as a valid tool to decide whether to remove the device early or leave it in place.

scholarly journals A Novel Objective Approach Towards Physicians' Knowledge and Practice Patterns to Optimize Central Venous Catheter Placement: A Cross-sectional Study

2020 ◽  
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Clinical Practices ◽  
Central Venous ◽  
Cross Sectional ◽  
Study Objective ◽  
Catheter Tip

Study objective: Central venous catheterization is an essential component of intensive care of critically ill patients, and proper positioning of the catheter is essential to prevent position-related complications. This study was conducted by using digital tape measurement to objectively assess clinician preferences for central venous catheter positioning based on specific position levels and landmarks on post-procedural chest radiographs. Design: A cross-sectional study using electronic questionnaire survey. Setting: Single academic teaching hospital participated in this study. Participants: The study enrolled 276 physicians from multiple clinical disciplines. Interventions: None. Measurements: A seven-level reference system labeled on a sample chest radiograph was used to identify the acceptable lower and upper limits and landmarks used to determine the optimal central venous catheter tip position as well as the pattern of clinical practices based on the specialty and level of experience of participants. Main results: Among the 276 respondents, the ratio of cumulative acceptance for the lower and upper catheter tip limit was 62% and 66.3% within a 4-cm range below or above the carina, respectively. Intensive care unit (ICU) physicians showed a greater tendency to choose a catheter tip 4 cm below and 6 cm above the carina (p = 0.004 and 0.002, respectively) as did experienced physicians (p = 0.007 and < 0.001, respectively). The commonest reason for catheter tip withdrawal was arrhythmia (50% of cases). Physicians in the ICU and experienced physicians were more concerned about the risk of cardiac perforation than other respondents (p < 0.001 and < 0.001, respectively). The carina was the most commonly used landmark in 71.7% of all physicians, although 50% of radiologists also used other landmarks. Conclusions: The acceptable limit of the catheter tip is 4 cm above and below the carina (-4 to +4), as determined on chest radiography, without a need for tip adjustment.

scholarly journals Prevalence of central venous catheter salvage in newborn with staphylococcal bloodstream infection

2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Izabela Linha Secco ◽  
Mitzy Tannia Reichembach ◽  
Higor Pacheco Pereira ◽  
Regina Paula Guimarães Vieira Cavalcante da Silva
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Antibiotic Therapy ◽  
Bloodstream Infection ◽  
Neonatal Intensive Care ◽  
Venous Catheter ◽  
Cross Sectional Study ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional

ABSTRACT Objectives: to establish the prevalence of salvage of central venous catheters in newborns with bloodstream infection caused by coagulase-negative staphylococci. Methods: retrospective cross-sectional study with 136 newborns admitted to the Neonatal Intensive Care Unit between 2011 and 2017. The total of 143 infection events undergoing antibiotic therapy were evaluated. Results: among the 143 infection events, 39 catheters in which antibiotic therapy was used were saved and in 69 cases, the device was removed. Positive central blood culture and single lumen catheter were factors associated with salvage failure. The probability of salvage decreased with infections diagnosed from 15 days of using the catheter. Negative blood culture raised the chance of salvage by fourfold. Conclusions: the use of antibiotic therapy in the treatment of infections resulted in a low prevalence of salvage of the central venous catheter. The probability of salvage was associated with variables of the device.

scholarly journals Jugular Venous Catheterization: A Case of Knotting

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
E. Erkılıç ◽  
M. Aksoy ◽  
T. Gümüş ◽  
S. Sarı ◽  
E. Kesimci
Keyword(s):  
Central Venous Catheter ◽  
Literature Review ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Central Catheter ◽  
Drug Infusion ◽  
Central Venous ◽  
Venous Catheterization ◽  
Invasive Method ◽  
The Right

A 79-year-old woman, diagnosed for cancer of the ovary, had a central catheter that was placed with difficulty through the right internal jugular vein intraoperatively. After oophorectomy, it was realized that the catheter was knotted. Thus, the central venous catheter was removed successfully using a traction technique in the operating room. Central venous catheter use may result in various complications, although it has been used as an invasive method for hemodynamic monitoring and fluid and drug infusion. Here, we present catheter knotting in a case with solutions for this complication, under literature review.

Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia

2020 ◽  
Vol 21 (6) ◽  
pp. 861-867 ◽  
Author(s):  
Emanuele Iacobone ◽  
Daniele Elisei ◽  
Diego Gattari ◽  
Luigi Carbone ◽  
Giuseppe Capozzoli
Keyword(s):  
Central Venous Catheter ◽  
Transthoracic Echocardiography ◽  
Venous Catheter ◽  
Atrial Arrhythmia ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Bubble Test ◽  
Central Catheters

Introduction: Transthoracic echocardiography with bubble test is an accurate, reproducible, and safe technique to verify the location of the tip of the central venous catheter. The aim of this study is to confirm the effectiveness of this method for tip location in patients with atrial arrhythmia. Methods: Transthoracic echocardiography with bubble test was adopted as a method of tip location in patients with atrial arrhythmia requiring central venous catheter. If bubbles were evident in the right atrium in less than 2 s after simple saline injection, tip placement was assumed as correct. In cases of uncertain visualization of the bubble effect, the test was repeated injecting a saline–air mixture. Tip location was also assessed by post-procedural chest X-ray. Results: In 42 patients with no evident P-wave at the electrocardiography, we placed 34 centrally inserted central catheters and 8 peripherally inserted central catheters. Transthoracic echocardiography with bubble test detected two centrally inserted central catheter malpositions. In four patients with peripherally inserted central catheter, transthoracic echocardiography with bubble test was positive only when repeated with the saline–air mixture. When the transthoracic echocardiography was positive, the mean (±standard deviation) time for onset of the bubble effect was 0.89 ± 0.33 s in patients with centrally inserted central catheter and 1.1 ± 0.20 s in those with peripherally inserted central catheter; such time difference was not statistically significant (p > 0.05). Conclusion: Tip location of central venous catheter by transthoracic echocardiography with bubble test is feasible, safe, and accurate in patients with atrial arrhythmia. This method can also be applied in peripherally inserted central catheters; however, further studies may be needed to confirm its use in this type of catheters.

scholarly journals Chronic Kidney Disease: Clinical and Epidemiological Scenario of Patients in Hemodialysis

2021 ◽  
Vol 13 (7) ◽  
pp. 61
Author(s):  
Liliane Bernardes Campos ◽  
Mônica Cristina Toffoli-Kadri ◽  
Vanessa Terezinha Gubert
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Central Venous Catheter ◽  
Treatment Time ◽  
Secondary Data ◽  
Venous Catheter ◽  
Drug Discontinuation ◽  
Central Venous ◽  
White Ethnicity ◽  
Stable Relationship

OBJECTIVE: To describe the clinical and epidemiological scenario of patients with chronic kidney disease undergoing hemodialysis. METHOD: Retrospective study with secondary data collected from the medical records of patients over 18 years of age on hemodialysis from January 2016 to December 2018. RESULTS: 507 patients underwent ambulatory and/or hospital hemodialysis during the study period. From these, 494 participants were included, comprising 383 who were still under treatment at the end of the study period and 111 who died during the study period. The majority of hemodialysis patients were male, with a mean age of 56.6 years, non-white (77.4%), in a stable relationship (51.6%), retired (54.9%), and with low education (73.9%). Most participants started hemodialysis with the use of a central venous catheter (83.3%), which was maintained for 43.8% of the treatment time. Participants used an average of 18.91 medications daily. More than half of the deaths occurred during the first two years of treatment, with 30.6% of these occurring in the first 12 months of hemodialysis. Evaluation of the results of the clinical outcome of death demonstrated a relationship between age (p= 0.003), number of comorbidities (p = 0.009), time using a central venous catheter (p = 0.025), and white ethnicity (p = 0.021). Septic shock was the main cause of death (56.8%). CONCLUSION: Some factors related to the prognosis of the disease cannot be changed, such as age and white ethnicity. However, greater attention to the management and adequate monitoring of comorbidities is necessary, as well as a reduction in the time spent using a central venous catheter. Due to polymedication, pharmacotherapeutic monitoring is indicated, both for the prevention of drug related problems and for discussions concerning drug discontinuation.

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