Journal articles on the topic 'Intravenous catheterization Complications'
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Schoster, A. "Complications of intravenous catheterization in horses." Schweiz Arch Tierheilkd 159, no. 9 (September 5, 2017): 477–85. http://dx.doi.org/10.17236/sat00126.
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Kulairi, Zain, Nisha Deol, Renee Tolly, Rohan Manocha, and Maliha Naseer. "Is Intravenous Heparin a Contraindication for TPA in Ischemic Stroke?" Case Reports in Neurological Medicine 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/9280961.
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There are approximately 2 million cardiac catheterizations that occur every year in the United States and with an aging population this number continues to rise. Adverse events due to this procedure occur at low rates and include stroke, arrhythmia, and myocardial infarctions. Due to the high volume of procedures there are a growing number of adverse events. Stroke after cardiac catheterization (SCC) has an incidence between 0.27 and 0.5% and is one of the most debilitating complications leading to high rates of mortality and morbidity. Given the relatively uncommon clinical setting of stroke after cardiac catheterization, treatment protocols regarding the use of IV or IA thrombolysis have not been adequately developed. Herein, we describe a case of a 39-year-old male who developed a stroke following a cardiac catheterization where IV thrombolysis was utilized although the patient was on heparin prior to cardiac catheterization.
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Shaker, Norhan. "Monitoring Peripheral Intravenous Catheters Complications in Pediatric Patients in Erbil City/Iraq." Erbil Journal of Nursing and Midwifery 5, no. 2 (November 30, 2022): 105–13. http://dx.doi.org/10.15218/ejnm.2022.12.
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Backgrounds and Objectives: Although most problems of peripheral intravenous catheterization are inconsiderable and easily treated, some are dangerous and require rapid management. This study aimed to explore peripheral intravenous catheter-related com-plications and the quality of nursing care for dressing sites of peripheral intravenous catheterization among the pediatric population. Methods: The study was conducted at Raparin Teaching Hospital for Children inpatient units in Erbil City/Iraq, using an observational study design. A purposive sample from 296 hospitalized children with peripheral intravenous catheterization was chosen for this study. The data was collected using a special check List (PIVC-miniQ) developed for checking the signs and symptoms and the quality of care for the catheter insertion site. Furthermore, the obtained data on peripheral intravenous catheterization problems was evaluated for exploring grades of phlebitis using the Phlebitis Scale developed by the Infusion Nursing Society in 2011. The data was processed and analyzed using SPSS using descriptive statistical analysis (frequency, percentage) and inferential statistical tests (Chi-squared, contingency coefficient). The probability value of ≤0.05 was regarded as statistically significant. Results: Most (82.4%) of patients were recruited in the emergency unit, with the highest percentage (36.8%) were toddlers. More than two-thirds (72.3%) of participants were assessed within the first peripheral catheter insertion. Regarding overall grades of patients’ peripheral intravenous catheterization complications (PIVC), less than a quarter (21.6%) were within the first grade, indicating being at risk for complications, and 6.8% were within the second grade, indicating slight phlebitis. Regarding the nursing care for PIVC site care, 62.5% of participants received fair care, and 22.3% received poor care. Conclusions: A quarter of observed children were at risk for having phlebitis and less than ten percent had slight phlebitis. About a quarter of patients received poor nursing care for the catheter insertion site. Most participants have not a documentation of peripheral intravenous catheter insertion date on the dressing and on the patient's chart.
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Salma, Umma, Mohammad Abdus Sattar Sarker, Nahida Zafrin, and Kazi Shamin Ahamed. "Frequency of Peripheral Intravenous Catheter Related Phlebitis and Related Risk Factors: A Prospective Study." Journal of Medicine 20, no. 1 (January 1, 2019): 29–33. http://dx.doi.org/10.3329/jom.v20i1.38818.
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Background: Peripheral Intravenous Catheterization (PIVC) related complication is a common and significant problem in clinical practices. The aim of the study was to see the pattern of complication developed by PIVC and to find out the associated risk factors.
Materials & methods: A prospective study was conducted amongst 300 patients and 420 PIVCs were observed.
Results: 76 (18.09%) patients developed phlebitis and among the phlebitis patients 55.26% were grade 2 and 22.37% grade 3. Hypertonic fluid infusion and some antibiotics were found as risk factors for phlebitis. Amongst the antibiotics flucloxacilin (60%), amikacin (50%), amoxicillin + clavulanic acid were most common antibiotics responsible for development of phlebitis.
Conclusions: Catheterization site and use of antibiotics and potassium chloride with associated co-morbidities are predisposing factors for phlebitis. Better insertion technique may be sought to lower the incidence of PIVC related complications.
J MEDICINE JUL 2019; 20 (1) : 29-33
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Barone, James E., James B. Tucker, Dennis Rassias, and Philip R. Corvo. "Routine Perioperative Pulmonary Artery Catheterization Has No Effect on Rate of Complications in Vascular Surgery: A Meta-Analysis." American Surgeon 67, no. 7 (July 2001): 674–79. http://dx.doi.org/10.1177/000313480106700718.
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Despite widespread use pulmonary artery catheterization has not been proven to reduce complications or mortality. One study supported the use of routine preoperative pulmonary artery catheterization in moderate-risk vascular surgery patients; several other studies have reported that pulmonary artery catheterization is not efficacious. Our goal was to scrutinize the data using meta-analysis. This is a systematic review of the literature. MEDLINE was searched for all articles on pulmonary artery catheterization, optimization, oxygen delivery, and preoperative preparation of vascular surgery patients. Data from papers judged appropriate for inclusion were analyzed using a computer program, Easy MA. Complications were defined as only those that could have reasonably have been prevented by or resulted from pulmonary artery catheterization. Of hundreds of possible papers only four were found to be adequate randomized prospective studies with similar exclusions, therapeutic endpoints, and interpretable complication and mortality rates. Controls included 174 patients versus 211 in the protocol group. Power analysis showed that the combined sample sizes were adequate. The meta-analysis demonstrates that the studies are homogeneous. The use of a pulmonary artery catheter does not prevent morbidity or mortality. Of the studies providing data on the amount of intravenous fluid administered three reported that statistically significantly more fluid was given to patients who underwent pulmonary artery catheterization. Meta-analysis indicates that in moderate-risk vascular surgery patients routine preoperative pulmonary artery catheterization is not associated with improved outcomes.
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Trotter, Carol. "Inadvertent Catheterization of the Ascending Lumbar Vein." Neonatal Network 28, no. 3 (May 2009): 179–83. http://dx.doi.org/10.1891/0730-0832.28.3.179.
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A NUMBER OF SERIOUS COMPLICATIONS can arise from malpositioned central venous catheters (CVCs), including cardiac tamponade and perforation, pleural effusions, and infusion into the vertebral venous system anywhere along the spinal column. Figure 1 is an x-ray of a premature infant taken after insertion of a 2.0 Silastic peripherally inserted central catheter (PICC), demonstrating the catheter entering the left ascending lumbar vein (ALV). Routine contrast injection of 0.3 mL of iothalamate meglumine 60 percent (Conray, Covidien Imaging Solutions, Hazelwood, Missouri) at the time of the PICC-placement film demonstrated that the contrast material extended into the vertebral venous plexus. The catheter was immediately withdrawn before intravenous fluid was administered, and the infant experienced no complications.
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SANTOLIM, THAIS QUEIROZ, ANDRÉ MATHIAS BAPTISTA, ARLETE MAZZINI MIRANDA GIOVANI, JUAN PABLO ZUMÁRRAGA, and OLAVO PIRES DE CAMARGO. "PERIPHERALLY INSERTED CENTRAL CATHETERS IN ORTHOPEDIC PATIENTS: EXPERIENCE FROM 1023 PROCEDURES." Acta Ortopédica Brasileira 26, no. 3 (June 2018): 206–10. http://dx.doi.org/10.1590/1413-785220182603189368.
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ABSTRACT Objectives The advantages of using a peripherally inserted central catheter (PICC) in hospitalized patients make this device very important for intravenous therapy. This study describes the use of PICCs at the Institute of Orthopedics and Traumatology at the Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo over the last 10 years. Methods This retrospective study analyzed 1,057 medical records and included 1,023 medical files with complete information on the punctured vein, diagnosis, duration of catheterization, complications, and catheter tip positioning. Results Seven hundred and twenty PICCs (70.4%) were considered successfully positioned, and mean duration of catheterization was 34.3 days. The basilic vein was used in 528 (51.6%) patients, while 157 (15.4%) catheters were removed due to complications. No cases of catheter-related thrombosis or infection were found. Eight hundred and sixty-six (84.6%) patients completed their treatment with PICC in place. Conclusion PICC is a safe intravenous device that can be successfully utilized for medium- and long-course intravenous therapy in hospitalized and discharged orthopedic patients. Level of Evidence IV; Case series.
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Sakaguchi, Masanori, Kiichiro Taguchi, and Tetsuya Ishiyama. "Acute pharyngitis, an unusual complication of intravenous hyperalimentation." Journal of Laryngology & Otology 108, no. 2 (February 1994): 159–60. http://dx.doi.org/10.1017/s0022215100126167.
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AbstractWhile the numerous complications of intravenous hyperalimentation (IVH) are well recognized, we encountered a unique one. A 60-year-old man developed a sore throat, neck pain and fever seven days after catheterization of the subclavian vein to provide post-operative nutrition. Marked swelling was visible at the right posterior wall of his oropharynx and hypopharynx. X-ray of the neck revealed that the tip of the catheter was positioned in the internal jugular vein, not the subclavian vein as intended. The acute pharyngitis, diagnosed as due to phlebitis of the internal jugular vein due to the malpositioned catheter, subsided within two days of catheter removal.
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Kaynar, Mehmet, Murat Akand, and Serdar Goktas. "A novel cannulation technique for difficult urethral catheterization." Archivio Italiano di Urologia e Andrologia 88, no. 1 (March 31, 2016): 60. http://dx.doi.org/10.4081/aiua.2016.1.60.
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Introduction: To propose a novel cannulation technique for difficult urethral catheterization procedures. Technique: The sheath tip of an intravenous catheter is cut off, replaced to the needle tip and pushed through the distal drainage side hole to Foley catheter tip, and finally withdrawn for cannulation. In situations making urethral catheterization difficult, a guide wire is placed under direct vision. The modified Foley catheter is slid successfully over the guide wire from its distal end throughout the urethral passage into the bladder. Results: The modified Foley catheter was used successfully in our clinic in cases requiring difficult urethral catheterization. Conclusions: This easy and rapid modification of a Foley catheter may minimize the potential complications of blind catheter placement in standard catheterization.
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Lubennikova, E. V., I. P. Ganshina, A. N. Lud, D. V. Komov, I. V. Kolyadina, Y. V. Vishnevskaya, I. K. Vorotnikov, et al. "EXPERIENCE WITH SUBCUTANEOUS TRASTUZUMAB USED IN RUSSIAN FEDERATION." Medical Council, no. 14 (November 14, 2017): 40–45. http://dx.doi.org/10.21518/2079-701x-2017-14-.
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The HannaH study showed that neoadjuvante-adjuvant subcutaneous and intravenous trastuzumab have similar efficacy and tolerability in patients with early HER2-positive breast cancer. The analysis of the results of the subcutaneous and intravenous trastuzumab usage in Russian population showed the favorable association between tpCR anf EFS. tpCR achiviement is associated with clinical benefit in HER2 positive breast cancer. For patients with difficult venous access who do not require intravenous chemotherapy currently, Subcutaneous trastuzumab allows to receive effective treatment without the risk of complications, which involves catheterization of a Central vein.
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Lubennikova, E. V., I. P. Ganshina, A. N. Lud, D. V. Komov, I. V. Kolyadina, Y. V. Vishnevskaya, I. K. Vorotnikov, et al. "EXPERIENCE WITH SUBCUTANEOUS TRASTUZUMAB USED IN RUSSIAN FEDERATION." Medical Council, no. 14 (November 14, 2017): 40–45. http://dx.doi.org/10.21518/2079-701x-2017-14-40-45.
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The HannaH study showed that neoadjuvante-adjuvant subcutaneous and intravenous trastuzumab have similar efficacy and tolerability in patients with early HER2-positive breast cancer. The analysis of the results of the subcutaneous and intravenous trastuzumab usage in Russian population showed the favorable association between tpCR anf EFS. tpCR achiviement is associated with clinical benefit in HER2 positive breast cancer. For patients with difficult venous access who do not require intravenous chemotherapy currently, Subcutaneous trastuzumab allows to receive effective treatment without the risk of complications, which involves catheterization of a Central vein.
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Catarino, Fernando, Cristina Lourenço, Célia Correia, João Dória, Maria Dixe, Cátia Santos, Joana Sousa, Susana Mendonça, Daniela Cardoso, and Cristina R. Costeira. "Nursing Care in Peripheral Intravenous Catheter (PIVC): Protocol of a Best Practice Implementation Project." Nursing Reports 12, no. 3 (July 13, 2022): 515–19. http://dx.doi.org/10.3390/nursrep12030049.
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Background: The use of a peripheral intravenous catheters (PIVC) is a common invasive practice in healthcare settings. It is estimated that about 70% of people with PIVCs will develop associated complications, such as infections. It is the consensus that best practices could reduce the appearance of such complications and reduce the length of stay in hospital. Methods: A project will be applied to implement the best approach in peripheral venous catheterization, provided by clinical nurses from an inland hospital in Portugal. The Joanna Briggs Institute methodology will be used on evidence implementation projects, which will be developed in three phases. First, a baseline audit will be performed. The second phase implements corrective measures, and the third phase is a follow-up audit. Conclusions: This project will improve the practice of the nursing team on peripheral venous catheterization nursing cares, positively influencing the quality of nursing care and patient safety. The implementation and dissemination of this project could boost its replication in other centres.
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Belitz, O. "On the issue of subcutaneous use of pilocarpine in postoperative urinary retention." Kazan medical journal 32, no. 4 (September 20, 2021): 339–43. http://dx.doi.org/10.17816/kazmj80536.
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Postoperative, as well as postpartum ischuria is a very unpleasant complication, since all commonly used means are heat to the bladder, instillation of 10% boric glycerin into the bladder (Corbineau method), liq. kalii acetici per os, injections of 1.0-2.0 25% magnesiae sulfur, under the skin (Voytashevsky method), intravenous injections of 5.0-10.0 40% urotropin (according to V o g t'y) - often give refusal or induce urination after many hours and thus force the use of a catheter. As for catheterization, this method is recognized as fraught with complications and should be used, according to Dieterichs, only as an ultimum refugium.
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Sanan, Neha, Marija Rowane, and Robert Hostoffer. "Radiologic Contrast Media Desensitization for Delayed Cardiac Catheterization." Allergy & Rhinology 10 (January 2019): 215265671989284. http://dx.doi.org/10.1177/2152656719892844.
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This protocol for rapid desensitization to intravenous radiographic contrast material (RCM) improves the strategy first reported by Uppal et al. Desensitization is a validated preventative measure for medical emergencies, such as cardiac catheterization, when patients present with histories of anaphylactoid reactions to the allergen of concern. The patient required another catheterization that was modified to repeat the final dosage of 320 mg/mL of Visipaque®, accommodating cardiac catheterization postponement, contrary to readministration of doses 4 (0.625 mg/mL) and 8 (10 mg/mL) as reported in Uppal et al. Our risk score calculations suggested that the patient was at low risk of contrast-induced nephropathy (CIN) that did not necessitate reduced dosage. No complications were reported following catheterization. We propose repetition of the final RCM dosage as a more effective and efficient desensitization strategy, as long as the scoring system does not indicate high risk for CIN.
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Suastika, Luh Oliva Saraswati, and Yudi Her Oktaviono. "Multiple Air Embolism during Coronary Angiography: How do We Deal with it?" Clinical Medicine Insights: Cardiology 10 (January 2016): CMC.S38040. http://dx.doi.org/10.4137/cmc.s38040.
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Coronary air embolism remains a serious complication of cardiac catheterization despite careful prevention. The complications of coronary air embolism range from clinically insignificant events to acute coronary syndrome, cardiogenic shock, and death. We report here a case of multiple air emboli in both left coronary arteries, complicated by cardiogenic shock and ventricular fibrillation in a 49-year-old male patient undergoing elective percutaneous coronary intervention. The patient recovered after supportive measures, including oxygen, intravenous dopamine infusion, and cardiac compression, and repeated forceful injection of heparinized saline successfully resolved the air emboli. He then eventually underwent successful percutaneous coronary intervention in the left anterior descending artery without any residual stenosis.
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Bostanci, Asli, and Murat Turhan. "Internal Jugular Vein Thrombosis following Oropharyngeal Infection." Case Reports in Vascular Medicine 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/538439.
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Internal jugular vein thrombosis (IJVT) is a rare condition which may lead to life-threatening complications such as sepsis and pulmonary embolism. Prolonged central venous catheterization, intravenous (IV) drug use, trauma, and radiotherapy are the most frequent causes of the IJVT. IJVT that develops after the oropharyngeal infection is a quite rare situation today. In this paper, a 37-year-old woman was presented; swelling occurred on her neck after acute tonsillitis and she was diagnosed with IJVT through Doppler ultrasonography and magnetic resonance imaging and managed without complications. Early diagnosis and conservative treatment with broad-spectrum IV antibiotics and anticoagulant agents have a critical importance for the prevention of fatal complications.
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Sakai, Takashi, Hirofumi Uehara, Shigekiyo Takahashi, Masayoshi Yamamoto, Masafumi Kawamura, and Hiroshi Kondo. "Surgical removal of a foreign body in the pulmonary artery." Trauma 21, no. 2 (October 14, 2018): 152–54. http://dx.doi.org/10.1177/1460408618802977.
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Foreign bodies, such as a fragmented catheter or metallic objects from industrial accidents, that have accidentally entered a major cardiac vessel or pulmonary artery have been successfully removed non-surgically via intravenous catheterization. We report the rare case of a cracked iron hammer fragment that had entered the femoral vein and migrated to the pulmonary artery through major blood vessels without causing hemorrhage, which eventually required surgical removal. A 19-year-old man accidentally smashed an iron hammer that broke into small pieces, one of which entered his femoral vein and eventually lodged in the pulmonary artery. After non-surgical intravenous catheterization to remove this foreign body was unsuccessful, it was removed surgically under video-assisted thoracoscopy. Foreign body residue over the long term can cause hemorrhage, pulmonary infarction, infection, and/or abscess. Transvenous recovery is the primary non-surgical means of removing a foreign body from the pulmonary artery. It is less harmful than surgical removal and causes fewer complications. Nevertheless, it is essential to be ready to execute a surgical approach for foreign body removal when other interventions have failed.
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Mannion, John D., Daniel Marelli, Todd Brandt, Megan Stallings, Jeffery Cirks, Mats Dreifaldt, and Domingos Souza. "“No-Touch” versus “Endo” Vein Harvest: Early Patency on Symptom-Directed Catheterization and Harvest Site Complications." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 9, no. 4 (July 2014): 306–11. http://dx.doi.org/10.1097/imi.0000000000000084.
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Objective “No-touch” (NT) saphenous vein harvesting preserves the adventitial vasa vasorum, prevents medial ischemia, and is associated with an improved short-term and long-term vein graft patency. It may also be associated with a higher rate of harvest site complications. Endovascular vein harvesting (endo-vein) has a low rate of harvest site complications but also a tendency toward a lower patency rate. Methods During a 2-year period (2011–2012), we compared the vein graft patency at symptom-directed cardiac catheterization as well as wound complication rates in 210 patients who received either NT (87 patients) or endo-vein (123 patients). Results The recatheterization rate for the two groups was similar: 9 (10.3%) of 87 of the NT patients versus 11 (9.0%) of 123 of the endo-vein patients. There was a significant difference in vein graft patency between the groups: 15 (94%) of 16 NT vein grafts were patent versus 6 (27%) of 22 of endo-veins ( P < 0.02). The endo-vein graft patency during this 2-year period was similar to the total endo-vein patency (37%) during a 4-year period. A comparison between a more experienced and a less experienced harvester revealed no difference in patency rate. Harvest site complications were significantly higher with the NT harvest: 18% of the NT patients requiring vacuum-assisted wound closure or intravenous antibiotics versus 2% of the endo-vein patients ( P < 0.0001). The application of platelet-rich plasma did not significantly lower wound complication rates ( P = 0.27). Conclusions These results suggest that NT vein harvesting may be associated with improved graft patency, but methods should be developed to lower wound complication rates.
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Rathod, Kamleshkumar G., and Ruta M. Deo. "Intracath in neonates- does size matter?" International Journal of Contemporary Pediatrics 7, no. 11 (October 21, 2020): 2194. http://dx.doi.org/10.18203/2349-3291.ijcp20204544.
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Background: Intravenous cannulation, though a first line procedure is very challenging in new-born patients. Improving its longevity will prevent frequent resisting and complications and help the baby and doctor immensely. this study analyses parameters that are likely to affect the longevity of intravenous cannula on same. This study analyses the parameters likely to affect the longevity of intravenous cannulas and effect of gauge on the same. The objectives considered are to determine the ideal gauge of cannula for peripheral vein catheterization, evaluate the complications necessitating its removal and to find the best possible peripheral vein for such cannulation; if any.Methods: This is a hospital based prospective observational study in 500 intravenous cannulas studied from point of insertion to removal. Results were tabulated and analysed based on Chi-square test and Kaplan Meir slopes were plotted. Main outcome measure- effect of cannula site on its in-situ life.Results: Term infants showed increased life span as gauge size increased (maximum with 20 G). Pre-terms had best longevity with 22 gauge. Most common cause warranting removal of cannulas were local swelling and erythema. Prick site complications leading to serious morbidity occurred in <5%.Conclusion: Gauge 22 is best suited for iv access in neonates. Gestational age and site of cannulation are strong determinants of gauge size and longevity. Intravenous cannulas in neonatal intensive care unit (NICU) should be selected considering factors for maximum lifespan of the catheter.
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Rehman, Khaliq Ur, Rizwan Aziz Qazi, and Khalid Hussain. "Investigation of Risk Factors for Tunneled Hemodialysis Catheter Dysfunction." Pakistan Journal of Medical & Health Sciences 16, no. 10 (October 30, 2022): 469–70. http://dx.doi.org/10.53350/pjmhs221610469.
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Introduction: Tunneled central venous catheters (CVC) is a flexible tube with prolonged vascular access providing for the management of intravenous medication treatments, fluids, or total parenteral nutrition, repeated blood sampling, and hemodialysis (HD). Objectives: The main objective of the study is to investigate the risk factors for tunneled hemodialysis catheter dysfunction. Material and methods: This observational study was conducted in Akbar Niazi Teaching Hospital, Barakahu, Islamabad during June 2022 till October 2022. All patients who underwent central venous catheterization for the first time in the hospital were included in the study. All catheterizations were performed ultrasound-guided and rechecked by fluoroscopy to confirm the proper replacement of the catheter in the Cava-atrial junction. Results: The data was collected from 235 patients. One hundred sixty-three patients (72.4%) had no CVC malfunction and sixty-two (27.6%) patients had malfunction. The median duration of follow-up was 162 days for patients with no malfunction and 48.5 days for patients with CVC malfunction. Practical implication: We can easily find the catheter related complications after reading this research analysis. Conclusion: It is concluded that the placement of TDCs in patients should be considered the last resort; however, with the increased use of TDCs and experience, the number of catheter-related complications can be expected to decrease. Keywords: TDCs, Catheter, CVC, Malfunction, Complications
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Moussawi, K., M. M. Ortiz, S. C. Gantz, B. J. Tunstall, R. C. N. Marchette, A. Bonci, G. F. Koob, and L. F. Vendruscolo. "Fentanyl vapor self-administration model in mice to study opioid addiction." Science Advances 6, no. 32 (August 2020): eabc0413. http://dx.doi.org/10.1126/sciadv.abc0413.
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Intravenous drug self-administration is considered the “gold standard” model to investigate the neurobiology of drug addiction in rodents. However, its use in mice is limited by frequent complications of intravenous catheterization. Given the many advantages of using mice in biomedical research, we developed a noninvasive mouse model of opioid self-administration using vaporized fentanyl. Mice readily self-administered fentanyl vapor, titrated their drug intake, and exhibited addiction-like behaviors, including escalation of drug intake, somatic signs of withdrawal, drug intake despite punishment, and reinstatement of drug seeking. Electrophysiological recordings from ventral tegmental area dopamine neurons showed a lower amplitude of GABAB receptor–dependent currents during protracted abstinence from fentanyl vapor self-administration. This mouse model of fentanyl self-administration recapitulates key features of opioid addiction, overcomes limitations of the intravenous model, and allows investigation of the neurobiology of opioid addiction in unprecedented ways.
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Prejean, Shane P., Gregory Von Mering, and Mustafa Ahmed. "Successful Treatment of Pseudoaneurysm Following Left Distal Transradial Cardiac Catheterization With Compression Device." Journal for Vascular Ultrasound 43, no. 2 (April 15, 2019): 81–85. http://dx.doi.org/10.1177/1544316719844061.
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Distal transradial artery access has emerged as a promising new method of access for coronary and endovascular procedures. With the increasing use of distal transradial artery access, operators will need to gain experience in the management of complications in the anatomical snuffbox. We review the rationale behind distal transradial access and summarize rate of vascular complications, based on the review of the literature. We then report a case of pseudoaneurysm in the distal left radial artery occurring 20 hours after cardiac catheterization likely precipitated by intravenous heparin and dual antiplatelet therapy with aspirin and prasugrel received during a second procedure. A modified compression technique with the TR band® (Terumo Medical Corporation, Tokyo, Japan) was used in which the rigid, plastic insert was removed prior to application to facilitate improved apposition of the band on the dorsum of the hand, and waveforms from continuous pulse oximetry were used to guide “patent compression.” Thrombosis of the pseudoaneurysm was achieved in 12 hours, and no further intervention was required.
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Batista, Odinéa Maria Amorim, Sarah Nayane Oliveira Abreu Coelho, Gabriella Moura de Oliveira, Maria Zélia De Araújo Madeira, Chrystiany Plácido De Brito Vieira, and Ana Maria Ribeiro dos Santos. "Risk factors for local complications of peripheral intravenous therapy factores/Fatores de risco para as complicações locais da terapia intravenosa periférica/Riesgo para complicaciones locales de la terapia intravenosa periférica." Revista de Enfermagem da UFPI 3, no. 3 (November 5, 2014): 88. http://dx.doi.org/10.26694/reufpi.v3i3.1540.
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ABSTRACT Objective: This study aimed to raise and discuss, on the literature, the aspects related to risk factors for local complications of Peripheral Intravenous Therapy in adults. Methodology: This is an integrative review, whose data collection happened in July 2013, in databases of the Latin American and Caribbean Center on Health Sciences Information and the Scientific Electronic Library Online about the risk factors for complications of Peripheral Intravenous Therapy in adults, from 2004 to 2013. Results: The sample consisted of seven articles that listed risk factors such as length of stay, material, location, salinization and maintenance of the catheter, patient’s age, type of drug, type of dressing, and non-adherence of nursing professionals to preventive measures. Conclusion: We conclude that there are risk factors for complications that are preventable and related to the conduct of nursing professionals. Therefore, we should intensify educational activities in order to reduce injuries to the patient. Descriptors: Nursing. Catheterization Peripheral. Infusions. Intravenous. RESUMO Objetivo: Este estudo objetivou levantar e discutir, na literatura, os aspectos relacionados aos fatores de risco das complicações locais da Terapia Intravenosa periférica em adultos. Metodologia: Trata-se de uma revisão integrativa, cuja coleta de dados ocorreu em julho de 2013, nas bases de dados Literatura Latino-Americana em Ciências da Saúde e Scientific Electronic Library Onlin sobre os fatores de risco para complicações da Terapia Intravenosa periférica em adultos, nos anos de 2004 a 2013. Resultados: Compuseram a amostra sete artigos que elencaram como fatores de risco tempo de permanência, material, localização, forma de manutenção e salinização do cateter; idade do paciente; tipo de fármaco, tipo de curativo e não adesão dos profissionais de Enfermagem às medidas preveníveis. Conclusão: Conclui-se que existem fatores de risco para complicações que são preveníveis e que estão ligados às condutas dos profissionais de Enfermagem. Por isso, devem-se intensificar as ações educativas com o intuito de diminuir injúrias ao paciente. Descritores: Enfermagem. Cateterismo Periférico. Infusões Intravenosas. RESUMEN Objetivo: El objetivo fue plantear y discutir en la literatura los aspectos relacionados con los factores de riesgo de complicaciones locales de la terapia intravenosa periférica en adultos. Metodología: Revisión integradora, llevada a cabo en julio de 2013, en las bases de datos Literatura Latino-Americana em Ciências da Saúde y Scientific Electronic Library Online acerca de los factores de riesgo para complicaciones de la terapia intravenosa periférica en adultos de 2004 a 2013. Resultados: Compusieron la amuestra siete artículos que apuntaron como factores de riesgo duración de la estancia, material, localización, forma de mantenimiento y salinización del catéter, edad del paciente, tipo de medicamento, tipo de aderezo y falta de adherencia de los profesionales de enfermería a las medidas de prevención. Conclusión: Existen factores de riesgo para complicaciones que son prevenibles y que se vinculan a comportamientos de los profesionales de enfermería. Así, se debe ampliar las acciones educativas reducir lesiones al paciente. Descriptores: Enfermería. Cateterismo Periférico. Infusiones Intravenosas.
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Katyal, Nakul, Amanda Korzep, and Christopher Newey. "Inadvertent Central Arterial Catheterization: An Unusual Cause of Ischemic Stroke." Journal of Neurosciences in Rural Practice 09, no. 01 (January 2018): 155–58. http://dx.doi.org/10.4103/jnrp.jnrp_460_17.
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ABSTRACTCentral venous catheter (CVC) insertion is extensively utilized in Intensive Care Units for evaluation of hemodynamic status, administration of intravenous drugs, and for providing nutritional support in critically ill patients. Unfortunately, CVC use is associated with complications including lung injury, bleeding, infection, and thrombosis. We present a patient with an acute ischemic stroke from an inadvertently placed CVC into the right common carotid artery. A 57-year-old male presented to our institution for left hemiplegia and seizures 2 days after a CVC was placed. He was found to have a right frontal ischemic stroke on computed tomography (CT). CT angiography noted that the catheter was arterial and had a thrombosis around it. He was started on a low-dose heparin infusion. A combination of cardiothoracic surgery and interventional cardiology was required to safely remove the catheter. Central arterial catheterization is an unusual cause for acute ischemic stroke and presents management challenges.
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Каchur, A. K., and V. K. Lyadov. "Key components of enhanced recovery after surgery protocol in lung cancer surgery." Research and Practical Medicine Journal 8, no. 3 (September 26, 2021): 70–83. http://dx.doi.org/10.17709/2410-1893-2021-8-3-7.
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Due to the high lung cancer morbidity and the need for surgical intervention in that patient population, introduction of the concept of standard protocol for enhanced recovery after surgery (ERAS) may lead to a significant decrease of the rate of postoperative complications and hospital stay. The aim of the review was to assess the main components of ERAS protocol in thoracic cancer surgery using video-assisted thoracoscopic interventions (VATS). Systematic implementation of specific measures in pre- (patient consulting before the intervention, compliance with fluid and nutrition regimen, exclusion of routine sedation, prophylaxis of venous thrombosis, use of intravenous antibiotics and alcohol skin-prepping solution with chlorohexidine), intra- (prevention of hypothermia, thoracoscopic approach, single-tube approach in anatomic lung resections, exclusion of pleural tube insertion, urethral catheterization for less than 2 hours and only in case of epidural anesthesia) and postoperative (early mobilization and cessation of intravenous infusion, pain control using combination of acetaminophen with NSAIDs, maintenance of normovolemy, use of balanced crystalloid solutions and non-pharmacological measures for nausea and vomiting control) periods promote improved outcomes, decrease of postoperative complication rate and postoperative mortality
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Anjum, Shazia, Sarbjit Singh, Zulfiqar Ali, Sheikh Ubaid, Syed Majid, and Syed Yusra Imtiyaz. "A comparative study of supraclavicular versus infraclavicular approach for central venous catheterization in neurosurgical patients." International Journal of Research in Medical Sciences 7, no. 9 (August 27, 2019): 3421. http://dx.doi.org/10.18203/2320-6012.ijrms20193614.
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Background: Central venous cannulation is a commonly performed procedure in neurosurgical patients to maintain the hemodynamic stability in the intraoperative period. It is used for infusion of intravenous fluids, vasopressors central venous pressure monitoring and detection of air embolism. Subclavian vein is commonly performed as there are minimal effects of positioning on it. Supraclavicular approach to subclavian vein cannulation is not as frequently employed as the infraclavicular approach. The purpose of this study was to compare the supraclavicular approach versus the infraclavicular approach in terms of number of attempts, success rate of catheterization and complications associated with the procedure.Methods: About 150 patients undergoing various neurosurgical procedures were enrolled in the study. They were divided into two groups. 75 patients underwent right supraclavicular catheterization of subclavian vein while as 75 patients underwent right infraclavicular catheterisation of the subclavian vein. The number of attempts for cannulation, success or failure of catheterization and any complications associated with the procedure or in the postoperative period were noted in each group. The data was compared between the two groups by using Chi-square test and Student’s Independent Samples T-test.Results: The right supraclavicular vein was successfully cannulated in 90.66% while as the right infraclaviclar vein was successfully cannulated in 96% of the patients (p >0.05). Malpositioning of catheter (threaded in contralateral subclavian) was noted in 4 patients in Group S and ipsilateral internal jugular vein in 2 patients. Pneumothorax was encountered in 1 patient in the group S undergoing supraclavicular subclavian vein cannulations while as subclavian arterial puncture was seen in 4 patients who underwent infraclavicular arterial puncture.Conclusions: There was no difference in successive cannulations between right the supraclavicular and right infraclaviclar veins. The rate of complications between the two approaches was comparable.
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2022, Malaysia Stroke Conference. "MALAYSIA STROKE CONFERENCE 2022 2." Journal Of Cardiovascular, Neurovascular & Stroke 4, no. 4 (December 31, 2022): 27–35. http://dx.doi.org/10.32896/cvns.v4n4.27-35.
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1. ISCHEMIC STROKE AND HYPERACUTE TREATMENT IN SEBERANG JAYA HOSPITAL: THE SEBERANG PRAI MODULE 2. ASSOCIATION OF ADMISSION BLOOD SUGAR LEVEL WITH ADMISSION NIHSS AND mRS 3 MONTHS POST ISCHEMIC STROKE THROMBOLYSIS: SEBERANG JAYA HOSPITAL 3. ASSOCIATION OF WEIGHT WITH ADMISSION STROKE SEVERITY AND FUNCTIONAL OUTCOME IN ACUTE ISCHEMIC STROKE PATIENTS WHO RECEIVED INTRAVENOUS THROMBOLYSIS IN SEBERANG JAYA HOSPITAL 4. ASSOCIATION OF SMOKING WITH ADMISSION STROKE SEVERITY, TYPES OF STROKE AND ISCHAEMIC STROKE SUBTYPES AMONG STROKE PATIENTS IN HOSPITAL SEBERANG JAYA 5. OUTCOME OF ISCHEMIC STROKE THROMBOLYSIS TREATMENT IN SEBERANG JAYA HOSPITAL, A SINGLE CENTER 10 YEARS REVIEW: 2012- 2021 6. A RARE COMPLICATION OF ACUTE ISCHEMIC STROKE DURING CARDIAC CATHETERIZATION: A CASE REPORT 7. STROKE AWARENESS AMONGST HEALTHCARE PROVIDERS IN AN UPPER MIDDLE-INCOME COUNTRY 8. HYPERCOAGULABLE STATE LEADING TO THROMBOTIC COMPLICATIONS AND CEREBRAL ARTERY INFARCTION IN PATIENT WITH SEVERE COVID-19 INFECTION: A CASE REPORT 9. LESSONS LEARNT FROM A POSTERIOR CIRCULATION STROKE IN A COVID-19 PATIENT: A CASE REPORT
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DiStefano, Youmna E., and Michael D. Lazar. "Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease." Case Reports in Anesthesiology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/106306.
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Peripheral nerve blockade (PNB) is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR). Evidence on the safety of PNB in patients with coagulopathy is lacking. We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD). Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year-old female undergoing TKR. A Humate-P intravenous infusion was started and the patient was positioned supinely. Using sterile technique with ultrasound guidance, a Contiplex 18 Gauge Tuohy needle was advanced in plane through the fascia iliaca towards the femoral nerve. A nerve catheter was threaded through the needle and secured without complications. Postoperatively, a levobupivacaine femoral catheter infusion was maintained, and twice daily Humate-P intravenous infusions were administered for 48 hours; enoxaparin thromboprophylaxis was initiated thereafter. The patient was discharged uneventfully on postoperative day 4. Given documentation of delayed, unheralded bleeding from PNB in coagulopathic patients, we recommend individualized PNB in vWD patients. Multidisciplinary team involvement is required to guide factor supplementation and thromboprophylaxis, as is close follow-up to elicit signs of bleeding throughout the delayed postoperative period.
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Lee, Jin Ho, Seun Deuk Hwang, Joon Ho Song, HeeYeoun Kim, Dong Yeol Lee, Joon Seok Oh, Yong Hun Sin, and Joong Kyung Kim. "Placement of tunneled cuffed catheter for hemodialysis: Micropuncture kit versus Angiocath IV catheter." Journal of Vascular Access 20, no. 1_suppl (August 2, 2018): 50–54. http://dx.doi.org/10.1177/1129729818777963.
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Introduction: Tunneled cuffed catheters provide stable, instantaneous, long-term intravenous access for hemodialysis. Because catheterization is often performed in emergency situations, speed and accuracy are emphasized. Methods: We retrospectively compared the Micropuncture kit with the standard 18-gauge Angiocath IV catheter for tunneled cuffed catheter insertion in the right jugular vein. From June 2016 to May 2017, 31 tunneled cuffed catheters were successfully inserted via the Micropuncture kit and another 31 via the Angiocath IV catheter. All patients underwent the same ultrasound-guided procedure performed by a single experienced interventionalist. Procedure time was the time from draping of the patient to the completion of povidone dressing after the catheterization. In our center, the Angio Lab nurse maintains records, including procedure time and method for every procedure. All patient records were retrospectively tracked through electronic medical record review. The primary outcome was procedure time and the secondary outcomes were complications and cost-effectiveness. Results: There were no significant differences in the patients’ demographic data between the two groups. However, procedure time was significantly shorter in the Angiocath group than in the Micropuncture group (12.4 ± 3.5 vs 17.6 ± 6.9 min, p = 0.001); there were no serious complications, such as hemorrhage, pneumothorax, or hematoma, in both groups. Moreover, cost-effectiveness was better in the Angiocath group than in the Micropuncture group (0.34 vs 52 US$, p < 0.01). Conclusions: Using the Angiocath IV catheter can reduce procedure time and cost with no severe complications. Moreover, experienced practitioners can reduce the risk of complications when using Angiocath. There are several limitations to this study. First, it was retrospective; second, it was not randomized; and finally, it was conducted by only one experienced interventionalist.
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Lind, Jolline, Mitzy Tannia Reichembach Danski, Luana Lenzi, Edivane Pedrolo, Alessandra Amaral Schwanke, and Derdried Athanasio Johann. "Cateter periférico com sistema fechado de infusão: implementação de tecnologia." Revista de Enfermagem UFPE on line 13, no. 5 (May 30, 2019): 1208. http://dx.doi.org/10.5205/1981-8963-v13i5a239008p1208-1215-2019.
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RESUMO Objetivo: estimar a incidência de complicações locais relacionadas ao uso do cateter intravenoso periférico com sistema fechado de infusão e identificar os fatores de risco associados. Método: trata-se de um estudo quantitativo, de coorte prospectivo, realizado com 90 adultos. Realizou-se a coleta mediante a observação diária do cateter. Utilizaram-se, nas análises estatísticas, os testes Qui-Quadrado, Exato de Fisher, Correção de Williams, Mann-Whitney e Risco Relativo. Apresentaram-se os resultados em forma de tabelas. Resultados: informa-se que a incidência de complicações locais foi de 55,6%, sendo 15 (16,7%) flebites, 12 (13,3%) trações, dez (11,1%) infiltrações, sete (7,8%) extravasamentos, cinco (5,6%) obstruções e uma (1,1%) infecção local. Têm-se como fatores de risco o sexo feminino (p=0,005), o tempo de internação (p=<0,001) e a infusão em bomba (p=0,014). Conclusão: acredita-se que a taxa de complicações locais foi alta e identificaram-se três fatores de risco relacionados ao uso do cateter intravenoso periférico com sistema fechado de infusão. Descritores: Cateterismo Periférico; Tecnologia Biomédica; Fatores de Risco; Enfermagem Baseada em Evidências; Adulto; Infusões Intravenosas. ABSTRACT Objective: to estimate the incidence of local complications related to the use of a peripheral intravenous catheter with a closed infusion system and to identify the associated risk factors. Method: this is a quantitative, prospective cohort study with 90 adults. The collection was performed by daily observation of the catheter. The Chi-Square, Fisher's exact, Williams's Correction, Mann-Whitney and Relative Risk tests were used in the statistical analyzes. Results were presented in the form of tables. Results: the incidence of local complications was 55.6%, with 15 (16.7%) phlebitis, 12 (13.3%) traction, ten (11.1%) infiltrations, seven (7, 8%) extravasations, five (5.6%) obstructions and one (1.1%) local infection. The risk factors were female gender (p = 0.005), hospitalization time (p = 0.001) and pump infusion (p = 0.014). Conclusion: it is believed that the rate of local complications was high and three risk factors related to the use of the peripheral intravenous catheter with closed infusion system were identified. Descriptors: Peripheral Catheterization; Biomedical Technology; Risk factors; Evidence-Based Nursing; Adult; Intravenous Infusions. RESUMEN Objetivo: estimar la incidencia de complicaciones locales relacionadas al uso del catéter intravenoso periférico con sistema cerrado de infusión e identificar los factores de riesgo asociados. Método: se trata de un estudio cuantitativo, de cohorte prospectivo, realizado con 90 adultos. Se realizó la recolección mediante la observación diaria del catéter. Se utilizaron, en los análisis estadísticos, las pruebas Chi-Cuadrado, Exacto de Fisher, Corrección de Williams, Mann-Whitney y Riesgo Relativo. Se presentaron los resultados en forma de tablas. Resultados: se informa que la incidencia de complicaciones locales fue 55,6%, de los cuales 15 (16.7%) flebitis, 12 (13,3%) tracciones, diez (11,1%) la infiltración, siete (7 8%) extravasaciones, cinco (5,6%) obstrucciones y una (1,1%) infección local. Se toman como factores de riesgo el sexo femenino (p = 0,005), el tiempo de internación (p = <0,001) y la infusión en bomba (p = 0,014). Conclusión: se cree que la tasa de complicaciones locales fue alta y se identificaron tres factores de riesgo relacionados al uso del catéter intravenoso periférico con sistema cerrado de infusión. Descritores: Cateterismo Periférico; Tecnología Biomédica; Factores de Riesgo; Enfermería Basada em la Evidencia; Adulto; Infusiones Intravenosas.
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John, Sam Aruputha, Abdullah Rajab, Ahamed Faiz Ali, Rasha Kassem, Hosam Atiya, and Aisha S. Khan. "Iatrogenic asymptomatic subclavian arteriovenous fistula after percutaneous catheterizationcutaneous catheterization." Case Studies in Surgery 3, no. 2 (May 3, 2017): 27. http://dx.doi.org/10.5430/css.v3n2p27.
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A 4-year-old child with chronic enteropathy underwent left percutaneous internal jugular vein Hickman catheter insertion for total parenteral nutrition (TPN) under general anaesthesia. Previously this child had undergone percutaneous Hickman line insertion on the right internal jugular vein in 2013 and the right subclavian vein in 2015. These lines had been removed before due to catheter sepsis. During the present procedure, 6.6 french Hickman line was inserted into the left internal jugular vein by percutaneous peel away technique under ultrasound guidance. Later in the ward it was noticed that Hickman line was not functioning and there was reverse flow of blood into the intravenous (IV) line. Blood gas sample taken from the line showed arterial values and the catheter was subsequently removed. Computed tomography (CT) angiography was done which reported arteriovenous (AV) fistula with pseudoaneurysm of the right subclavian vein. The child was then referred to department of cardiothoracic surgery for further management. From the above case report we can infer that patients who underwent repeated percutaneous central line insertions may develop iatrogenic AV fistula or pseudo aneurysm. These complications can be asymptomatic for years. Failure to recognize this may lead to catastrophe during reinsertion. Hence proper history taking, clinical examination for bruit, thrill over the neck veins and cardiac examination should be done preoperatively if there is past history of multiple insertions. Investigations like venous blood gas sampling, USG doppler for neck veins, echocardiography, and CT angiography should be done in these cases preoperatively.
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Aedinova, Irina V., M. N. Chernyak, Yulia Ulianova, Viktoriya L. Volkova, Natalia A. Chertova, and Mamuka Bauzhadze. "Endovascular treatment for locally advanced head and neck tumors." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e17554-e17554. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e17554.
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e17554 Background: Treatment of locally advanced head and neck tumors is an extremely difficult task. Preoperative polychemotherapy allows improving the efficiency of combined treatment in most cases. We performed 6 chemoembolization procedures for locally advanced head and neck cancer in order to increase the effectiveness of chemotherapy with minimal systemic side effects and to reach cytostatic concentrations in tumors higher than at their intravenous administration. Methods: We performed the standard puncture femoral approach and selective catheterization of the external carotid artery followed by angiography. Superselective catheterization of targeted vessels using 2.6 F microcatheter was performed after evaluation of blood supply to the affected area. Chemoembolization was performed with platinum drugs (cisplatin at a mean dose of 50 mg/m2) in an oil emulsion with Lipiodol (4 patients) and saturable microspheres (2 patients). Results: All patients showed a severe pain syndrome during embolization with its increase by the evening of the day and its regression on the third day after surgery; general toxic symptoms were not observed. Significant perioperative complications were not registered. A marked necrosis of the tongue base tumor was observed in one patient after 10 days. All patients showed a partial positive response to the therapy which allowed radical surgical treatment. Conclusions: Chemoembolization with polymeric microspheres provides a longer (up to one month) contact between malignant cells and antitumor agents; chemoembolization is not accompanied by the development of adverse reactions and complications or immunosuppressive effect which allows its use in the most serious cases.
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Verburg, Frederik A., Martin Wiessmann, Georg Neuloh, Felix M. Mottaghy, and Marc-Alexander Brockmann. "Intraindividual comparison of selective intraarterial versus systemic intravenous 68Ga-DOTATATE PET/CT in patients with inoperable meningioma." Nuklearmedizin 58, no. 01 (February 2019): 23–27. http://dx.doi.org/10.1055/a-0802-5039.
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Abstract Aim Here we describe the results of superselective intraarterial application of diagnostic Ga-68-DOTA0,Tyr3-octreotate (Ga-68-DOTATATE) in a series of patients with inoperable WHO grade II meningiomas which were no longer amenable to radiotherapy. Methods Four patients with inoperable WHO grade II meningioma underwent systemic venous infusion of Ga-68-DOTATATE followed by PET/CT. Ga-68-DOTATATE application was repeated intraarterially via transfemoral catheterization of vessels supplying the meningioma and another PET/CT was performed. Results Selective arterial infusion of Ga-68-DOTATATE increased the median value for the maximum standardized uptake value (SUV) by 2.6-fold (median venous: 7.1, median arterial: 21.6; range 2.0–5.0) and the median value for mean SUV by 2.7-fold (median venous: 4.3, median arterial: 11.2; range 1.6–5.6) compared to systemic intravenous infusion. Arterial application was well tolerated by all patients without complications. When compared to liver uptake, intravenous tracer uptake was insufficient for PRRT, whereas tracer uptake after superselective intraarterial tracer injection was sufficient to allow for peptide receptor radionuclide therapy (PRRT) in all patients. Conclusion Insufficient tracer uptake in meningiomas after intravenous application of Ga-68-DOTATATE may be safely increased by a factor of 2–5 using transfemoral selective intraarterial tracer application.
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Hryzhymalskyi, Ye V. "The main complications of infusion therapy and methods to overcome them." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 57–59. http://dx.doi.org/10.32902/2663-0338-2020-3.2-57-59.
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Background. Infusion therapy (IT) is an integral part of the modern treatment process and the most common method of inpatient treatment. Indications for the IT use include dehydration, changes in blood properties, intoxication, the impossibility or inexpediency of the drug administration in other ways, the impossibility of oral nutrition, and impaired immunity.
Objective. To describe the main complications of IT and their treatment.
Materials and methods. Analysis of literature data on this issue.
Results and discussion. Before conducting IT, you should take into account all the indications and contraindications and carefully read the instructions for use of drugs. It is advisable to use several drugs to reduce the number and severity of side effects. The rate of administration is important: in most cases, the safe rate is 20-30 drops per minute. Accidental needle injuries (ANI) and blood contact are potential IT risks for healthcare professionals. The National Union of Nurses of Private Practice has launched a survey of health workers to reduce the prevalence of these injuries. There are three components to injection safety: safe solution preparation, safe injection, and safe disposal. IT via the needle has a number of disadvantages: complications due to frequent punctures, limited ability to conduct long-term IT, increased risk of ANI. The installation of a permanent venous catheter reduces the likelihood of these defects. After catheter placement, before and after infusion, it should be flushed with 0.9 % NaCl, heparin or Soda-Bufer solution (“Yuria-Pharm”). However, as the number of catheterizations increases, the number of catheter-associated infections increases too, ranking third among nosocomial infections and first among the causes of bacteremia. In general, the frequency of complications of venous catheterization is 15 %. Mechanical complications occur in 5-19 % of patients, infectious – in 5-26 %, thrombotic – in 2-26 %. Complications of IT are classified into the complications due to violation of the rules of administration (hematoma, tissue damage, thrombophlebitis (septic, mechanical and chemical), embolism) or blood composition disorders (acidosis, blood thinning), as well as overdose, and specific complications (anaphylactic shock, pulmonary edema, hyperthermia). Anaphylaxis most often accompanies the introduction of nonsteroidal anti-inflammatory drugs, antibiotics, muscle relaxants, radiocontrast, hypnotics, etc. The first line of treatment of anaphylactic shock involves drug discontinuation, intravenous adrenaline, 100 % oxygen, rapid intravenous infusion of crystalloids, in case of bronchospasm – 2-3 inhalations of salbutamol. Additionally, antihistamines and glucocorticoids may be prescribed.
Conclusions. 1. IT is an integral part of the modern treatment process and the most common method of treatment in the hospital. 2. In IT, it is advisable to use several drugs, which reduces the number and severity of side effects. 3. Potential IT risks for healthcare professionals include ANI and blood contact. 4. Injection safety requires three components: safe solution preparation, safe injection, and safe disposal. 5. Complications of IT are divided into complications due to violations of the rules of installation or violation of blood composition, as well as overdose, and specific complications. 6. Anaphylaxis often accompanies the introduction of nonsteroidal anti-inflammatory drugs, antibiotics, muscle relaxants, radiocontrast, hypnotics, etc.
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Finck, Christine, Sam Smith, Richard Jackson, and Charles Wagner. "Percutaneous Subclavian Central Venous Catheterization in Children Younger than One Year of Age." American Surgeon 68, no. 4 (April 2002): 401–4. http://dx.doi.org/10.1177/000313480206800420.
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Children younger than one year of age frequently require central venous lines (CVLs) for total parenteral nutrition, intravenous antibiotics, and chemotherapy. In many instances surgical cut-down has been favored over percutaneous access. The purpose of this study was to demonstrate the safety and success of percutaneous central venous access in children less than one year of age. Percutaneous access of the subclavian vein was obtained by Seldinger technique. Using the medical procedure code index we reviewed the charts of those patients less than one year of age from January 1, 1999 through December 31, 1999 requiring central venous access. Age, diagnosis, number of CVLs required, site placed, success rate, and weight were recorded. In 1999 a total of 84 patients younger than one year of age received a total of 110 CVLs. In patients less than 6 months of age the success rate for percutaneous access of the subclavian vein was 78.8 per cent and for those children over 6 months the success rate was 96 per cent. The average weight for those less than 6 months was 3.1 kg and for those older than 6 months was 7.63 kg. There were no complications from the procedure. Percutaneous CVL placement in children younger than one year of age is safe and effective. This paper details our technique and reviews infant venous anatomy in the subclavian area.
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Sarı, Dilek, İsmet Eşer, and Ayşe Akbıyık. "Phlebitis associated with peripheral intravenous catheters and nursing carePeriferik intravenöz kateterle ilişkili flebit ve hemşirelik bakımı." Journal of Human Sciences 13, no. 2 (July 14, 2016): 2905. http://dx.doi.org/10.14687/jhs.v13i2.3674.
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Phlebitis, defined as inflammation of the tunica intima, is most important of complications associated with peripheral intravenous catheters and, occurs between 0.1% and 63.3% of patients with peripheral intravenous catheter. Phlebitis can be originated mechanical, chemical and, bacterial. Whatever the reason, phlebitis extends the duration of hospitalization, raise the cost of treatment, causes bacteremia. There are reported to be effective some factors such as type of catheter material, catheter size, dwell time of catheterisation, anatomical region used for catheterisation, health personnel’s ability to place the catheter, liquid flow rate, using infusion pumps, number of intravenous medication, on the development of mechanical phlebitis. Chemical phlebitis, developes due to characteristics such as pH and osmolarity of the drug and fluid infused which caused irritation of the endothelial layer through the cannula. Bacterial phlebitis, which is occured a bacterial infection of vein intima, can be a source of serious systemic infections including bacteremia. As a result, phlebitis is a complication of intravenous application, can be avoided as long as working in accordance with certain principles. The risk development of phlebitis can be minimized, in case of compliance with the standards during peripheral intravenous catheter insertion and throughout of catheterization. In this article was focused on phlebitis definition, epidemiology, risk factors and prevention of the development phlebitis for risk factors and patient care with phlebitis. ÖzetVenin tunika intima tabakasının enflamasyonu olarak tanımlanan flebit, periferik intravenöz kateterlerle ilişkili komplikasyonların en önemlisi olup, periferik intravenöz kateter takılan hastaların %0.1-%63.3’ünde görülmektedir. Flebit mekanik, kimyasal ve bakteriyel kaynaklı olabilir. Flebit nedeni ne olursa olsun hastaların yatış süresini uzatmakta, tedavi maliyetini yükseltmekte ve bakteriyemiye neden olmaktadır. Kateter materyalinin tipi, kateteterin boyutu, kateterin vende kalış süresi, kullanılan anatomik bölge, kateteri yerleştiren kişinin becerisi, sıvı akış hızı, infüzyon pompalarının kullanımı, verilen ilaçların sayısı gibi faktörlerin mekanik flebit oluşumunda etkili olduğu bildirilmektedir. Kimyasal flebit, kanül boyunca infüze edilen ilaç ve sıvıların pH’sı ve osmolaritesi gibi özelliklerinden dolayı venin endoteyal katmanını tahriş etmesi sonucunda gelişir. Ven intimasının bakteriyel enfeksiyonu sonucu gelişen bakteriyel flebit bakteriyemi gibi ciddi sistemik enfeksiyonların kaynağı olabilmektedir. Sonuç olarak, flebit belirli ilkelere uygun çalışıldığında intravenöz uygulamaların önlenebilir bir komplikasyonudur. Periferik intravenöz kateter takma ve izlem sırasında belirlenen standartlara uyulma hassasiyeti gösterildiği taktirde flebit gelişimi minimize edilebilir. Bu makalede, flebitin tanımı, epidemiyolojisi, risk faktörleri ve risk faktörlerine yönelik flebit gelişimini önleme önerileri ve flebit gelişen hastanın bakımı üzerinde odaklanılmıştır.
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Leishangthem, Lakshmi, and Sudhakar R. Satti. "Vessel perforation during withdrawal of Trevo ProVue stent retriever during mechanical thrombectomy for acute ischemic stroke." Journal of Neurosurgery 121, no. 4 (October 2014): 995–98. http://dx.doi.org/10.3171/2014.4.jns132187.
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The authors report a case of an intracranial extravasation during the withdrawal of a Trevo ProVue stent retriever device in a patient being treated for acute ischemic stroke. An 82-year-old woman developed sudden left hemiparesis and aphasia during an urgent cardiac catheterization procedure for a non–ST elevation myocardial infarction. She had a baseline National Institutes of Health Stroke Scale (NIHSS) score of at least 10 and no improvement with intravenous administration of tissue plasminogen activator (tPA). Cerebral angiography was performed with conscious sedation, confirming an occlusion of the superior division of the right middle cerebral artery (MCA). Using standard technique, a Trevo thrombectomy device was deployed across the clot. Post-thrombectomy control angiography demonstrated complete revascularization of the right MCA. The device was then gently withdrawn without difficulty. Immediately afterward the patient's blood pressure showed a sudden and significant elevation. Immediate posttreatment angiography demonstrated active extravasation from the posterior wall of the communicating segment of the right internal carotid artery. Rapid cessation of bleeding was achieved with intravenous administration of protamine and induced hypotension. Immediate neurological assessment was performed, which showed motor improvement. An immediate postintervention CT scan confirmed a moderate-sized subarachnoid hemorrhage and contrast in the prepontine cistern. The patient was discharged home on postoperative Day 3 with an NIHSS score of zero. At 6-month follow-up in the neurointerventional clinic, her NIHSS and modified Rankin Scale scores were both zero. Endovascular stent retriever devices are increasingly being used as first-line thrombectomy devices in acute embolic strokes. A unique and previously undescribed complication is vessel perforation during withdrawal of a stent retriever. Conservative treatment options and reversal of anticoagulation should be the first line of treatment for such complications. In the authors' case, performing the procedure without anesthesia was helpful in assessing the patient's neurological status.
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Davydov, V. V., and E. M. Tretyakova. "INTRAOSSEUS ACCESS BY AMBULANCE." EMERGENCY MEDICAL CARE 22, no. 1 (April 6, 2021): 13–19. http://dx.doi.org/10.24884/2072-6716-2021-22-1-13-19.
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Background. Emergency physicians often have difficulty providing vascular access to patients in critical condition. In these conditions, intraosseous access has an advantage over traditional peripheral vein catheterization. Currently, intraosseous access is not widely used at the stage of emergency medical care.Aim. Analysis and generalization of current information on the use of the method of intraosseous access to emergency medicine.Materials and methods. We have found publications in Russian and international search engines (PubMed, eLIBRARY, etc.) over the past 20 years. Publications reflected current issues of intraosseous access application. 74 articles were found and 30 were selected for review.Results. Intraosseous access showed good results in patients with weakly expressed venous network at the stage of emergency medical care. The method has a simple technique of manipulation, does not have a large number of complications and contraindications. Doctors who have received training often use intraosseous access, taking into account the indications for use.Conclusion. Intraosseous access has an advantage over peripheral intravenous access in patients in critical condition at the stages of emergency care.
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Khadija, Ghulam, Waqas Hasan Syed, Sana Ullah, Munazzah Aziz, Sumaira Nawaz, Abeera Zareen, Mehwish Changeez, Sara Malik, Maham Tariq, and Jahangir Sarwar Khan. "Intravenous analgesia versus thoracic epidural catheterization in moderately severe pancreatitis: A randomized controlled trial in a tertiary care health facility." Professional Medical Journal 28, no. 10 (September 30, 2021): 1401–6. http://dx.doi.org/10.29309/tpmj/2021.28.10.6303.
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Objective: In this study we evaluated the two most commonly used methods for pain relief in acute pancreatitis i.e. epidural analgesia and I/V analgesia and compared the results. Study Design: Randomized Controlled Clinical Trial. Setting: Surgical Unit-1 of Holy Family Hospital, Rawalpindi. Period: June 2019 to June 2020. Material & Methods: Patients presenting with acute pancreatitis with moderate severity were divided into groups A and B. In group A patients, epidural catheter was passed at T9-T10 level epidural space and they received 0.125% Bupivacaine injection every 4 hours, while group B patients received combination analgesia in the form of IV tramadol 100mg TDS and IV Toradol 30mg BD. Pain was assessed by using visual analog scale (VAS) at 12 hour intervals. Rescue analgesia, in the form of IV paracetamol 1g given in the case of >7 VAS score was also recorded. Results: Total 100 patients were included according to the inclusion criteria of the study. Patients were randomly divided into two groups; Group A (Epidural) and group B (intravenous). Mean age (years) in the study was 42.39+11.21 whereas there were 37 male and 63 female patients who were included in the study. In our study, mean pain score in group A was 3.16+1.23 which was significantly lower than group B (5.42+1.01), p-value < 0.0001. There was a single mortality in the study. 6 patient’s required ventilatory support due to respiratory complications, 5 in group B and 1 in group A. Conclusion: Epidural analgesia is superior to I/V analgesics in pain management of moderately severe pancreatitis and it also reduces respiratory morbidity in these patients.
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Desai, Rohan, Cynthia T. Welsh, and Samuel O. Schumann. "Elsberg Syndrome, Lumbosacral Radiculopathy, and Myelitis Due to Herpes Zoster in a Patient With Smoldering Myeloma." Journal of Investigative Medicine High Impact Case Reports 10 (January 2022): 232470962110633. http://dx.doi.org/10.1177/23247096211063348.
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Herpes zoster (HZ) is a common illness caused by the reactivation of latent varicella zoster virus (VZV) due to waning immunity, often secondary to old age or an underlying immunocompromised state. Its complications can manifest in variety of ways, including persistent neuralgias, vasculopathies, and stroke. Here, we describe a case of a 45-year-old man with a history of cryptogenic stroke and smoldering myeloma who was admitted with sacral HZ complicated by right lumbosacral radiculopathy and myelitis, otherwise known as Elsberg syndrome (ES). He was found to have an enhancing lesion in the peripheral conus medullaris on magnetic resonance imaging (MRI) with nonspecific inflammation and necrosis on biopsy pathology and cerebrospinal fluid (CSF) polymerase chain reaction (PCR) positive for VZV. The patient was initially treated with intravenous acyclovir and dexamethasone and discharged with a steroid taper and indefinite valacyclovir therapy. Twelve months postdischarge, the patient’s right lumbosacral radiculopathy and myelitis had almost completely resolved; however, he continued to require bladder self-catheterization. We believe that the patient’s underlying smoldering myeloma lead to an immunocompromised state, allowing for reactivation of latent VZV, resulting in both the patient’s cryptogenic stroke years earlier and recent ES.
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Polkovnikov, O. Yu, A. M. Materukhin, and N. V. Izbytska. "Specifics of endovascular embolization for cerebral aneurysmsin the acute period of subarachnoid hemorrhage." Zaporozhye Medical Journal 23, no. 6 (October 29, 2021): 813–19. http://dx.doi.org/10.14739/2310-1210.2021.6.235069.
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Aim – to assess the benefits of modern methods for endovascular occlusion of ruptured cerebral aneurysms in the acute period of subarachnoid hemorrhage (SAН). Materials and methods. Medical records of patients undergoing treatment in the acute period of aneurysmal SAН between 2010–2021 were analyzed. 2 groups were formed: I – the use of standard surgical catheters, minimal use of adjunctive techniques for aneurysm embolization (2010–2016), II – routine use of triaxial access systems, intraarterial infusion of nimodipine, active use of adjunctive techniques for aneurysm embolization, intraoperative antiplatelet therapy immediately after aneurysm occlusion – 500 mg of solution Acelysin administrated intravenously (2017–2021). The severity of SAН according to the Hunt–Hess, Fisher scales, the treatment outcome according to the modified Rankin Scale (mSR), the location and size of aneurysms and intraoperative complications were analyzed. Results. There were 156 observations in group I, 91 – in group II. The median age was 48.26 years in group I, 51.44 years – in group II. On the basis of gender status, there was a majority of women in both groups. Aneurysms of the anterior cerebral-anterior communicating artery complex predominated in both groups; the internal carotid artery was the second most frequent localization. The severity of SAН according to the generally accepted scales (Hunt–Hess, Fisher) did not differ significantly. Coil embolization was used in 100 % of cases, balloon-assisted coiling was used in 6.48 % in group I and in 14.80 % – in group II, stent-assisted coiling – in 2.56 % and 9.30 %, respectively, distal access catheter with the triaxial system was not used in group I and it was performed in 57.4 % of cases in group II. Pharmacoangioplasty using nimodipine solution was used in 16.6 % in group I and in 22.2 % in group II. Intravenous drip infusion of 0.5 g Acelysin was performed immediately after aneurysm occlusion in 22.2 % of cases in group II. Intraoperative aneurysm rupture was observed in 5.1 % in group I and in 1.1 % in group II. Distal coil migration or into the maternal artery occurred in 6.41 % in group I and in 2.20 % in group II. Thromboembolic complications were noted in 7.69 % and in 2.20 %, respectively. The mean value of dysfunction degree on mSR amounted to 2.27 in group I and 1.45 – in group II. A good treatment outcome (mRS score 1–2) was defined in 71.2 % of observations in group I and in 87.9 % – in group II. The death rate was 12.82 % and 7.62 %, respectively. Conclusions. Routine use of triaxial access systems and intraarterial pharmacoplasty with nimodipine allow adequate prevention of mechanically induced vasospasm during catheterization of the aneurysm cavity. The triaxial access system stability provides better control of the microguidewire and microcatheters reducing the risk of aneurysmal wall perforation during catheterization. The use of adjunctive techniques for embolization of ruptured cerebral aneurysms in the acute period of SAH and prophylactic infusion of Acelysin solution after aneurysm occlusion significantly reduces the incidence of thromboembolic complications. The earliest possible occlusion of a ruptured cerebral aneurysm is not only the prevention of re-rupture, but also expands the possibilities of intensive care for preventing secondary complications of SAH.
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HAMPEL, DIERK J., CHRISTINE SANSOME, MA SHA, SERGEY BRODSKY, WILLIAM E. LAWSON, and MICHAEL S. GOLIGORSKY. "Toward Proteomics in Uroscopy: Urinary Protein Profiles after Radiocontrast Medium Administration." Journal of the American Society of Nephrology 12, no. 5 (May 2001): 1026–35. http://dx.doi.org/10.1681/asn.v1251026.
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Abstract. Previous attempts to use urinary protein profiles for diagnostic purposes have been rather disappointing with respect to their clinical validity, in part because of the insufficient reproducibility, sensitivity, and rapidity of available techniques. Therefore, a newly developed, high-throughput technique, namely surface-enhanced laser desorption/ionization (SELDI) ProteinChip array-time of flight mass spectrometry, was studied, to assess its applicability for protein profiling of urine and to exemplify its use for a group of patients receiving radiocontrast medium. Assessment of the accuracy, sensitivity, and reproducibility of SELDI in test urinary protein profiling was performed. Renal function was studied in 20 male Sprague-Dawley rats before and after intravenous administration of either 1.25 g/kg ioxilan (n = 10) or hypertonic saline solution (n = 10) as a control. Urine samples from 25 patients undergoing cardiac catheterization were obtained before, immediately after, and 6 to 12 h after the procedure. Administration of ioxilan to rats resulted in changes in the abundance of proteins of 9.9, 18.7, 21.0, and 66.3 kD. For patients, even in uncomplicated cases of radiocontrast medium infusion during cardiac catheterization, perturbations in the protein composition occurred but returned to baseline values after 6 to 12 h. Proteins with molecular masses of 9.75, 11.75, 23.5, and 66.4 kD changed in abundance. For patients with impaired renal function, these changes were not reversible within 6 to 12 h. As a proof of principle, one of the peaks, i.e., that at 11.75 kD, was identified as β2-microglobulin. SELDI is a promising tool for the detection, identification, and characterization of trace amounts of proteins in urine. Even for patients without renal complications, proteins with a broad range of molecular masses either appear in or disappear from the urine. Some of these might represent markers of impending nephropathy.
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Han, Xiaoling, Jiayi Li, Ping Zeng, Chunfeng Luo, and Dongmei Zhou. "Effect of the Kanghuier Transparent Hydrocolloid Dressing in Preventing Central Venous Catheter Infection and Phlebitis after Cardiac Surgery." Computational and Mathematical Methods in Medicine 2022 (April 1, 2022): 1–11. http://dx.doi.org/10.1155/2022/4700257.
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Background. As cardiac surgery is complicated, time-consuming, and traumatic, it may cause great damage to the patient’s body. Therefore, postoperative indwelling venous catheters are required for hemodynamic monitoring and rapid fluid replenishment. Intravenous catheterization infection can easily lead to phlebitis, which not only affects the success of the operation and patient recovery but may also lead to death in severe cases. Good perioperative care is key to reducing postoperative infection in patients, and the choice of dressings for patients with catheterization plays an important role in reducing catheter infection. Objective. The Kanghuier transparent hydrocolloid dressing is known to effectively prevent and treat wound infections. This study is aimed at exploring whether it can reduce the incidence of postoperative catheter infection and phlebitis in patients undergoing cardiac surgery. Methods. A total of 196 patients undergoing cardiac surgery in the Department of Cardiothoracic Surgery of Zhuhai People’s Hospital (Zhuhai Hospital Affiliated with Jinan University) from January 2020 to June 2020 were selected. Among them, 98 patients receiving Kanghuier transparent dressing intervention were selected as group A, and the remaining 98 patients receiving traditional sterile gauze intervention were selected as group B. The incidence of infection and related complications, phlebitis, inflammatory factors, pain at the infusion site, nursing comfort and satisfaction, and quality of life were analyzed and compared between the two groups. Results. It was found that compared with group B, the postoperative central venous catheter infection rate and the incidence of phlebitis were significantly lower in group A. In addition, the inflammatory response of patients in group A was better relieved. Moreover, the nursing comfort and satisfaction and the quality of life of patients in group A were significantly improved. Conclusion. This study suggests that the Kanghuier transparent hydrocolloid dressing is effective in the prevention and treatment of central venous catheter infection and phlebitis in patients after heart surgery.
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Lee, Max C., and R. Loch Macdonald. "Intraoperative Cerebral Angiography: Superficial Temporal Artery Method and Results." Neurosurgery 53, no. 5 (November 1, 2003): 1067–75. http://dx.doi.org/10.1227/01.neu.0000088739.89056.04.
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Abstract OBJECTIVE To report the method for and results of intraoperative cerebral angiography performed via the superficial temporal artery, for assessment of cerebral aneurysm surgery. METHODS All patients undergoing craniotomies for treatment of intracranial aneurysms were prospectively entered into a database. A policy of performing angiography via the superficial temporal artery in appropriate cases was instituted. This procedure was performed with retrograde catheterization of the superficial temporal artery, as it coursed over the zygomatic arch, with an 18-gauge, 1.88-inch, intravenous catheter and hand injection of contrast material, with intraoperative digital subtraction fluoroscopic guidance. RESULTS Thirty-six patients who underwent 38 craniotomies for clipping of 43 aneurysms underwent intraoperative angiography via the superficial temporal artery. There were six unexpected findings (14%), including four unexpected arterial occlusions and two unexpected residual aneurysms. One aneurysm was observed to be patent when it was punctured, after intraoperative angiography had indicated no filling of the aneurysm. Additional clips were placed. Three patients (8%) developed multiple arterial infarctions in the territory of the injected carotid artery, for which multiple causes were possible. Adequate angiographic images could usually be obtained with this method. CONCLUSION Intraoperative angiography via the superficial temporal artery is simple and is not associated with substantial complications. It is a reasonable alternative to transfemoral angiography for detection of adverse consequences of intracranial aneurysm clipping.
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Sedakov, Igor, Vladlena Dubinina, Oleksandr Bondar, Oleg Lukianchuk, and Oleksandr Zavoloka. "COMPARATIVE CHARACTERISTICS OF THE METHODS OF CHEMODRUGS ADMINISTRATION IN THE TREATMENT OF PATIENTS WITH LOCALLY-ADVANCED BREAST CANCER." EUREKA: Health Sciences 1 (January 29, 2016): 31–39. http://dx.doi.org/10.21303/2504-5679.2016.00038.
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The development of new methods of treating patients with breast cancer (BC) causes no doubts at anyone at present moment. The statistical data testify to steady growth of BC sickness rate during recent 20 years without tendency to stabilization The special attention is paid to the development of new methods of treating BC patients (regional forms of disease) with unfavorable factors for forecast of tumor growth. The presented methods of treatment of patients with locally-advanced breast cancer consist in giving complex treatment using two simultaneous ways of administration of chemodrugs - selective intra-arterial and endolymphatic in combination with a systemic one. The results obtained demonstrated greater efficacy of treatment with combinations of selective intra-arterial chemotherapy with a systemic one compared with endolymphatic chemotherapy in combination with the systemic one for the treatment of this disease. Materials and methods. The present study was based on the data of 285 patients with locally-advanced forms of breast cancer HER/2-neu positive and basal-like biological subtypes, with the stages T4N0-2M0, the treatment was given in Donetsk regional antitumor center and Odessa University Clinic in 2000-2014. During the research for an adequate analysis of the results of treatment by the technique under consideration there were formed two groups of patients. The first investigated group included 221 patients, in 168 patients were diagnosed HER/2-neu positive tumors in immunohistochemical conclusion and 53 patients had basal-like biological subtype of the tumor. The program of the comprehensive treatment of patients in this group included the internal thoracic artery catheterization through the upper epigastric artery, two or three cycles of SIAPCT in combination with intravenous one with an interval of 21 days, evaluation of the effect of radiation therapy (RT) on the breast and zone of the regional lymph outflow in the static mode SFD- 2-2.5 Gy, CFD- 40 Gy, the interval, estimation of the effect. Mastectomy in the patients of the investigated group was performed only when there was a complete or partial tumor response (136 surgeries in a radical scope). Courses of intraarterial PCT were given in continuous long-term infusion (4 hours) by the scheme CMF, CAF or CAMF. Taking into account the possibility of local complications against the background of administration of some chemotherapeutic agents (most often - doxorubicin), half of the drug dose was administered intravenously. The total course doses of chemodrugs were calculated according to BSA criteria. The control group included 64 patients, 45 were identified to have HER/2-neu positive and 19 basal-like subtypes of breast cancer. The program of comprehensive treatment of the patients of this group includes endolymphatic chemotherapy according to the method developed by Donetsk regional antitumor center. As the main method of administration of chemodrugs in the lymphatic system there was used infusion introduction with the help of the system for intravenous drip, infusion rate was 0.3-0.5 ml/min that allowed us to exclude the possibility of extravasation of the chemodrug solution. The course dose of the drug was administered endolymphatically within 5-7 days. At the interval of 21 days two or three courses of ELPHT were given combined with the intravenous administration of anthracyclines (at the end of each cycle the catheter was removed, the catheterization was performed repeatedly). Then the effectiveness of the treatment by the criteria of RECIST was evaluated. Radiation therapy (RT) to the breast and area of the regional lymph outflow was given in a static mode SFD- 2-2.5 Gy, CFD- 40 Gy followed by evaluation of the effect. Mastectomy in the patients of the control group was performed only at the complete or partial tumor response (36 operations in a radical scope). Courses of endolymphatic PCT were given by the continuous long-term infusion (up to 8 hours) scheme of CMF, CAF or CAMF. Taking into account the possibility of local complications against the background of introduction of some chemotherapeutic agents, intercalator doxorubicin was administered intravenously, and antimetabolites and alkylating agents (methotrexate, 5-fluorouracil and cyclophosphamide) in all schemes were introduced endolymphatically. Results. The average life expectancy of patients of the investigated group was 3.43 ± 0.18 years, while in the control group it was 2.82 ± 0.3 that significantly exceeded the statistical data of domestic and foreign authors. Indices of total 3-year survival rate of patients of the investigated group were 59.9 ±4.5% and 5-year- - 43.1 ±5.5 months. In the control group indices of cumulative 3- and 5-year survival rates were significantly lower - 37.8% ± 6.6 and 25.2 ± 7.0%months respectively. Conclusions. 1. The results of complex treatment of locally-advanced breast cancer with unfavorable prognostic factors of tumor growth by the developed technique by using a combination of selective intra-arterial injection and intravenous chemotherapy in a pool of the internal thoracic artery in combination with radiation and hormonal therapy exceed the results of standard treatment programs for the patients with locally-advanced breast cancer with performing mastectomy and systemic chemotherapy. 2. The method developed by the authors can be recommended for widespread use in these patients.
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Park, So Hye, Gina Lim, Ki Won Oh, and Jae Kon Ko. "Neonatal Atrial Flutter: Clinical Characteristics of 14 Cases in a Single Center." Neonatal Medicine 29, no. 3 (August 31, 2022): 97–104. http://dx.doi.org/10.5385/nm.2022.29.3.97.
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Purpose: Atrial flutter is an uncommon arrhythmia in the neonatal period. This study aimed to describe the cause and clinical course of atrial flutter in neonates.Methods: The medical records of 14 patients diagnosed with atrial flutter at Ulsan University Hospital Neonatal Intensive Care Unit (NICU) between March 2008 and August 2020 were reviewed retrospectively.Results: All 14 cases occurred on the first day of birth. Of these, two were term infants, and 12 were preterm infants. Causes of atrial flutter included three cases of the umbilical venous catheter misplacement, one with a diabetic mother, and one ivolving atrial flutter after an intravenous aminophylline injection. Thirteen patients had structurally normal hearts with no congenital heart diseases. The patient, born to a diabetic mother, had an atrial septal defect and ventricular hypertrophy. Adenosine was administered first to differentiate it from paroxysmal supraventricular tachycardia. Synchronized cardioversion was attempted in 11 patients, while one received it after an esmolol injection that failed to convert to sinus rhythm. One patient had a recurrence after the intrusion of a peripherally inserted central catheter; however, atrial flutter disappeared after repositioning it. No patient had a recurrence after discharge.Conclusion: Neonatal atrial flutter is a rare tachyarrhythmia with the risk factors often unknown; however, it could occur in structural heart disease, mispositioning of the umbilical venous catheter, and if the mother has diabetes. During umbilical venous catheterization, clinicians should be cautious and ensure appropriate monitoring of infants in the NICU as it may cause complications.
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Karpov, A. A., N. A. Anikin, D. E. Cherepanov, A. M. Mikhailova, M. V. Krasnova, S. S. Smirnov, N. S. Bunenkov, et al. "Model of chronic thromboembolic pulmonary hypertension in rats, caused by repeated intravenous administration of biodegradable microspheres from sodium alginate." Regional blood circulation and microcirculation 18, no. 1 (May 3, 2019): 86–95. http://dx.doi.org/10.24884/1682-6655-2019-18-1-86-95.
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Introduction. Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the most severe complications of pulmonary embolism (PE), characterized by poor prognosis and insuffcient effectiveness of standard treatment approaches. A small number of representative models of CTEPH make it diffcult to conduct preclinical studies of promising pharmacological substances.Objective – development and validation of the experimental model of CTEPH in rats by embolization of the distal branches of the pulmonary artery with biodegradable microspheres.Material and methods. Male Wistar rats were used for the experiments. Biodegradable microspheres (MS) based on sodium alginate and autologous blood clots (AT) were used as embolizing particles. The animals were divided into groups: control: saline solution was injected 4 times with an interval of 8 days into the tail vein; AT: according to the above protocol, 50 μL of AT was injected; MS was administered intravenously in a volume of 50 μl of MS according to two protocols: MS4: 4 times with an interval of 8 days; MS8: 8 times with an interval of 4 days. After 2 and 6 weeks after the last injection, a histological examination of the lungs was performed; after 6 weeks: echocardiographic study (TTE), right ventricular catheterization (RV) with measurement of right ventricular systolic pressure (RVSP), treadmill test, assessment of serum endothelin1 levels by the immunoassay method.Results. During the experiments, the survival rate in the MS8 group was 50 %. In the other groups, there were no animal losses. According to the treadmill test 6 weeks after the modeling of PE, exercise tolerance was signifcantly reduced in the MC4 and MC8 groups compared with the control group. TTE data indicate a signifcant increase in the diameter of the pulmonary trunk and the right ventricular outflow tract in the MC8 compared with the control and AT. There were signifcant increase in RVSP and the level of endothelin1 compared with the control only in the MS8. After 6 weeks, the index of hypertrophy of vessel wall of the pulmonary artery in the MC4 and MC8 was signifcantly higher compared with the control and AT groups.Conclusion. Based on the use of MS, administered under the MS 8 protocol, a new representative model of CTEPH has been created, which can be used to test promising pharmacological substances.
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Young, Guy, and Lynn K. Boshkov. "Prospective Study of Direct Thrombin Inhibition with Argatroban in Pediatric Patients Requiring Nonheparin Anticoagulation." Blood 110, no. 11 (November 16, 2007): 1868. http://dx.doi.org/10.1182/blood.v110.11.1868.1868.
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Abstract This multicenter, open-label study evaluated the safe, effective dose of intravenous argatroban for prophylaxis or treatment of thrombosis in patients ≤16 years of age requiring nonheparin anticoagulation. The protocol-specified argatroban dose for systemic anticoagulation was 1.0 μg/kg/min (0.25 μg/kg/min for patients with impaired hepatic function; 0.5 μg/kg/min for patients <6 months old, reduced to 0.125 μg/kg/min with impaired hepatic function), adjusted to achieve activated partial thromboplastin times (aPTTs) 1.5–3 times the baseline value, or for procedures requiring immediate anticoagulation, an initial bolus then an infusion with doses varying by procedure (eg, 250 μg/kg bolus, then 15 μg/kg/min for cardiac catheterization, adjusted to achieve an activated clotting time of 200–300 seconds, with doses reduced if impaired hepatic function). Primary efficacy endpoints were the occurrence/recurrence of thrombosis and of thromboembolic complications including death and amputations resulting from the complication. Primary safety endpoints were major bleeding and death secondary to bleeding complications. The study population comprised 18 patients (age range: 1.6 weeks to 16.1 years; 12 males) with confirmed (8), suspected (5), or risk of (2) heparin-induced thrombocytopenia (HIT), or conditions such as heparin resistance or antithrombin deficiency (5); 2 patients met 2 inclusion diagnoses, and most had serious comorbidities. Overall, 17 patients received continuous argatroban, 6 underwent procedures, 5 received a bolus [median (range), 250 (11.2–250) μg/kg], and 14 completed the study. The median (range) treatment duration was 2.9 (<0.1–13.8) days. The median (range) infusion dose was 1.5 (0.38–13) μg/kg/min in 13 patients with normal hepatic function and 0.8 (0.4–0.9) μg/kg/min in 4 patients with serum total bilirubin >2.0 mg/dL secondary to hepatic impairment or cardiac complications. Of 11 patients administered 1.0 μg/kg/min initially, target aPTTs were achieved without dose adjustment in 4 patients by 2 h and with no or little dose adjustment in 8 patients by 9 h and all patients by 26 h. Within the 30-day follow up, 5 patients had 6 thrombotic events (2 patients had an event during therapy). No patient required amputation or died due to thrombosis during therapy. In each patient with confirmed HIT, the platelet count recovered during treatment. Two critically ill patients had major bleeding (each event was fatal): 1 patient died 2 days after argatroban cessation due to cerebral infarction and intracranial hemorrhage, and 1 patient on extracorporeal membrane oxygenation for heart failure had fatal subarachnoid bleeding on study day 25. The most frequent treatment-emergent adverse events were hypokalemia, constipation and hypotension (n=5, each). In this first prospective study of direct thrombin inhibition in both infants and children requiring nonheparin anticoagulation, argatroban was well tolerated and rapidly provided adequate levels of anticoagulation for noninterventional or interventional needs in seriously ill pediatric patients.
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Hu, Qiu, YanHong Su, and Li Yan. "Effects of Peripherally Inserted Central Catheter (PICC) Catheterization Nursing on Bloodstream Infection in Peripheral Central Venous Catheters in Lung Cancer: A Single-Center, Retrospective Study." Computational and Mathematical Methods in Medicine 2022 (September 15, 2022): 1–7. http://dx.doi.org/10.1155/2022/2791464.
Full textAbstract:
Background. Peripherally inserted central catheter (PICC), as one of the important intravenous routes for the rescue and treatment of critically ill patients, has been widely used in the fluid resuscitation of critically ill patients in intensive care. In particular, PICC can be widely used in the treatment of cancer patients. With the wide application of peripheral central venous catheterization, the clinical findings of bloodstream infection complications caused by PICC have gradually attracted the attention of doctors and patients. Aims. To investigate the effect of specialized placement and PICC placement care on patients with lung cancer who underwent PICC puncture. Patients were selected and divided into a comparison group and an observation group of 40 patients each according to the randomized residual grouping method. In the comparison group, routine PICC placement and catheter maintenance were performed, while the observation group was provided with specialized placement and PICC placement care. The differences in immune and tumor marker levels and nursing compliance between the two groups were observed and compared before and after nursing care. Results. There was no significant difference in the comparison of tumor marker levels between the two groups of patients before care, while the levels of CYFRA21-1, CA125, and VGEF in the observation group were significantly lower than those in the comparison group after care, and this difference was statistically significant ( P < 0.05 ). There was no statistically significant difference in the comparison of immune levels between the two groups before care ( P > 0.05 ), while the comparison of CD4+, CD3+, and CD4+/CD8+ after care was significantly different and higher in the observation group than in the comparison group, and the comparison was statistically significant ( P < 0.05 ). The compliance rate of 93.8% in the observation group was significantly higher than that of 77.9% in the comparison group, and this difference was statistically significant for comparison ( P < 0.05 ). Conclusion. PICC placement care is more effective in patients with lung cancer and performing PICC puncture, significantly improves patients’ immune and tumor marker levels, improves patients’ negative emotions, reduces disease uncertainty, and improves nursing compliance.
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Hryzhymalskyi, Ye V. "Features of short-term and long-term infusion therapy: review of the vascular access technologies from the point of view of the nurse. Catheterization of peripheral veins." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 60–62. http://dx.doi.org/10.32902/2663-0338-2020-3.2-60-62.
Full textAbstract:
Background. Infusion therapy (IT) has a number of features that both doctors and nurses need to know. IT can be performed via a needle, a peripheral intravenous catheter (PIC), and an implanted system for long-term infusions (ISLI).
Objective. To describe the features of short-term and long-term IT.
Materials and methods. Analysis of literature sources on this topic.
Results and discussion. First of all, every healthcare worker should remember that the patient should be identified before any manipulation and then the procedure may start. IT via the needle has a number of disadvantages: complications due to the frequent punctures and prolonged stay of needle in the vein; limited possibility of long-term IT; increased risk of needle injuries among medical staff. The advantages of PIC above needle include the lower risk of infection, better safety, the possibility of rapid administration of drugs in various combinations, easy use of IT and parenteral nutrition, and the ability to monitor central venous pressure. PIC are classified by the presence of an additional injection port, by the material from which they are made, by the shape of the needle tip sharpening, by the visibility on X-ray and size. Venoport Plus (“Yuria-Pharm”) is an elastic teflon catheter with a low coefficient of surface friction, X-ray contrast strips and the possibility of a long stay in a vein (up to 72 hours). The advantages of the Venoport Plus PIC are the adaptive shape of the cap, the optimal inclination angle and SMART SLOT – a hole near the tip of the needle, which allows you to visualize the blood between the catheter and the needle without waiting for it to appear in the indicator chamber. The most suitable for the PIC placement veins are located on the outside of the hand and on the inner surface of the forearm. It is recommended to use the ulnar vein only for laboratory blood sampling and emergency medical care. When choosing PIC one should take into account the vein diameter, necessary speed of infusion, potential time of stay of a catheter in a vein, and features of the infused solution. After installing PIC, it is advisable to use special transparent aseptic bandages. Bandage replacement is performed as needed; daily replacement is not required. After PIC installation and after infusion, PIC should be washed with 0.9 % NaCl, heparin (1:100 dilution), or Soda-Bufer solution (“Yuria-Pharm”). If the catheter is not used, washing should be performed once a day. ISLI Yu-Port (“Yuria-Pharm”) provides long-term venous access and can be used if the patient needs multiple administrations of drugs during a long course of therapy.
Conclusions. 1. IT can be conducted via a needle, PIC, or ISLI. 2. The advantages of PIC over the needle injection are lower risk of infection, better safety, the possibility of rapid administration of drugs in various combinations, facilitated use of IT and parenteral nutrition, and the ability to monitor central venous pressure. 3. PIC Venoport Plus (“Yuria-Pharm”) is an elastic teflon catheter with an adaptive shape of the cap and the optimal angle. 4. When choosing PIC one should take into account the vein diameter, the required speed of infusion, the potential time of stay of a catheter in a vein, and the features of the infused solution. 5. ISLI Yu-Port provides long-term venous access and can be used if necessary for the multiple administrations of drugs during a long course of therapy.