The journal of vascular access
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The objective of this study was to determine through a systematic review of the literature and meta-analysis whether success rates, time to cannulation, and number of punctures required for peripheral venous access are improved with ultrasound guidance compared with traditional techniques in patients with difficult peripheral venous access. ⋯ In patients with difficult peripheral venous access, ultrasound guidance increased success rates of peripheral venous placement when compared with traditional techniques. However, ultrasound guidance had no effect on time to successful cannulation or number of punctures required for successful cannulation.
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Observational Study
Effects of incrementally increasing tidal volume on the right internal jugular vein in pediatric patients.
The aim of the present study was to evaluate the effects of incremental increases of tidal volume (TV) on the cross-sectional area (CSA) and size of the right internal jugular vein (RIJV), and the relationship between RIJV and the carotid artery (CA). ⋯ This study reveals that a TV of 10 mL/kg in anesthetized children achieved the greatest size in the RIJV, and caused no difference in the CA overlap. These results suggest that a TV of 10 mL/kg is the optimal choice when facilitating catheterization and in the avoidance of complications in anesthetized children connected to mechanical ventilator that are required to undergo RIJV catheterization.
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Congenital anomalies of superior vena cava and their implications in central venous catheterization.
Congenital anomalies of superior vena cava (SVC) are generally discovered incidentally during central venous catheter (CVC) insertion, pacemaker electrode placement, and cardiopulmonary bypass surgery. Persistent left SVC (PLSVC) is a rare (0.3%) anomaly in healthy subjects, usually asymptomatic, but when present and undiagnosed, it may be associated with difficulties and complications of CVC placement. ⋯ To improve knowledge of this rare but potentially dangerous condition, we describe the embryological origin of SVC, its normal anatomy, and possible congenital anomalies of the venous system and of the heart, including the presence of a right to left cardiac shunt. Diagnosis of PLSVC as well as the clinical complications and technical impact of SVC congenital anomalies for CVC placement are emphasized.
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The purpose of this study is to evaluate the complications of peripherally inserted central catheters (PICCs) in orthopedic patients with chronic bone orthopedic infection. ⋯ Even in orthopedic patients with chronic orthopedic bone infection, PICCs have a low rate of complication. The increasing lumen number of the PICC is a potential risk factor in our series.
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To investigate the role of wall shear stress in aspects of the formation of fibrin sheath and intimal thickening in a dog model. ⋯ After catheter placement, fibrin sheath formation partially covered the catheter. Meanwhile, focal areas of intimal thickening were also seen in the venous wall adjacent to the sites of high wall shear stress. These findings indicate an important role of wall shear stress profiles in fibrin sheath formation and intimal thickening.