scholarly journals Pseudoaneurysm in the left pulmonary artery induced by double-lumen catheter inserted from left jugular vein: a case report

2015 ◽  
Vol 22 (5) ◽  
pp. 457-458
Author(s):  
Nobuo Sakagoshi ◽  
Takuya Higuchi ◽  
Katsukiyo Kitabayashi ◽  
Keisuke Miyake
Perfusion ◽  
2002 ◽  
Vol 17 (6) ◽  
pp. 415-419 ◽  
Author(s):  
Khodayar Rais-Bahrami ◽  
Dawn M Walton ◽  
Jeffrey E Sell ◽  
Oswaldo Rivera ◽  
Gerald T Mikesell ◽  
...  

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.


2019 ◽  
Vol 26 (08) ◽  
pp. 1278-1282
Author(s):  
Muhammad Ali ◽  
Bhagwan Das ◽  
Santosh Kumar ◽  
Rafia Memon ◽  
Bella Dayu ◽  
...  

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.


2019 ◽  
Vol 7 (1) ◽  
pp. 124-126 ◽  
Author(s):  
I Nyoman Semadi ◽  
Heru Sutanto Koerniawan ◽  
Hendry Irawan

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.


2020 ◽  
pp. 205141581989650
Author(s):  
Leandro Blas ◽  
Javier Roberti ◽  
Francisco Lopez ◽  
Carlos Alberto Ameri

Intravesical catheter knotting is a rarely reported event that could lead to serious complications. We present a case that occurred during urodynamic test with two K30 tubes: a 56-year-old female with a double knot of two K30 (8.4 Fr) tubes. This case was resolved by removing the catheters with sustained traction. Because catheter knotting can be a serious complication, we recommend the use of a double-lumen catheter when possible and assessment of a safe insertion length.


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 ◽  
...  

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. 


1995 ◽  
Vol 18 (10) ◽  
pp. 569-573 ◽  
Author(s):  
V. Varnholt ◽  
P. Lasch ◽  
J. Sartoris ◽  
W. Koelfen ◽  
W. Kachel ◽  
...  

A comparison was done between neonates requiring veno-arterial (VA) ECMO (too small jugular vein, inability to insert a 12 Fr double lumen catheter or cardio-circulatory instability) and neonates treated with veno-venous (VV) ECMO in the same period of time. From 1991-1995 ECMO was done in 48 neonates after failure of maximum conventional treatments, NO-inhalation and HFOV. 30/48 babies were treated with VV-ECMO, with a switch to VA-ECMO later on in 3 of them. In 18 infants VA-ECMO was installed primarily. Differences between the VA- and VV-ECMO group were: the 01 was higher in the VV-treated babies (62±20 vs. 48±13, p < 0.03), as were birth weight (3385±570 vs. 2963±653 g, p< 0.04), gestational age (39.7 ± 1.6 vs. 37.9 ± 2.7 weeks, p< 0.01) and MAP (18.7 ± 2.2 vs. 17.1 ± 2.4 cm H2O, p< 0.05). Severe ICH's occurred more frequently in the VA-treated babies (29 vs. 7%, p< 0.05), the rate of other complications was equal. The mortality rates were 43% (VA) and 15% (VV), p< 0.05. About one third of neonatal ECMO candidates will be treated with VA-ECMO, even if the VV-ECMO technique is available. Need for VA-ECMO implies - due to a higher number of preterm babies and a greater severity of illness before ECMO - a higher incidence of ICH's and a higher mortality rate.


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