scholarly journals Retrieval of Intravascular Fractured Fragment of Tunnelled Double Lumen Catheter in Hemodialysis Patient

2019 ◽  
Vol 7 (1) ◽  
pp. 124-126 ◽  
Author(s):  
I Nyoman Semadi ◽  
Heru Sutanto Koerniawan ◽  
Hendry Irawan
Keyword(s):  
Internal Jugular Vein ◽  
Distal Part ◽  
Foreign Bodies ◽  
Hemodialysis Patient ◽  
Jugular Vein ◽  
Rare Complication ◽  
Double Lumen ◽  
Double Lumen Catheter ◽  
Lumen Catheter ◽  
The Right

BACKGROUND: Intravascular fractured fragment of double lumen catheter with embolisation is a serious and rare complication. Another serious complication includes infection, thrombosis, arrhythmias, and pulmonary embolism. We report a successful surgical venous cut-down technique in the retrieval of an intravascular fractured fragment of tunnelled double lumen catheter in a hemodialysis patient. CASE REPORT: A 51-year-old female underwent hemodialysis through a tunnelled double lumen catheter and had her arterio-venous graft matured. During retrieval of tunnelled double lumen catheter procedure, the distal part of the catheter was fractured and slipped into the internal jugular vein. Chest radiograph revealed intravascular double lumen catheter extending from the distal part of the right internal jugular vein to right atrium. The procedure of foreign body retrieval was done the next day under general anaesthesia and C-Arm guidance using right internal jugular venous cut-down approach. A right-angle clamp was used to retrieve the fragment without any post-procedure complications. CONCLUSION: Intravascular fractured fragment of double lumen catheter is a dangerous situation as are all the intravascular foreign bodies. The choices of the technique for retrieval of the fractured fragment are varied. It depends on the type and site of a fractured fragment as well as the surgeon experiences.

scholarly journals Catheter related infection in hemodialysis patients with double lumen catheter.

2019 ◽  
Vol 26 (08) ◽  
pp. 1278-1282
Author(s):  
Muhammad Ali ◽  
Bhagwan Das ◽  
Santosh Kumar ◽  
Rafia Memon ◽  
Bella Dayu ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Femoral Vein ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Double Lumen ◽  
Cross Sectional ◽  
Catheter Related Infection ◽  
Double Lumen Catheter ◽  
Lumen Catheter

Catheter related infections are common issue, a major cause of morbidity and mortality in patients with uremia. Clinical findings, including fever, redness, or tenderness at catheter site are unreliable for the diagnosis of catheter-related infection due to poor sensitivity and specificity. Study Design: Descriptive Cross sectional Study. Setting: Department of Nephrology, Jinnah Postgraduate Medical Centre, Karachi. Period: September 2014 to March 2015. Materials and Methods: All patients with age 25-50 years of either gender undergoing hemodialysis via double-lumen catheter were enrolled. Regular monitoring of temperature and WBC counts was carried out. If a patient develops fever (100 F or more) or leukocytosis (TLC 12,000 /mcl), a through re-examination, urinalysis and chest X-ray was done to exclude other causes of infection in this patient. Blood cultures from catheter tip and a peripheral blood culture was sent. Growth of the organism from both the cultures was noted and catheter related infection was termed positive if same organism s found to be present in both the cultures. Results: Mean age of the patients was 42.69 ±6.86 years. There were 75 (58.10%) females and 54 (41.90%) males. In majority of the patients, site of catheter was right internal jugular vein 54 (41.90%), followed by femoral vein 30 (23.30%), left internal jugular vein 24 (18.60%) and subclavian vein in 21 (16.30%) patients. Frequency of catheter related infection was found to be 19 (14.70%). Conclusion: The frequency of catheter related infection was found in 19 (14.70%) patients undergoing hemodialysis via double-lumen catheter.

Improved oxygenation with reduced recirculation during venovenous ECMO: comparison of two catheters

Perfusion ◽  
2002 ◽  
Vol 17 (6) ◽  
pp. 415-419 ◽  
Author(s):  
Khodayar Rais-Bahrami ◽  
Dawn M Walton ◽  
Jeffrey E Sell ◽  
Oswaldo Rivera ◽  
Gerald T Mikesell ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Oxygen Saturation ◽  
Jugular Vein ◽  
Bleeding Complications ◽  
Cerebral Oxygen ◽  
Double Lumen ◽  
Double Lumen Catheter ◽  
Lumen Catheter ◽  
The Right ◽  
Vv Ecmo

Objectives: To determine whether the new double-lumen catheter made by OriGen Biomedical (Austin, TX) for venovenous (VV) extracorporeal membrane oxygenation (ECMO) would reduce recirculation and improve oxygenation during VV ECMO when compared with the Kendall double-lumen catheter (Kendall Healthcare Products, Mansfield, MA). Design: Prospective intervention study. Setting: The animal research laboratory at Children’s National Medical Center, Washington, DC. Subjects: Nine newborn lambs one to seven days old and weighing 4.4± 0.8 kg. Intervention: Animals were anesthetized, intubated, and ventilated. The ductus arteriosus was ligated. Femoral arterial and venous, cephalic jugular vein, and pulmonary artery catheters were placed. After systemic heparinization, the catheter to be tested, an OriGen catheter, was placed in the right internal jugular vein and advanced into the right atrium. The animal was placed on ECMO and stabilized, with the ventilator settings decreased to a peak inspiratory pressure of 15-20 cmH2O, peak end-expira-tory pressure of 5 cmH2O, rate of 15-25 breaths/min, and a fractional inspired oxygen concentration of 0.21-0.30. ECMO flows were increased in 100-ml increments from 200 to 600 ml/min with measurements taken 15 min after each change. The OriGen catheter was removed, the Kendall catheter was placed, and the studies were repeated. Measurements and Main Results: Heart rate, mean blood pressure, paO2, jugular cerebral oxygen saturation, pulmonary artery oxygen saturation, pump venous oxygen saturation, and postmembrane circuit pressures were measured at each study period. The OriGen catheter improved oxygenation, with higher systemic paO2, higher pulmonary artery and cerebral oxygen saturations, and lower pump venous oxygen saturations (indicating less recirculation). With the OriGen catheter, paO2 levels ranged from 69± 18 mmHg [9.2± 2.4 kPa] to 114 ± 45 mmHg [15.2± 6.0 kPa], compared range from 61± 15 mmHg [8.1± 2.0 kPa] to 87± 34 mmHg [11.5± 4.5 kPa] for the Kendall catheter. These findings indicate that, at all flow rates studied, less recirculation occurred with the OriGen catheter than with the Kendall catheter. The postmembrane pressures were significantly lower for the OriGen catheter at any given flow (from 30 ± 5 to 122 ± 18 mmHg) when compared with the Kendall catheter (from 77± 16 to 330 ± 78 mmHg). Conclusions: These findings indicate that the OriGen catheter resulted in a reduction of recirculation, thereby resulting in an improvement in oxygenation while on VV ECMO. The lower postmembrane pressure potentially could reduce the risk of ECMO circuit complications such as tubing rupture, bleeding complications, as well as hemolysis. This new catheter makes VV ECMO more effective and represents a design that could be used for neonatal and/or pediatric ECMO.

Incidence of infection in patients temporary with a catheter for hemodialysis

2009 ◽  
Vol 4 (1) ◽  
pp. 173
Author(s):  
Gilson de Vasconcelos Torres ◽  
Samira Celly Lima de Carvalho Santos ◽  
Luciana Pedrosa Leal ◽  
Ana Elza Oliveira de Mendonça ◽  
Analucia Filgueira Gouveia Barreto ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Jugular Vein ◽  
Chronic Renal Disease ◽  
Microsoft Excel ◽  
Double Lumen ◽  
Venous Catheterization ◽  
Double Lumen Catheter ◽  
Co Morbidity ◽  
Lumen Catheter ◽  
The Right

ABSTRACT  Objective: to investigate the incidence of infection related to the use of temporary double lumen Catheter (TDLC) in chronic renal disease undergoing hemodialysis. Methodology: this is about a descriptive exploratory study, from quantitative, performed in a clinic of nephrology of Natal/RN after approval by the ethics committee (protocol number 67/2008), April-June 2008, with data collected through a semi-structured form. The data were categorized and processed through Microsoft Excel XP. Results: 47 patients participated in the study, 70.21% male, 40.42% in the age group 60 to 79 years, married (61.70%), primary school (38.30%). The main co-morbidity was associated with hypertension (31.91%). As for the local (51.06%) catheters were implanted in the right jugular vein, mainly by loss of arteriovenous fistula (ACF)  (46.81%), followed by 44.68% who needed treatment immediately. As for the signs of infection were present in 38.30% patients, always a cause for withdrawal of the catheter. The maximum time of use was 120 days, but prevailed in the range 1 to 20 days with (40.43%). Conclusion: it was observed that the more permanent catheters increases the incidence of infection. Thus, the relevance of the educational activities of nurses, to patients with kidney, stimulating self-care, preventing and detecting early infection. Descriptors: central venous catheterization; hemodialysis; nursing. RESUMOObjetivo: investigar a incidência de infecção relacionada ao uso de Cateter Temporário Duplo Lúmem (CTDL) em renais crônicos submetidos à hemodiálise. Metodologia: estudo exploratório descritivo, quantitativo, realizado em uma clínica de nefrologia de Natal/RN após aprovação do comitê de ética (número de protocolo 67/2008), no período de abril a junho de 2008, com dados coletados por meio de um formulário semi-estruturado. Os dados foram categorizados e processados pelo uso do Microsoft-Excel XP. Resultados: participaram do estudo 47 pacientes, 70,21% do sexo masculino, 40,42% na faixa etária de 60 a 79 anos; casados (61,70%); com ensino fundamental incompleto (38,30%). A principal co-morbidade associada foi à hipertensão (31,91%). Quanto ao local, 51,06% cateteres foram implantados na veia jugular direita, principalmente por perda da Fístula Artério-Venosa (FAV) 46,81%, seguido pelos 44,68% que necessitaram de tratamento imediato. Quanto aos sinais de infecção, estiveram presentes em 38,30%, sendo sempre motivo de retirada do cateter. O tempo máximo de uso foi de 120 dias, porém prevaleceu o intervalo de 1 a 20 dias (40,43%). Conclusão: observou-se que maior permanência dos cateteres aumenta a incidência de infecção. Evidenciando assim, a relevância da atuação educativa do enfermeiro, junto aos pacientes renais, estimulando o auto-cuidado, prevenindo e detectando precocemente as infecções. Descritores: cateterismo venoso central; hemodiálise; enfermagem. RESUMENObjetivo: investigar la incidencia de infección relacionada con el uso temporal de catéter de doble lumen en la enfermedad renal crónica en hemodiálisis. Metodología: estudio exploratorio descriptivo y cuantitativo, realizado en una clínica de nefrología de Natal / RN después de la aprobación por el comité de ética (número del regsitro 67/2008), abril-junio de 2008, con datos recogidos a través de una entrevista semi-estructurada. Los datos fueron clasificados y procesados a través del Excel XP. Resultados: 47 pacientes participaron en el estudio, 70,21% varones, 40,42% en el grupo de edad de 60 a 79 años, se casó con (61,70%), con la escuela primaria (38,30%). Los principales co-morbilidad se asocia con hipertensión arterial (31,91%). En cuanto a los locales de (51,06%) catéteres fueron implantados en la vena yugular derecha, principalmente por la pérdida de la fístula arteriovenosa (46,81%), seguido por 44,68% que requirieron tratamiento inmediatamente. En cuanto a los signos de la infección está presente en 38,30% pacientes, siempre un motivo de retirada del catéter. El tiempo máximo de uso es de 120 días, pero prevaleció en el rango de 1 a 20 días con (40,43%). Conclusión: se observó que los catéteres permanentes más aumenta la incidencia de la infección. Por lo tanto, la pertinencia de las actividades educativas de las enfermeras, a los pacientes con riñón, estimulando la auto-cuidado, la prevención y detección temprana de infección. Descriptores: cateterización venosa central; la hemodiálisis; la enfermería. 

Massive hemoptysis following cannulation of right internal jugular vein for insertion of cuffed hemodialysis catheter: A rare complication of central venous catheterization

2020 ◽  
pp. 112972982091030
Author(s):  
Hamed Ghoddusi Johari ◽  
Mohammad Mehdi Lashkarizadeh ◽  
Parviz Mardani ◽  
Reza Shahriarirad
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Main Bronchus ◽  
Rare Complication ◽  
Posterior Mediastinum ◽  
Chest Roentgenogram ◽  
Massive Hemoptysis ◽  
Rare Presentation ◽  
Hemodialysis Catheter ◽  
The Right

Here we report an extremely rare presentation of internal jugular vein catheterization, presenting as massive hemoptysis which was noted during right internal jugular vein cuffed hemodialysis catheter insertion of a 39-year-old man known-case of End-Stage Renal Disease. Chest roentgenogram and computerized tomography scan showed pleural effusion and misplacement of the tip of hemodialysis catheter in the posterior mediastinum causing possible damage to the right main bronchus. After chest tube insertion and removing the misplaced hemodialysis catheter, a proper cuffed catheter was inserted and the patient was discharged with an uneventful post-op course.

Congenital Diaphragmatic Hernia

2018 ◽  
Author(s):  
Sabina A. Khan ◽  
Nitin Wadhwa
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Internal Jugular Vein ◽  
Diaphragmatic Hernia ◽  
Jugular Vein ◽  
Respiratory Compromise ◽  
Ecmo Circuit ◽  
Pharmaceutical Management ◽  
Cardiopulmonary Support ◽  
Double Lumen Catheter ◽  
Lumen Catheter

Congenital diaphragmatic hernia (CDH) is characterized by malformation of the diaphragm, allowing for herniation of abdominal contents into the thoracic cavity. The most significant sequelae of this herniation are pulmonary hypoplasia and pulmonary hypertension, both contributing to significant morbidity and mortality. Multiple strategies exist to minimize respiratory compromise and improve outcome in a patient with CDH, including fetal intervention in selective cases, medical and pharmaceutical management, advanced ventilation strategies, extracorporeal membrane oxygenation (ECMO), and complete surgical repair. Veno-arterial ECMO (circuit between the internal jugular vein and the carotid artery) is used in infants who are unstable and require aggressive cardiopulmonary support, and veno-venous ECMO (circuit with a double lumen catheter in the internal jugular vein) is used in infants who only need respiratory support.

Transcardiac cerebral angiography in a child

2013 ◽  
Vol 11 (1) ◽  
pp. 95-99 ◽  
Author(s):  
Masaki Komiyama ◽  
Tomoya Ishiguro ◽  
Aiko Terada ◽  
Yosuke Murakami
Keyword(s):  
Cerebral Angiography ◽  
Femoral Vein ◽  
Balloon Catheter ◽  
Double Lumen ◽  
Double Lumen Catheter ◽  
Aneurysmal Dilation ◽  
Lumen Catheter ◽  
The Right ◽  
Aortic Interruption ◽  
Unusual Situation

The authors present a case in which transfemoral venous, transcardiac cerebral angiography was performed. In this 5-year-old girl with PHACE syndrome, both transfemoral and transbrachial arterial routes could not be used due to aortic interruption and aneurysmal dilation and small looping of the proximal portion of bilateral subclavian arteries. A 5-F balloon-tipped double-lumen catheter was advanced to the right atrium of the heart from the femoral vein. The catheter was then advanced to the left atrium through the patent foramen ovale and was further advanced to the left ventricle and then to the ascending aorta. The balloon catheter was exchanged for a 4-F catheter. Bilateral common carotid angiography was performed without difficulty. This transcardiac approach is useful in the unusual situation in which both femoral and brachial arterial routes are not available.

scholarly journals Characteristics Of Chronic Kidney Failure Patients Using Vascular Access For Hemodialysis In Vascular Surgical Division Dr. Mohammad Hoesin General Hospital Period 1 Januari – 31 Desember 2018

2020 ◽  
Vol 3 (2) ◽  
pp. 80-93
Author(s):  
Kemas Muhammad Dahlan ◽  
Wahyu Sholekhuddin ◽  
Fahmi Jaka Yusuf
Keyword(s):  
Vascular Access ◽  
Chronic Kidney Failure ◽  
Double Lumen ◽  
Hemodialysis Vascular Access ◽  
Double Lumen Catheter ◽  
Lumen Catheter ◽  
History Of ◽  
Male Patients ◽  
The Right ◽  
Av Shunt

Abstract Hemodialysis has been accepted as a method of treatment in patients with CKD in stage 5. A-V fistula is the closest ideal hemodialysis vascular access, so that it can reduce morbidity and mortality of CKD patients. This research is a retrospective descriptive study with data obtained from the A-V fistula surgery form archive in the Vascular and Endovascular Division of the Department of Surgery, FK UNSRI in January 2018-December 2018 and from the patient's medical record. Data processing was carried out with SPSS 16.0. The results of the study obtained 203 patient data with the use of AV Shunt that met the inclusion criteria. The mean age of patients was 50.53 years. There were 114 (56%) male patients and 89 (44%) female patients. Risk factors such as smoking were found in 9 (4%) patients. History of the disease prior to experiencing chronic renal failure was hypertension in 115 patients (56.6%) and diabetes in 81 (40%). There were 69 patient’s Hb data before AV shunt with Hb <7 (1%) in 2 people, 7-8.9 (33%) 67 people, 9-10.9 (53%) 108 people,> 11 (13%) 26 people. 128 (63%) patients had double lumen catheters installed in the right jugular, 5 (2%) patients were placed in the left jugular, and 70 (34%) patients did not have a double lumen catheter. A total of 169 (83%) patients had a history of using AV Shunt. There were 71 (35%) patients with the wrist region anastomosis, 132 (65%) patients with cubiti region anastomosis. Native AV shunt was the most commonly performed in 202 (99.5%) patients. There were no recorded complications after AV Shunt placement in 99 (48.8%) patients, 51 (25.2%) patients had AVF branches, 23 (11.3%) had AV Shunt rupture, 18 (8.8%) AVF stenosis, 1 (0.5%) central stenosis, 1 (0.5%) thrombus, and 11 (5.4%) infections. A total of 167 (82.2%) patients took AV Shunt after 3 months.

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