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Jeon MH, Kim CS, Han KD, Kim MJ. Efficacy and Safety of Midline Catheters with Integrated Wire Accelerated Seldinger Technique. Vasc Specialist Int 2022; 38:2. [PMID: 35307696 PMCID: PMC8938155 DOI: 10.5758/vsi.210062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/06/2022] [Accepted: 02/20/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose The midline catheter (MC) is a peripheral venous access device with the catheter tip located in the axilla and available for mid-term intravenous (IV) therapy. This study evaluated the efficacy and clinical outcomes associated with the placement of MCs with an integrated wire-accelerated Seldinger technique for IV access. Materials and Methods A retrospective review was conducted at a single center in South Korea between March 2020 and July 2020. Consecutive patients in whom MC insertions were performed by vascular surgeons were enrolled. The outcomes included catheter indwelling time and incidence of catheter-related adverse events. Results Ninety-five patients (117 catheters) were included in the study. The total indwelling time was 1,964 days, with a median of 16.7 days (range, 0-76). The complication-free catheter rates at 5 and 28 days were 92.9% and 65.5%, respectively. Overall, 32 (27.4%) catheters were removed due to complications; however, major complications, such as symptomatic deep venous thrombosis and catheter-induced bloodstream infections, were confirmed in only 3 (2.6%) catheters. A common reason for premature catheter removal is inadvertent removal owing to patient inattention. A high body mass index and female sex were identified as risk factors for short indwelling times and complicated premature catheter removal. Conclusion MC insertion is a simple and operator-friendly procedure with a low rate of major complication. It enables mid-term IV treatment through a single procedure if there are no specific complications, thereby improving quality of life of patients during hospital stay.
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Affiliation(s)
- Mun Hee Jeon
- Division of Vascular Surgery, Department of Surgery, Presbyterian Medical Center, Jeonju, Korea
| | - Cheol Seung Kim
- Division of Vascular Surgery, Department of Surgery, Presbyterian Medical Center, Jeonju, Korea
| | - Kyu Dam Han
- Division of Vascular Surgery, Department of Surgery, Presbyterian Medical Center, Jeonju, Korea
| | - Mi Jin Kim
- Division of Vascular Surgery, Department of Surgery, Presbyterian Medical Center, Jeonju, Korea
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Suvvari P, Nair A, Mantha SSP, Saifuddin MS, Naik V, Rayani BK. Management of Malignant Ascites by Indwelling Tunnelled Catheters in Indian Setup: A Case Series. Indian J Palliat Care 2021; 27:349-353. [PMID: 34511807 PMCID: PMC8431247 DOI: 10.25259/ijpc_416_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/31/2021] [Indexed: 11/05/2022] Open
Abstract
Malignant Ascites (MA) poses significant symptom burden in patients with peritoneal malignancies at the end of life. Various treatment options are available and Indwelling Tunneled Catheters (ITC) have the advantage of increased patient comfort being soft on abdomen, less painful, easy to tap fluid, and less chances of infection etc. A total of 5 patients underwent insertion of ITC after proper counseling and assessment. Insertion was done in operation theatre under combined ultrasonogram and fluoroscopy guidance. Results: 4 out of 5 patients had favorable outcomes in terms of symptom free days spent at home at end of life. ITC’s are a suitable option to manage symptoms in patients with terminal malignant ascites. Careful patient selection and proper education of the caregivers will increase the success rates of procedures.
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Affiliation(s)
- Praneeth Suvvari
- Department of Oncoanaesthesia, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Abhijit Nair
- Department of Anaesthesiology, Ibra Hospital, Ibra, Muḩāfaz̧at Janūb ash Sharqīyah, Oman
| | - Srinivasa Shyam Prasad Mantha
- Department of Oncoanaesthesia, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Mohammad Salman Saifuddin
- Department of Oncoanaesthesia, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Vibhavari Naik
- Department of Oncoanaesthesia, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Basanth Kumar Rayani
- Department of Oncoanaesthesia, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
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Abstract
This thematic review was part of a bigger literature review into the effects of short-term urinary catheters on patients who are discharged home from an acute hospital. This integrated review examined the risks associated with short-term urinary catheters. The MEDLINE, British Nursing Index and CINAHL databases were searched for studies published between 2013 and 2018 that researched the effects of short-term urinary catheters on patients. Twelve research studies were included, which showed the presence of short-term indwelling urinary catheters increased the risk of infection, length of hospital stay and mortality rates. Short-term urinary catheters should be strictly monitored and removed as soon as they are not required.
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Affiliation(s)
- Evelyn Gyesi-Appiah
- Research Student, De Montfort University, Leicester, and Nurse, University Hospitals of Leicester NHS Trust
| | - Jayne Brown
- Professor of Nursing (Older People), School of Nursing and Midwifery, De Montfort University, Leicester
| | - Andrew Clifton
- Associate Professor, Mental Health Nursing, School of Nursing and Midwifery, De Montfort University, Leicester
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4
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Koszutski M, Faure M, Guillaumot A, Gomez E, Mercy M, Chabot F, Chaouat A. [Tunnelled central venous catheter infection during treatment with epoprostenol]. Rev Mal Respir 2018; 35:324-327. [PMID: 29602480 DOI: 10.1016/j.rmr.2017.03.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 03/31/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Pulmonary arterial hypertension is a pulmonary vascular disease with a poor prognosis. Continuous intravenous treatment with prostacyclin analogues requires the placement of a tunnelled catheter. The occurrence of catheter-related infections in this context is unusual due to the alkaline pH of the prostacyclin analogue solutions. OBSERVATION A 50-year-old patient with inherited pulmonary artery hypertension, treated with bosentan, sildenafil and epoprostenol, experienced generalized malaise associated with a weight loss of 9kg over a 12-month period without evidence of a source of infection or malignancy. There was no evidence of hemodynamic disturbance. The diagnosis was made after 1 year of follow-up, when the patient presented with a 38° fever and a biological inflammatory syndrome. Repeated peripheral blood cultures were positive for Dietzia, an alkalophilic coryneform bacillus. The patient's condition responded favourably to antibiotic therapy. CONCLUSION Infection of a tunneled intravenous catheter should be considered in the case of non-specific symptoms or where there is evidence of sepsis, in patients treated with intravenous prostacyclin analogues administered intravenously. In this context, the laboratory should be warned to search for slow-growing organisms.
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Affiliation(s)
- M Koszutski
- Pôle des spécialités médicales, département de pneumologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
| | - M Faure
- Pôle des spécialités médicales, département de pneumologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - A Guillaumot
- Pôle des spécialités médicales, département de pneumologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - E Gomez
- Pôle des spécialités médicales, département de pneumologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - M Mercy
- Pôle des spécialités médicales, département de pneumologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - F Chabot
- Pôle des spécialités médicales, département de pneumologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - A Chaouat
- Pôle des spécialités médicales, département de pneumologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France; INGRES, EA 7298, université de lorraine, 54500 Vandœuvre-lès-Nancy, France
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Schettini DA, Freitas FG, Tomotani DY, Alves JC, Bafi AT, Machado FR. Incidence and risk factors for urinary retention in critically ill patients. Nurs Crit Care 2018; 24:355-361. [PMID: 29430778 DOI: 10.1111/nicc.12341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 11/24/2017] [Accepted: 01/15/2018] [Indexed: 01/31/2023]
Affiliation(s)
- Daniel A Schettini
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Flávio Gr Freitas
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Daniere Yv Tomotani
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Jane Cd Alves
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Antonio T Bafi
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Flávia R Machado
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, São Paulo, SP, Brazil
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Lai CH, Chang WC, Liu TJ, Lee WL, Su CS. Endovascular Treatment of Concomitant Obstructions of a Denver Drainage Catheter and Superior Vena Cava in a Patient With Liver Cirrhosis. Int Heart J 2017; 58:447-450. [PMID: 28484121 DOI: 10.1536/ihj.16-300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
With the increased use of intravascular catheters and devices, they have become the major non-malignant cause of superior vein cava (SVC) syndrome. We report a patient with liver cirrhosis who had received a peritoneovenous drainage catheter for refractory ascites, and then developed SVC syndrome because of concomitant occlusions of both the SVC and the drainage catheter. The patient regained patency of both the occluded vessel and the drainage catheter through percutaneous transluminal venoplasty, and there was dramatic improvement of clinical symptoms and good performance of the drainage catheter. Percutaneous intervention may be a feasible and effective therapy for SVC syndrome and intra-catheter thrombosis-related dysfunction.
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Affiliation(s)
- Chih-Hung Lai
- Cardiovascular Center, Taichung Veterans General Hospital.,Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine
| | - Wei-Chun Chang
- Cardiovascular Center, Taichung Veterans General Hospital.,Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine
| | - Tsun-Jui Liu
- Cardiovascular Center, Taichung Veterans General Hospital.,Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine
| | - Wen-Lieng Lee
- Cardiovascular Center, Taichung Veterans General Hospital.,Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine
| | - Chieh-Shou Su
- Cardiovascular Center, Taichung Veterans General Hospital.,Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine
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Abstract
This article discusses one of the problems associated with urinary catheterisation. It focuses on catheter blockage and explains the effects of this on patients and the health service and aims to guide nurses in their management of this complex issue. The length of time a catheter remains functional is unique to the individual and imperative to good catheter care. Coupled with this the cause of the blockage needs to be identified before a treatment plan can be formulated. Encrustation is identified as a major problem and the reliability of using the pH value of urine to monitor is discussed. Adequate fluid intake is essential for catheter management and the benefits of citrate drinks are highlighted. The treatment regime of catheter maintenance solution is examined and while this may be an option for some patients the suggestion of proactive catheter changes would appear to be the most appropriate.
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Abstract
Benign prostatic hyperplasia (BPH) is one of the most common conditions experienced by aging males and a frequent cause of bladder outlet obstruction and macroscopic haematuria. Giant prostatic hyperplasia (GPH) is an extremely rare form of prostatic hyperplasia. We present a case of a patient with GPH of 800 mL. To our knowledge, this is the fourth largest prostatic hyperplasia ever reported in the literature.
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Affiliation(s)
- Luke Wang
- Department of Urology, Eastern Health, Nelson St, Box Hill, Victoria, Australia
- Corresponding author.
| | - Paul Davis
- Department of Urology, Eastern Health, Nelson St, Box Hill, Victoria, Australia
| | - Kevin McMillan
- Department of Urology, Eastern Health, Nelson St, Box Hill, Victoria, Australia
- Monash University, Eastern Health Clinical School, Arnold St, Box Hill, Victoria, Australia
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Mead PA, Safdieh JE, Nizza P, Tuma S, Sepkowitz KA. Ommaya reservoir infections: a 16-year retrospective analysis. J Infect 2014; 68:225-30. [PMID: 24321561 DOI: 10.1016/j.jinf.2013.11.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 11/20/2013] [Accepted: 11/26/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Ommaya reservoirs (OmR) are used in the treatment of cancer yet risk factors and outcome of infection are not well characterized. We therefore examined our experience with this device. METHODS Using administrative databases, we identified all patients with OmR in situ between 1993 and 2008 at Memorial Sloan-Kettering Cancer Center. Charts were reviewed for laboratory, demographic, and clinical information. RESULTS During the study period, 616 patients with OmRs received care at MSKCC comprising 462,467 Ommaya-days. 34 patients with OmR infection were identified (5.5% of patients, 0.74 infections per 10,000 Ommaya-days). 32% of infections occurred within 30 days of OmR placement. Most (74%) OmR infections occurring after 30 days post-placement were associated with OmR access in the preceding 30 days. Recovered organisms included coagulase-negative staphylococci (56%) and Propionibacterium acnes (24%). 70% of patients had fever and/or headache and 69% had cerebrospinal fluid pleocytosis. 50% of patients had the reservoir removed during treatment of the infection. CONCLUSIONS OmR infection occurs in one of every 20 persons with the device. A third of the infections appear related to OmR placement while the remainder may occur at any time and usually are associated with recent reservoir access. Treatment often includes device removal.
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Fazeli MR, Hosseini V, Shamsa F, Jamalifar H. Preparation and in-vitro Antibacterial Evaluation of Electroless Silver Coated Polymers. Iran J Pharm Res 2010; 9:259-64. [PMID: 24363735 PMCID: PMC3863440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Long-term use of indwelling medical catheters has often been hindered by catheter-associated nosocomial infections. In this study the effectiveness of silver coating of polystyrene and polyethylene polymers was investigated. Polymer pieces of 2 cm(2) each were coated with a thin layer of silver using electroless plating technique. Silver-coated polymers were challenged with cultures of four different microorganisms known for their involvement in nosocomial infections in both solid and broth media. The tested bacteria included Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa. Silver release from the coated polymers was 2-5 μg/cm(2) which was confirmed by chemical and biological methods. The silver coating thickness ranged between 20-450 nm. P. aeruginosa and S. aureus were the most adherent bacteria to polystyrene sheets while E. coli showed minimum adherence effect. The survival rate of different bacteria after 80 min in a time course experiment tended to dominate E. coli as the most sensitive bacteria to the effect of silver with zero survival rate while around 4% of P. aeruginosa were detected after same period. Silver coating of indwelling polymers by electroless technique seems promising in combating nosocomial infections due to long-term catheterization.
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Affiliation(s)
- Mohammad Reza Fazeli
- Department of Drug and Food Control, School of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vahid Hosseini
- Department of Drug and Food Control, School of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fazel Shamsa
- Department of Pharmaceutical Chemistry, School of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding author: E-mail:
| | - Hossein Jamalifar
- Department of Drug and Food Control, School of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
A 79-year-old male was transferred to the intensive care unit for postoperative respiratory support. An indwelling bowel management system was inserted for containment of noninfective diarrhoea. Following only 11 days of continual use the patient developed life-threatening rectal bleeding. Preoperative normal rectal mucosa and anatomy were documented. There was no evidence of postoperative coagulopathy. Mesenteric angiography identified bleeding from a branch of the superior rectal artery. Rectal mucosa pressure necrosis secondary to the indwelling Flexi-Seal® Fecal Management System was diagnosed. The patient required an 11-unit transfusion of packed red cells. Following intraarterial coil embolization of the superior rectal artery the bleeding abated. Indwelling bowel management systems are commonly used in immobile and critically ill patients with diarrhoea or faecal incontinence. This is the first report of this important complication in the literature.
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