Ultrasound‐guidance of peripheral venous catheterization in apheresis minimizes the need for central venous catheters

2020 ◽  
Vol 35 (3) ◽  
pp. 200-205
Author(s):  
Anna Söderström ◽  
Maria S. Nørgaard ◽  
Anna‐Marie E. Thomsen ◽  
Betina S. Sørensen
Keyword(s):  
Ultrasound Guidance ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Venous Catheterization ◽  
Peripheral Venous Catheterization

527. Permanent implantable central venous catheters under ultrasound guidance as a part of one-day surgery

2016 ◽  
Vol 42 (9) ◽  
pp. S174
Author(s):  
R. Sitarz ◽  
W. Budny ◽  
M. Pilecka ◽  
R. Maciejewski ◽  
W. Polkowski
Keyword(s):  
Ultrasound Guidance ◽  
Day Surgery ◽  
Central Venous Catheters ◽  
Central Venous

Ultrasound guidance for placement of central venous catheters

1996 ◽  
Vol 24 (12) ◽  
pp. 2053-2058 ◽  
Author(s):  
Adrienne G. Randolph ◽  
Deborah J. Cook ◽  
Calle A. Gonzales ◽  
Charles G. Pribble
Keyword(s):  
Ultrasound Guidance ◽  
Central Venous Catheters ◽  
Central Venous

scholarly journals Unusual complications of the central venous catheterization in trauma patients

2021 ◽  
Vol 6 (1) ◽  
pp. 32-35
Author(s):  
Yoonjung Heo ◽  
Dong Hun Kim
Keyword(s):  
Subclavian Artery ◽  
Central Venous Catheterization ◽  
Air Embolism ◽  
Central Venous Catheters ◽  
Trauma Patients ◽  
Central Venous ◽  
Cerebral Air Embolism ◽  
Venous Catheterization

Central venous catheters (CVCs) are commonly used in patients with trauma. The placement and removal of the CVCs can result in various complications regardless of the skill of the professionals. Herein, two cases of rare complications are presented— an inadvertent subclavian artery catheterization and a cerebral air embolism after a CVC removal. Moreover, practical solutions for each complication are provided in detail.

scholarly journals Inadvertent arterial puncture involving the subclavian artery and the aorta during central venous catheterization: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mark Henry Alon
Keyword(s):  
Case Report ◽  
Diabetic Ketoacidosis ◽  
Subclavian Vein ◽  
Ultrasound Guidance ◽  
Central Venous Catheterization ◽  
Arterial Puncture ◽  
Central Venous ◽  
Vein Cannulation ◽  
Venous Catheterization ◽  
Catheter Tip

Abstract Background This case report describes a subclavian vein cannulation that inadvertently led to an arterial puncture with the catheter tip radiologically seen at the level of the aorta. This case emphasizes the importance of postprocedural imaging and the disadvantages of not using ultrasound guidance in central venous catheterization. Case presentation A 24-year-old Caucasian man with diabetes mellitus type 1 presented himself to the emergency department due to abdominal pain accompanied by nausea and vomiting. The patient’s vital signs revealed blood pressure of 84/53 mmHg, heart rate of 103 beats per minute, respiratory rate of 18 breaths per minute, and temperature of 98.2 °F (36.7 °C). On physical examination, he was found to have dry oral mucosa with poor skin turgor, with diagnostics showing that he was in diabetic ketoacidosis after running out of insulin for 2 days. The patient was transferred to the intensive care unit to receive a higher level of care. Unfortunately, due to difficulty of peripheral line placement, only a gauge-22 cannula was secured at the left dorsum of the hand. Efforts to replace the current peripheral line were unsuccessful, and a decision to perform a central vein cannulation via the internal jugular vein was made. This was futile as well due to volume depletion, prompting a subsequent right subclavian vein route attempt. The procedure inadvertently punctured the arterial circulation, leading to the catheter tip being visible at the level of the aorta on postprocedure X-ray. The subclavian line was immediately removed with no adverse consequences for the patient. A right femoral line was successfully placed, and continuous management of the diabetic ketoacidosis ensued until normalization of the high anion gap was achieved. Conclusion Utilization of real-time ultrasound guidance via the subclavian approach could have allowed for direct visualization of needle insertion to the anatomical structures, guidewire location, and directionality, all of which can lead to decreased complications and improved cannulation success compared with the landmark technique. A leftward direction of the catheter seen on postprocedural X-rays should raise high suspicion of inadvertent catheter placement and immediate correction. This complication should have been prevented if ultrasound guidance had been used.

Catheter-Associated Deep Vein Thrombosis (CADVT) in a Pediatric ICU: A Retrospective Case-Control Study

2020 ◽  
Vol 25 (3) ◽  
pp. 45-55
Author(s):  
Sandeep Tripathi ◽  
Kimberly Burkiewicz ◽  
Jonathan A. Gehlbach ◽  
Yanzhi Wang ◽  
Michele Astle
Keyword(s):  
Deep Vein Thrombosis ◽  
Central Venous Catheter ◽  
Ultrasound Guidance ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Retrospective Case ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Control Study

Highlights Abstract Introduction: Catheter-associated deep vein thrombosis (CADVT) in children has been recognized as a significant hospital-acquired condition. This study was undertaken to retrospectively analyze the impact of CADVT on outcomes and to identify risk factors for the development of deep vein thrombosis in children with central venous catheters. Methods: This was a single-center retrospective case-control study of patients with central venous catheters in a pediatric intensive care unit (ICU) from January 2014 to December 2018. Forty-one patients with central venous catheters who developed CADVT were compared with 100 random controls. Central venous catheter type, along with patient and disease-specific characteristics, were compared between the two groups by univariate and multivariate regression. Outcome comparison was made after adjusting for confounding variables. Results: Median time from insertion to the development of CADVT was 4 days (interquartile range, 2–9). Forty percent (16/40) of patients had a blood urea nitrogen greater than 20 mg/dL, and 86.6% (13/15) had a C-reactive protein greater than 1 mg/dL within 48 hours of development of CADVT. Central venous catheter duration (odds ratio [OR], 1.05), mechanical ventilation (OR, 7.49), and upper versus lower extremity site of the central venous catheter (OR, 0.324) were associated with the development of CADVT. Ultrasound guidance occurred significantly less in patients who developed CADVT (39.3% vs 70.7%); however, it was not independently associated with increased risk. Age, body mass index, mechanical ventilation, and severity of illness–adjusted hospital and ICU length of stay were significantly higher in patients who developed CADVT. Conclusions: CADVT is independently associated with worse outcomes. Ultrasound guidance and site selection are potential modifiable risk factors in the development of CADVT in pediatric patients. Future studies should target an effective chemoprophylaxis regimen.

Landmark Versus Ultrasound-Guided Subclavian Central Venous Catheterization with a Combined Short and Long Axis Approach in an Intensive Care Setting

2017 ◽  
Vol 71 (1) ◽  
pp. 44-49
Author(s):  
Darko Sazdov ◽  
Marija Jovanovski Srceva ◽  
Zorka Nikolova Todorova
Keyword(s):  
Intensive Care ◽  
Real Time ◽  
Complication Rate ◽  
Ultrasound Guidance ◽  
Central Venous Catheterization ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Venous Catheterization ◽  
Out Of Plane

Abstract Introduction. Central venous catheterization of the subclavian vein can be achieved with a landmark and an ultrasound-guided method. Using ultrasound the vein can be catheterized with a long axis in plane or a short axis out of plane approach and a combined approach. The aim of the study was to compare the success, average number of attempts and mechanical complication rate between the landmark and the combined ultrasound-guided method. Methods. A total of 162 adult patients from the Intensive Care Unit at Clinical Hospital Acibadem-Sistina, Skopje were included in this prospective study. Patients randomized in the examined group (n=71) were catheterized with real-time ultrasound guidance with a combined short axis out of plane and long axis in plane method. Patients randomized in the control group (n=91) were catheterized with the landmark method. Subclavian vein was catheterized in both groups. Overall success, success on first attempt, number of attempts and complications at the moment of catheterization were the main outcome measures. Results. Catheterization using the landmark method was successful in 94.5% of patients, 65.9% of which during the first attempt. Cannulation using real-time ultrasound guidance was successful in all patients with a first pas success of 83.1%. The complication rate in the ultrasound group was 2.82% and 16.5% in the landmark group (p=0.004404). Conclusion. Real-time ultrasound guidance with a combined short axis out of plane and long axis in plane approach improves success, decreases number of attempts, and reduces mechanical complications rate.

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