The journal of vascular access
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Comparative Study
Bursting pressure of triple-lumen central venous catheters under static and dynamic loads.
Central venous catheter (CVC) access is commonplace in intensive care units. Patients undergoing computed tomographic angiography require injection of contrast at high flow rates (4.5 mL/s), often CVC access is not used due to safety concerns. The CVC might rupture at high flow rates, resulting in CVC fragmentation and embolization or contrast extravasation.The objective of this study is to determine the pressure required to burst a CVC under static load and compare this to the pressure generated by injection of contrast at high flow rates (dynamic load) through the distal (16-g) lumen of a triple-lumen CVC. ⋯ No CVCs failed under dynamic loading with injection of contrast at flow rates (4.5 and 7 mL/s) high enough to support computed tomographic angiography. This suggests 16-cm triple-lumen CVCs can be used safely.
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The coexistence of a double superior vena cava (SVC) and a partially left inferior vena cava (PLIVC) with a circumaortic collar, associated with other congenital malformations, was not described previously. ⋯ The double SVC was related to the persistence of the caudal part of the anterior cardinal veins. As to the PLIVC, the iliac and subrenal parts of the inferior vena cava can be related to the persistent left supracardinal vein, while the circumaortic venous collar to the persistent intersupracardinal and left subsupracardinal anastomoses. All invasive procedures, and particularly those potentially complicated, must be performed under EST, now considered a mandatory tool for CVC implants, owing to the hypothesis of possible venous congenital anomalies.
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Comparative Study Observational Study
Outcomes of a nephrologist-driven tunnelled dialysis catheter insertion service in South East Asia.
Tunnelled dialysis catheters (TDCs) are being increasingly inserted by nephrologists globally but there is limited experience and paucity of published outcomes data from South-East Asia (SEA). This study was conducted to analyse the outcomes of TDC insertion by nephrologists from a single centre in SEA. ⋯ This is one of the first reports of TDC insertion by nephrologists from SEA. Our outcomes compare favourably with those reported in the literature.
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Comparative Study
Femorally inserted central venous catheter in patients with superior vena cava obstruction: choice of the optimal exit site.
This study assessed patient comfort and catheter indwelling time and decreased incidence of complications in patients with femorally inserted venous catheters (FIVCs) via different exit sites. ⋯ Compared with the conventional exit site at the groin, the exit site at the mid-thigh for FIVCs increased patients' comfort and catheter indwelling time, and decreased the rate of complication and pain scores. However, it did not decrease the success rate in SVCO patients.