scholarly journals Cause of Subclavian Catheter Malposition and Technical Procedures to Take Care

2012 ◽  
Vol 3 (4) ◽  
Author(s):  
Sedat Gurkok
Keyword(s):  
Catheter Malposition ◽  
Subclavian Catheter

Perforation of the Superior Vena Cava by a Subclavian Hemodialysis Catheter: Early Detection by Angiography

1992 ◽  
Vol 15 (11) ◽  
pp. 666-668 ◽  
Author(s):  
C.J. Kaupke ◽  
J. Ahdout ◽  
N.D. Vaziri ◽  
L.S. Deutsch
Keyword(s):  
Early Detection ◽  
Superior Vena ◽  
Vena Cava ◽  
Rapid Diagnosis ◽  
Clinical Suspicion ◽  
Dialysis Access ◽  
Hemodialysis Catheter ◽  
Catheter Tip ◽  
Catheter Malposition ◽  
Subclavian Catheter

A dual-lumen subclavian catheter was placed for temporary dialysis access in a 36-year-old woman. Clinical suspicion for a possible vena caval perforation by the catheter tip was confirmed by injection of contrast through the catheter. This technique allowed rapid diagnosis and prevented further potential complications related to catheter malposition.

Supradiaphragmatic central venous catheter malposition detection using the parasternal long-axis echocardiographic view and dextrose 50% contrast solution: A pilot study

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110517
Author(s):  
Mohd Jazman Che Rahim ◽  
Shaik Farid Abdull Wahab ◽  
Mohd Hashairi Fauzi ◽  
Chandran Nadarajan ◽  
Siti Azrin Ab Hamid
Keyword(s):  
Pilot Study ◽  
Central Venous Catheter ◽  
Blood Sugar ◽  
Venous Catheter ◽  
Capillary Blood ◽  
Brachiocephalic Vein ◽  
Central Venous ◽  
Perfect Agreement ◽  
Catheter Malposition ◽  
Contrast Solution

Background Contrast-enhanced ultrasonography (CEUS) using saline was studied to detect supradiaphragmatic central venous catheter malposition. Commonly used echocardiographic views are apical 4-chamber (A4c) and subcostal views. However, this standard method is not feasible in certain situations. We explored the feasibility of the right ventricle inflow parasternal long axis (RVI-PLAX) echocardiographic view and dextrose 50% (D50%) contrast solution for detecting supradiaphragmatic central venous catheter malposition. Method This pilot study screened 60 patients who underwent ultrasound-guided supradiaphragmatic central venous catheter insertion. We compared the investigators' guidewire's J-tip detection, D50% rapid atrial swirl sign (RASS) findings on the RVI-PLAX view and the central venous catheter tip on chest radiograph. We also compared the mean capillary blood sugar level before and after the 5 ml D50% flush. Results No guidewire J-tips were detected from the RVI-PLAX view. The first and second investigators’ diagnosis of central venous catheter malposition detected on RVI-PLAX CEUS achieved an almost perfect agreement (κ = 1.0 (95% confidence interval (CI): 0.90 to 1.0), p < .0001). The RVI-PLAX CEUS was not able to detect two central venous catheter malpositions (one atrial malposition and one left brachiocephalic vein venous catheter malposition). The capillary blood sugar was significantly elevated (8.96 mmol/L vs. 9.75 mmol/L) after D50% flush ( p < 0.005) with no complications reported within 30 minutes after the D50% flush. Conclusion RVI-PLAX view should not be used for guidewire detection. CEUS using D50% and RVI-PLAX view are potentially useful tools in detecting central venous catheter malposition. Further studies comparing them with conventional methods are needed.

Fatal outcome of haemodialysis catheter malposition into the hepatic vein causing Budd-Chiari Syndrome

2017 ◽  
Vol 18 (3) ◽  
pp. e37-e38 ◽  
Author(s):  
Mohammad Ali Husainy ◽  
Rajdeep Chhina ◽  
Riad Alchanan ◽  
Praveen Peddu
Keyword(s):  
Hepatic Vein ◽  
Fatal Outcome ◽  
Budd Chiari Syndrome ◽  
Haemodialysis Catheter ◽  
Chiari Syndrome ◽  
Catheter Malposition

scholarly journals Proceso de Enfermería a paciente con cetoacidosis diabética y riesgo de síndrome de desuso

2013 ◽  
Vol 2 (4) ◽  
pp. 48
Author(s):  
Guillermina Silva Monroy ◽  
Jessica Selene Altamirano Luna
Keyword(s):  
Diabetes Mellitus ◽  
Cleft Lip ◽  
Pressure Ulcers ◽  
Distal Portion ◽  
Model Assessment ◽  
Glargine Insulin ◽  
Nasogastric Feeding ◽  
Risk Of Falls ◽  
Transurethral Catheter ◽  
Subclavian Catheter

<div>RES&Uacute;MEN&nbsp;</div><div><br /></div><div>Este trabajo es un PE aplicado al &nbsp;paciente ADPG de la UCI del HGZ 24 utilizando el modelo de los 11 Patrones Funcionales de Marjory Gordon con fecha de valoraci&oacute;n del 2 de abril del 2013, con diagn&oacute;stico m&eacute;dico de cetoacidosis diab&eacute;tica, patolog&iacute;a de base Diabetes Mellitus I, 17 a&ntilde;os de evoluci&oacute;n, actualmente tratada con infusi&oacute;n de insulina glargina. T/A 130/81 mmHg, F.C 99/min., F.R 26/min., SO2 100%. Temp. 37&deg;C, glicemia capilar 40 mg/dl a las 08:00 y de 80 mg/dl a las 10:00. Valores de gasometr&iacute;a pH 7.20, HCO3 19 mol/1, PCO2 35 mmHg, PO2 66 mmHg. ADPG encamado, bajo sedaci&oacute;n con Propofol, Ramsay 4, riesgo alto de ca&iacute;das y &uacute;lceras por presi&oacute;n, inm&oacute;vil, mioclon&iacute;as faciales, ausencia de reflejos oculares, sonda nasog&aacute;strica para alimentaci&oacute;n y drenaje, ventilaci&oacute;n mec&aacute;nica asisto control. Piel seca y palidez, mucosas orales deshidratadas, fisura en labio inferior, lengua con ulceraci&oacute;n en porci&oacute;n distal debido a la c&aacute;nula endotraqueal. Cat&eacute;ter subclavio derecho, monitorizado por electrodos, edema en manos (+), hematoma en yema del dedo &iacute;ndice de MSD. Hipoactividad intestinal, sonda transuretral tipo Foley, &uacute;lcera en regi&oacute;n cox&iacute;gea estad&iacute;o II y en MsPs regi&oacute;n calc&aacute;nea en estadio II, presenta mioclon&iacute;as en extremidades, pie cavo izquierdo. Paciente en abandono por cuidador primario. Se diagnostic&oacute; con Riesgo de s&iacute;ndrome de desuso, identificamos capacidades del paciente se elabor&oacute; un plan con duraci&oacute;n de 4 d&iacute;as, entre las intervenciones ejecutadas estuvieron cuidados a paciente encamado, cuidado de las ulceras por presi&oacute;n principalmente, evaluando que nuestro objetivo se cumpli&oacute; en un 60%.</div><div><br /></div><div><br /></div><div>ABSTRACT</div><div><br /></div><div>This work is a PAE applied to the patient ADPG of the UCI of HGZ 24 using the Marjory Gordon&rsquo;s 11 functional patterns model; assessment dated April 2, 2013 with a medical diagnosis of diabetic ketoacidosis, Diabetes Mellitus underlying pathology I, 17 years of evolution, currently treated with glargine insulin infusion. T / A 130/81 mmHg, HR 99/min., FR 26/min., SO2 100%. Temp. 37 &deg; C, capillary glucose 40 mg / dl at 0800 and 80 mg / dl at 10:00. Blood gas values ​​pH 7.20, HCO3 19 mol / 1, PCO2 35 mmHg, PO2 66 mmHg. ADPG bedridden, under sedation with Propofol, Ramsay 4, and high risk of falls and pressure ulcers, immobile facial myoclonus and absence of eye reflexes, nasogastric feeding and drainage, attend ventilation control. Dry and pale skin, oral mucosa dehydrated, cleft lip, tongue ulceration distal portion due to the endotracheal tube. Right subclavian catheter, monitored by electrodes, edema in hands (+), hematoma index fingertip MSD. Underactive bowel, Foley transurethral catheter type, coccygeal ulcer stage II and stage MSPs calcaneal region II, presents myoclonus in limbs, arched feet left. Patient abandoned by primary caregiver. Was diagnosed with disuse syndrome risk, we identified the patient&rsquo;s capability and elaborated a plan lasting four days, between interventions were executed bedridden patient cares, care of pressure ulcers mainly assessing our objective was met by 60 %.</div>

Subclavian Catheter Infections

1988 ◽  
Vol 12 (5) ◽  
pp. 511-512 ◽  
Author(s):  
Scott G. Rose ◽  
Robert J. Pitsch ◽  
F. William Karrer ◽  
B.J. Moor
Keyword(s):  
Subclavian Catheter ◽  
Catheter Infections

MO715PROFILE OF INFECTIVE ENDOCARDITIS IN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Samarra Badrouchi ◽  
Hajji Mariem ◽  
Samia Barbouch ◽  
Fethi Ben Hmida ◽  
Harzallah Amel ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Vascular Access ◽  
Rare Complication ◽  
Hemodialysis Patients ◽  
Infectious Complications ◽  
Chronic Hemodialysis ◽  
Therapeutic Modalities ◽  
Duke Criteria ◽  
Profile Characteristics ◽  
Subclavian Catheter

Abstract Background and Aims Infectious complications are the second leading cause of death in hemodialysis patients. This population is particularly exposed to bacteremia, on the one hand, because of the vascular access necessary for hemodialysis, which is a gateway to the various micro-organisms, and on the other hand, factors of susceptibility to infections. Infective endocarditis (IE) is the cardiac endothelium infection associated with bacteremia. It is a rare complication but its mortality remains high especially in patients on chronic hemodialysis. The aim of this study was to determine the microbiological profile, clinical and-biological profile, characteristics in the ultrasound, therapeutic modalities, and prognosis of IE in hemodialysis. Method This is a retrospective descriptive study of including chronic hemodialysis patients, admitted in the Nephrology and Internal Medicine Department A of the Charles Nicolle Hospital in Tunis for an IE during the period from 1973 to 2018. We used the modified Duke criteria to confirm the diagnosis of IE. Results Nineteen patients were included, including 12 men and 7 women (gender ratio=1.7). The average age was 49.1 years [29-66 years]. Seven of them (37%) were known to have a valvular disease, two of them had a double mitro-aortic valve replacement. Six of them (32%) were diabetic and two patients (11%) were on immunosuppressive therapy. The vascular access initially used for HD were arteriovenous fistula in 9 cases (47%), internal jugular catheter in 3 cases (16%), subclavian catheter in 1 case (5%), Canaud catheter in 3 cases (16%), and 2 patients were dialyzed by femoral catheter (11%). Clinically, all patients had an altered general condition, fever was present in 14 cases (74%) and a heart murmur in 10 cases (53%). Blood cultures were positive in 14 cases (74%). The isolated germs were Staphylococcus Aureus in 8 cases, Staphylococcus epidermidis in 4 cases, Pseudomonas aerogenosa in 3 cases, Enterobacterium in 1 case, enterococcus faecalis in 1 case, and Klebsielle oxytoca in one patient. On cardiac ultrasound, mitral valve damage was found in 10 patients, aortic sigmoid in 4 patients and tricuspid valve in 3 patients. The treatment included appropriate antibiotic therapy in all cases and a valvuloplasty was indicated in 7 patients. Nine patients (47%) died during their hospitalization. Conclusion Hemodialysis patients are particularly exposed to IE. The most appropriate preventive method is the strict observance of asepsis when handling the vascular access first and the rapid eradication of all infectious outbreaks.

Pathophysiology of Ultrafiltration in Peritoneal Dialysis

1990 ◽  
Vol 10 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Claudio Ronco ◽  
Mariano Feriani ◽  
Stefano Chiaramonte ◽  
Alessandra Brendolan ◽  
Luisa Bragantini ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peritoneal Dialysis ◽  
Glucose Concentration ◽  
Peritoneal Membrane ◽  
Dialysis Membrane ◽  
Ultrafiltration Rate ◽  
Peritoneal Equilibration Test ◽  
Common Causes ◽  
Catheter Malposition ◽  
Causes Of Failure

Pathophysiology of peritoneal ultrafiltration is analyzed in the present study. Peritoneal equilibration test is the easiest procedure to study in detail the possible causes of failure to control the ultrafiltration rate in patients undergoing peritoneal dialysis. Membrane failure, reduction in peritoneal blood flow, excessive lymphatic reabsorption catheter malposition, and fluid sequestration are the most common causes of ultrafiltration loss. Pharmacologic manipulation of peritoneal membrane, correction of mechanical inconvenients, reduction in peritonitis rate and in the level of immunostimulation of the mesotelial macrophages, together with a careful policy in terms of glucose concentration in the dialysate and dwell times may contribute not only to treat different forms of ultrafiltration loss but also to prevent their incidence.

Sign in / Sign up

Export Citation Format

Share Document