scholarly journals A Case of Abscess of the Rectus Abdominis Muscle Formed as a Result of Mispositioning of a Central Venous Catheter Inserted into the Femoral Vein in the Inferior Epigastric Vein

Author(s):  
Masakazu OHNO ◽  
Yuta YAMAZAKI ◽  
Takahiro NAKAJIMA ◽  
Shiro TAKASE ◽  
Nobuya KUSUNOKI ◽  
...  
2019 ◽  
Vol 47 (1) ◽  
pp. 18-21
Author(s):  
Zeenat Afroz ◽  
Mohammad Jobayer ◽  
Md Ferdous Mian ◽  
Farook Ahamed ◽  
Mizanur Rahman ◽  
...  

The clinical condition of the patient, type of central venous catheter (CVC), site and duration of CVC placement are the factors affecting the risk of infection. The aim of this study was to examine and find out the risk factors of CVC related blood stream infections (CVC-BSI). This cross sectional study was carried out in the Department of Microbiology and Immunology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July 2011 to June 2012. One hundred patients who were admitted in ICU of BSMMU and ICU and haemodialysis unit of Dhaka Medical College Hospital (DMCH) having central venous catheter, were enrolled in the study. The rate of CVC-BSI was 11% and the incidence was observed to be 11.14/1000 catheter days. Both CVC-BSI and CVC colonization were higher in trilumen than in bilumen central venous catheter. CVC-BSI rate was 12.79% in trilumen whereas there was no CVC-BSI in patient with bilumen catheter. The mean duration from CVC insertion to development of CVC-BSI was 14 days, CVC colonization was 8.41 days and noninfected CVC was 6 days. CVC-BSI and CVC colonization were most common in right femoral vein where CVC-BSI was 18.52% and CVC colonization was 59.26%, whereas no CVC-BSI was found in right internal jugular vein. Risk factors for CVC-BSI included type of CVC, site of CVC placement, duration of catheterization were not found statistically significant in this study. CVC-BSI and CVC colonization were higher in trilumen catheter and rate raised with increased duration of placement and highest number of CVC-BSI and colonization was found in right femoral vein. Bangladesh Med J. 2018 Jan; 47 (1): 18-21


PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 842-847
Author(s):  
Robert K. Kanter ◽  
Jerry J. Zimmerman ◽  
Richard H. Strauss ◽  
Kathleen A. Stoeckel

Prospective observations made during surveillance of routine central venous catheterizations for hemodynamic monitoring were evaluated to determine the safety and effectiveness of femoral insertion of central venous catheters and to demonstrate the feasibility of teaching pediatric residents to perform this procedure. During a 19-month period of observation, 29 pediatric patients requiring a central venous catheter underwent attempted percutaneous femoral vein catheterization. Femoral catheterization was successful in 86% of patients attempted, and insertions by pediatric residents were successful in 68% of patients attempted. Arterial puncture was the only significant complication of insertion, occurring in 14%, and was not associated with adverse sequelae. During 33 months of observations, complications of indwelling femoral central venous catheters did not significantly exceed the frequency for internal and external jugular, subclavian, and antecubital central venous catheters. During more than 4 years of observation, the significant complications associated with indwelling femoral central venous catheters were swelling of the leg or documented thrombosis in 11 % of 74 critically ill patients. These observations indicate safety and effectiveness of femoral central venous catheters which compares favorably to central venous catheter insertion by other routes. In contrast to previous reports of central venous catheter insertion via subclavian and internal jugular veins, we observed no cardiorespiratory compromise as a result of femoral central venous catheter complications. Skill in this technique is a feasible educational goal for pediatric residents.


2018 ◽  
Vol 23 (3) ◽  
pp. 167-175 ◽  
Author(s):  
Matthew Ostroff ◽  
Nancy Moureau ◽  
Mourad Ismail

Abstract Background: Bedside vascular access options have been limited to the short peripheral intravenous, midline catheter, peripherally inserted central catheter, and central venous catheter (CVC) insertion sites such as the jugular, subclavian, and femoral vein. Many patients with limited options for upper extremity, subclavicular, supraclavicular, and cervical limitations have traditionally received a femoral CVC in the inguinal region. This insertion site is considered a high risk for infection because of its location in the inguinal region and associated difficulties with maintaining the dressing integrity. An alternative location was selected for the insertion of a femoral vein central venous catheter in the midthigh to reduce the risk of infection. Methods: After a multiple-year implementation process, midthigh femoral (MTF) insertions were performed on a select group of patients. The case studies that are included in this report outline the indications, procedures, and other pertinent aspects of the MTF placement. Patients at this institution with contraindications to upper extremity and thoracic catheter insertion received a MTF vein CVC in place of a traditional common femoral vein catheter insertion in the inguinal area. All procedural consents include permission for photography of procedure sites. Results: All but a single patient completed their therapy without complication; 1 intentional dislodgement by a patient was recorded. There were no MTF catheter-related bloodstream infections and 2 confirmed central line associated bloodstream infections (n = 2 of 100) with the second noted as probable contaminated specimen. Outcomes reflected no procedural complications (eg, expanding hematoma or femoral nerve injury or any other femoral artery or vein injuries) and 1 nonocclusive deep vein thrombosis (n = 1 of 100). Conclusions: The MTF CVC provides an alternative to traditional common femoral vein catheter placement for nonemergent patients with upper extremity and thoracic contraindications to central line placement.


2021 ◽  
pp. 112972982110150
Author(s):  
Megan Ladd ◽  
Dominic Lullo ◽  
Shabir Abadin

In our aging population, there is an increased incidence of concurrent IVC filter and central venous catheter use. One of the risks of concurrent use is filter embolization, which almost always occurs due to the J-tipped guidewire. In this case, we describe the successful placement of a central venous catheter in the femoral vein in a patient with an IVC filter. Some guidelines exist concerning CVC placement in patients with IVC filters, and this case highlights the benefits of placing a CVC in the femoral vein. While little research exists regarding higher rates of IVC filter embolization in internal jugular and subclavian vein access sites, we hypothesize it is due to the conical shape of IVC filters.


2018 ◽  
Vol 48 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Shuiqin Cheng ◽  
Shutian Xu ◽  
Jinzhou Guo ◽  
Qunpeng He ◽  
Aijuan Li ◽  
...  

Background: The incidence of central venous catheter-related bloodstream infection (CRBSI) for continuous renal replacement therapy (CRRT) in kidney intensive care unit (ICU) patients is worthy of particular attention and recently, we analyzed clinical characteristics and risk factors of CRBSI for CRRT in our kidney ICU patients. Methods: To be part of this retrospective study, 1,523 patients who had a central venous catheter (CVC) for CRRT during the period April 2010 to May 2015 in our centre were enrolled. The clinical features and pathogens of CRBSI patients were investigated. Patients who also had CRRT of kidney ICU hospitalization without CRBSI were enrolled in a 1: 2 ratio as control. Risk factors of the CRBSI were analyzed. Results: A total of 57 patients had central venous CRBSI. The incidence of the infection was 3.7%. The mean rate of CRBSI was 3.9 per 1,000 catheter days, and the catheter median indwelling time was 14 (7–30) days. The most common pathogens were Gram-positive bacteria, which were noted in 29 cases (50.9%), followed by Gram-negative bacteria (36.8%). The most common pathogens causing CRBSI were Staphylococcus aureus (10 cases) and sewer enterobacteriaceae (10 cases) followed by Staphylococcus epidermidis (9 cases). CVC insertion sites included internal jugular vein (33 cases) and femoral vein (24 cases), accounting for 2.9% of internal jugular vein catheterization (1,140 cases) and 6.3% of femoral vein catheterization (383 cases) respectively. In total, 16, 20, 7 and 14 cases of CRBSI were noted in Spring, Summer, Autumn and Winter, accounting for 28.1, 35.1, 12.3 and 24.6% respectively. The most common infectious manifestations were chills (68.4%), fever (100%), and septic shock (49.1%). Multivariate analysis showed that catheterization of the femoral vein, long catheter indwelling time, low CD4+ lymphocytes and high acute physiology and chronic health evaluation (APACHE) II scores were independent factors associated with CRBSI. Conclusions: The incidence of CRBSI in our kidney ICU was 3.7%. Central venous CRBSI for CRRT was associated with catheterization of the femoral vein, long catheter indwelling time, compromised immune function and high APACHE II scores. Understanding pathogens and risk factors for central venous CRBSI in kidney ICU can help doctors prevent and treat CRBSI earlier.


1985 ◽  
Vol 19 (4) ◽  
pp. 142A-142A
Author(s):  
Robert K Kanter ◽  
Jerry J Zimmerman ◽  
Richard H Strauss ◽  
Kathleen A Stoeckel ◽  
Frank A Oski

2018 ◽  
Vol 71 (3) ◽  
pp. 1115-1121 ◽  
Author(s):  
Alessandra Amaral Schwanke ◽  
Mitzy Tannia Reichembach Danski ◽  
Letícia Pontes ◽  
Solena Ziemer Kusma ◽  
Jolline Lind

ABSTRACT Objective: To measure the incidence of infection in short-term central venous catheter for hemodialysis and to identify the associated risk factors. Method: Prospective cohort study conducted in a teaching hospital from September 2015 to April 2016. Patients requiring central venous catheter for hemodialysis were included and data was collected through direct and systematic observation of the catheter insertion procedure by the researchers. Results: The final sample consisted of 69 patients, who used 88 catheters. The incidence of infection was 9.1%, and the risk factors were length of hospital stay and insertion of the catheter in the left femoral vein. Conclusion: The observation of the actions performed during the insertion of the catheter made it possible to identify the risk factors associated with infection, and the research protocol may have contributed to the reduction of infection rates.


Sign in / Sign up

Export Citation Format

Share Document