scholarly journals Current Management of Difficult Central Venous Access in Pediatric Patients

2019 ◽  
Author(s):  
Wongsakorn Chaochankit ◽  
Surasak Sangkhathat
Keyword(s):  
Pediatric Patients ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Surgical Techniques ◽  
Venous Access ◽  
Current Approach ◽  
Central Venous ◽  
End Stage

The central venous catheter (CVC) has become an integral part of various long term parenteral therapies including chemotherapy and parenteral nutrition. In pediatric patients with a long term CVC, multiple repeated accesses and catheter-related complications may lead to difficulty in reestablishment of a line. Strategies in CVC management in these patients should begin with choosing an appropriate catheter according to its purpose, choosing the right access site and prompt treatment of potential complications, especially catheter-related thrombosis. In patients with severe restriction of the superior vena cava and its tributaries, end-stage central venous access is diagnosed. Management of this situation requires a multidisciplinary team and alternative routes of venous access including access through small collateral veins, or through an unusual vein such as the hepatic vein or a gonadal vein, and/or use of alternative surgical techniques. This article provides a comprehensive review regarding the current approach and surgical options in pediatric patients with end-stage central venous access.

Long-Term Central Venous Access in Pediatric Patients at High Risk: Conventional versus Antibiotic–Impregnated Catheters

2014 ◽  
Vol 25 (3) ◽  
pp. 411-418 ◽  
Author(s):  
Kevin M. Baskin ◽  
Christopher Hunnicutt ◽  
Megan E. Beck ◽  
Elan D. Cohen ◽  
John J. Crowley ◽  
...  
Keyword(s):  
High Risk ◽  
Pediatric Patients ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous

scholarly journals Chylothorax and Chylopericardium: A Complication of Long-Term Central Venous Catheter Use

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
James Livesay ◽  
Isaac Biney ◽  
J. Francis Turner
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Disease Patient ◽  
Vena Cava ◽  
Venous Catheter ◽  
Central Venous ◽  
Vena Cava Syndrome ◽  
Stage Renal Disease ◽  
End Stage

The development of chylothorax and chylopericardium is an uncommon complication of the long-term use of central venous catheters. We describe a unique case of an end stage renal disease patient on hemodialysis with a left jugular tunneled catheter who developed superior vena cava syndrome. Our patient presented with both a large pleural and pericardial effusion that despite drainage continued to reaccumulate. Further imaging with CT scan of the thorax revealed stenosis of the superior vena cava leading to recurrent chylothorax and chylopericardium.

scholarly journals Avoiding harm: central venous access in Kartagener syndrome and other vascular anomalies

2021 ◽  
Vol 9 (41) ◽  
pp. 40-43
Author(s):  
Brad Snodgrass ◽  
Victoria Chu
Keyword(s):  
Patient Outcomes ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Central Venous ◽  
Kartagener Syndrome ◽  
Internal Jugular Vein Catheterization ◽  
The Right ◽  
Landmark Technique

Placement of internal jugular catheters is more likely to be complicated if a left-sided approach is used, assuming normal anatomy. Kartagener syndrome is the sine qua non of sidedness confusion and results in cognitive challenges that increase the risk of adverse patient outcomes. The altered anatomy can cause profound disorientation from our usual processes.  In normal circumstances the right-sided approach is used for placement of internal jugular catheters, but in Kartagener syndrome the left-sided approach should be preferred.  Surgical volume and use of ultrasound guided techniques are positively correlated with better outcomes.  Clinical experience may be a detriment to performance. Knowledge of these issues will help clinicians maintain vigilance and avoid error.    Keywords: Kartagener syndrome, central venous access, superior vena cava, landmark technique, internal jugular vein catheterization cognitive bias

Central Venous Access in Pediatric Patients

2001 ◽  
Vol 2 (3) ◽  
pp. 125-128 ◽  
Author(s):  
F. Fusaro ◽  
M.G. Scarpa ◽  
R. Lo Piccolo ◽  
G.F. Zanon
Keyword(s):  
Pediatric Patients ◽  
Inferior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Chronic Administration ◽  
Venous Access ◽  
Central Venous Line ◽  
Venous Cannulation ◽  
Central Venous ◽  
Central Venous Thrombosis

Occlusion of traditional sites for central venous cannulation is a challenging problem in patients that require a permanent central venous line for chronic administration of nutrients or drugs. In rare cases, extensive central venous thrombosis of the superior and inferior vena cava may preclude catheterization, and uncommon routes should be used. We describe our approach for placement of chronic central venous lines in two pediatric patients with short bowel syndrome and extensive caval occlusion.

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.

scholarly journals Superior Vena Cava Duplication: The Red Herring of Central Line Placement

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Karin Gunther ◽  
Carmen Lam ◽  
David Siegel
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Catheter ◽  
Venous Access ◽  
The United States ◽  
Central Line ◽  
Central Venous ◽  
Central Venous Access Lines

5 million central venous access lines are placed every year in the United States, and it is a common surgical bedside procedure. We present a case of a central venous catheter placement with port for chemotherapy use, during which a duplication of a superior vena cava was discovered on CTA chest after fluoroscopy could not confirm placement of the guidewire. Due to its potential clinical implications, superior vena cava duplication must be recognized when it occurs.

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