scholarly journals The Evaluation of the Effects of Erythrocyte Transfusion on Central Venous Oximetry in Major Surgery Patients

2018 ◽  
Vol 16 (2) ◽  
pp. 70-75
Author(s):  
Emil Gasimov ◽  
Ahmet Kemalettin Koltka ◽  
Nükhet Sivrikoz ◽  
Ali Emre Çamcı
Keyword(s):  
Major Surgery ◽  
Erythrocyte Transfusion ◽  
Central Venous ◽  
Venous Oximetry

The value of real-time ultrasound-guidance for definite placement of a right supraclavicular subclavian central venous catheter

2021 ◽  
pp. 112972982199853
Author(s):  
Jens M Poth ◽  
Stefan F Ehrentraut ◽  
Se-Chan Kim
Keyword(s):  
Ultrasound Guidance ◽  
Venous Catheter ◽  
Needle Insertion ◽  
Major Surgery ◽  
Axillary Vein ◽  
Central Venous ◽  
Supraclavicular Fossa ◽  
The Right ◽  
High Index Of Suspicion ◽  
Insertion Process

Central venous catheters (CVC) are widely used in critically ill patients and in those undergoing major surgery. Significant adverse events, such as pneumothorax and hemothorax, can be caused by needle insertion during CVC insertion. CVC misplacement is less often described, yet equally important, as it can lead to deleterious complications. Here, we describe a case in which misplacement of a guidewire following infraclavicular puncture of the right axillary vein was detected by continuous ultrasound employing the right supraclavicular fossa view. Utilizing this ultrasound view, the insertion approach to the vessel was changed and correct CVC placement could be achieved. While ultrasound guidance is widely accepted for vessel puncture, this case demonstrates the value of continuous ultrasound guidance for the entire process of CVC insertion: vessel puncture, correct guidewire advancement, catheter placement, and exclusion of complications such as pneumothorax. It also shows that there should be a high index of suspicion for guidewire misplacement, even after successful venipuncture. In conclusion, ultrasound protocols covering the complete CVC insertion process should be implemented into current clinical practice.

The Use of Temporary Central Venous Catheters for Optimizing Continuous Infusion in Hemophilia Patients Undergoing Major Surgical Procedures

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2822-2822
Author(s):  
Ana Boban ◽  
Catherine M Lambert ◽  
Cedric R. Hermans
Keyword(s):  
Continuous Infusion ◽  
Surgical Procedures ◽  
Jugular Vein ◽  
Central Venous Catheters ◽  
Clotting Factor ◽  
Major Surgery ◽  
Peripheral Vein ◽  
Central Venous ◽  
Short Term ◽  
Factor Concentrate

Abstract Introduction: Continuous infusion (CI) of clotting factor concentrate has facilitated surgical procedures and intensive replacement therapy in hemophilia patients. The advantage of CI over bolus infusions is ability to maintain steady-state levels of coagulation factors and moreover, to reduce the total amount of factor concentrate spent. CI is commonly delivered through a peripheral vein. However, a significant number of hemophilia patients have distorted peripheral veins which can compromise continuous flow of factor concentrate needed for successful treatment. Also, thrombophlebitis at the site of venous access, an adverse effect of CI previously reported, can further impair the delivery of factor concentrate in CI and make the future use of the vein for concentrate administration impossible or difficult. Use of central venous catheter can ease the application of CI. By searching the literature, we found only a few case reports describing the use of temporary non-tunneled central venous catheters (CVC) for administrating CI in patients with hemophilia. The aim of this study was to evaluate the efficacy and safety of short-term used non-tunneled CVC for CI during surgical procedures in hemophilia patients. Methods: In this study we have retrospectively studied patients with hemophilia that had temporarily used non-tunneled CVC for CI of factor concentrate during and after major surgery in the Saint-Luc University Hospital in Brussels between August 2000 and April 2014. The indication for CVC usage was a major surgery with anticipated need for CI of factor concentrate longer than 5 days. CVC was inserted by an experienced anesthesiologist in the operating room after the induction of general anesthesia and normalization of APTT. Before the CVC insertion, the patient would have already received bolus of clotting factor concentrate and have the CI started through the peripheral vein. Upon placement, the CI was switched to the CVC. The CVC was kept in place until leaving hospital or cessation of the need for continuous infusion. Results: During the study period, 40 male patients with hemophilia A or B (37 and 3 patients, respectively) underwent 67 major surgical procedures covered by CI of factor concentrate delivered through CVC. Patients, age 21 -81, had severe, mild or moderate disease (33, 5 and 2 patients, respectively). Patients had altogether 65 CVC for 67 surgical procedures. The same catheter was used for 3 surgeries and 16 patients had CVC placed more than once; 14 patients twice, one patient three times and one ten times. Patients underwent orthopedic surgery (79%), gastrointestinal surgery (15%) and cardiovascular surgery (5%) while one patient (1%) had surgery of urinary tract. The CVC were placed in the right jugular vein (58%), the left jugular vein (18%), the left subclavian vein (8%) and right subclavian vein (3%), while the data were missing in 6 patients. Median duration of catheter was 12 days, with range from 5 to 107 days. No CVC was removed prematurely and no malfunctions of catheters were recorded. Moreover, no complications related to the CVC were noted whatsoever. We searched for bleeding at the site of puncture of the catheter, signs of local infection, pneumothorax following placement of CVC, catheter thrombosis, malfunction of the catheter and surgical site infection. Finally, most of the patients reported satisfaction related to the use of CVC for CI of factor concentrate. Conclusions: Based on results of this study, we can conclude that the use of short-term non-tunneled CVC should be considered in patients with hemophilia undergoing major surgery with the need for prolonged CI of factor concentrates. By placing CVC we can ensure undisturbed flow of factor concentrate during CI and preserve peripheral veins for the future concentrate administration. Disclosures No relevant conflicts of interest to declare.

Clinical Experience of Percutaneous Femoral Venous Catheterization in Critically Ill Preterm Infants Less Than 1,000 Grams

2001 ◽  
Vol 95 (3) ◽  
pp. 637-639 ◽  
Author(s):  
Kuen-Bao Chen
Keyword(s):  
Critically Ill ◽  
Preterm Infants ◽  
Anesthetic Management ◽  
Femoral Vein ◽  
Vena Cava ◽  
Major Surgery ◽  
Common Iliac Vein ◽  
Central Venous ◽  
Nutrition Supplementation ◽  
Venous Catheterization

Background Venous access is relatively difficult in preterm infants. Central venous catheterization is indicated for pressure monitoring, drug therapy, and nutrition supplementation, which are often critical in the anesthetic management of infants undergoing major surgery. Methods In 49 critically ill preterm infants weighing less than 1,000 g, the femoral vein was cannulated using a 22-gauge Angiocath (25 mm; Beckton Dickinson, Sandy, UT). A 2.5-ml syringe was attached to the Angiocath, and the Angiocath was advanced with constant negative pressure over the syringe. When blood return was observed, the cannula was advanced. When free blood reflux was achieved, a J wire was inserted, followed by a 24-gauge central venous catheter. Results The overall catheterization success rate was 79.6% (39 of 49 attempts). The time required for successful catheterization was less than 10 min in 18 cases (46.2%), 10-20 min in 17 cases (43.6%), and 20-30 min in 4 cases (10.3%). In the successful group, 1 catheter tip was positioned in the vein of the liver (2.6%), 2 were in the common iliac vein (5.1%), 6 were in the right atrium (15.4%), and 30 were in the infracardiac inferior vena cava (76.9%). Complications included hematoma in six cases (12.2%), arterial puncture in five cases (10.2%), bleeding in two cases (4.1%), and transient bradycardia in two cases (4.1%). Conclusions The results indicate that percutaneous femoral venous catheterization is a reliable and valuable technique for critically ill preterm infants weighing less than 1,000 g.

Correlation of peripheral venous and central venous pressures after major surgery in the postanaesthesia care unit

2005 ◽  
Vol 22 (Supplement 34) ◽  
pp. 20
Author(s):  
C. Espí ◽  
M. T. Moreno ◽  
F. Cobano ◽  
M. A. Barberà ◽  
S. Muñoz ◽  
...  
Keyword(s):  
Major Surgery ◽  
Central Venous ◽  
Postanaesthesia Care Unit

Evaluation of a pediatric central venous oximetry catheter in critically ill children

2010 ◽  
Vol 11 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Neil Spenceley ◽  
Gordon Krahn ◽  
Peter W. Skippen ◽  
Niranjan Kissoon
Keyword(s):  
Critically Ill ◽  
Critically Ill Children ◽  
Central Venous ◽  
Venous Oximetry
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