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Comparison of intraosseous access and central venous catheterization in Chinese adult emergency patients: A prospective, multicenter, and randomized study

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World Journal of Emergency Medicine 2021年第2期12卷 105-110页

作者： Yan-yan Liu Yu-peng Wang Ling-yun Zu Kang Zheng Qing-bian Ma Ya-an Zheng Wei Gao Department of Cardiology and Institute of Vascular Medicine Peking University Third HospitalNHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesKey Laboratory of Molecular Cardiovascular SciencesMinistry of EducationBeijing Key Laboratory of Cardiovascular Receptors ResearchBeijing 100191China Department of Emergency Medicine Peking University Third HospitalBeijing 100191China

BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous(IO) access and central venous catheterization(CVC) in critically ill Chinese ***: In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned ***: A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group(91.7% vs. 50.0%, P<0.001;52.0 seconds vs. 900.0 seconds, P<0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion(1.5 vs. 0.0, P=0.044). Complications were not observed in the two ***: IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.

关键词： Intraosseous access central venous catheterization Success rates Procedure time Pain score

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Ultrasound-Guided central venous catheterization: A Protocol to Be Followed in Pediatrics?

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Open Journal of Pediatrics 2017年第3期7卷 128-139页

作者： Mayara Goncalves Marques Regina Grigolli Cesar Pediatrics Department-Pediatric Intensive Care Unit Irmandade da Santa Casa de Misericordia de Sao PauloSao PauloBrazil

Objective: To investigate the effectiveness of ultrasound-guided central venous catheterization when compared to the conventional procedure. Method: A prospective cohort study was carried out over a 9-month period from February to October 2016 involving 144 inpatients at PICU of Irmandade da Santa Casa de Sao Paulo Hospital, undergoing central venous catheterization. The patients were matched in pairs of identical patients according to the levels of potentially intervening variables (age, nutritional status, puncture site, professional experience), differing only as to the CVC technique: ultrasound-guided (USG-CVC) or conventional (C-CVC). Discarding data from non-paired patients, the remaining did forming 47 pairs, matched as two related samples: USG-CVC and C-CVC groups. Success parameters: number of puncture attempts;time spent at CVC;success rate and complications. Results: In the USG-CVC group, the number of attempts (mean = 2.04) and the time spent at catheterization (mean = 11.89 minutes) were lower (t = 2.34, df = 46, t 0.95 = 2.02, p t = 3.07, df = 46, t 0.95 = 2.02, p 0.05) when considering several attempts. Complications were found less frequently in the USG-CVC group (3/47) than in the CVC-C (13/47), (F (1, 46) = 8.24;Q (1) = 7.14, p < 0.05). Conclusion: USG-CVC was found to be more effective than the conventional technique, especially regarding success at the first puncture attempt.

关键词： central venous Catheters Ultrasonography central venous catheterization Pediatrics Pediatric Intensive Care Units Patient Safety

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Current Research Progress of central venous Catheter-Associated Fibrin Sheath Prevention and Nursing Care

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Journal of Clinical and Nursing Research 2024年第5期8卷 135-144页

作者： Linzhi Xu Yue Li Hongjuan Wu Yan’an University Yan’an 716000Shanxi ProvinceChina Shaanxi Provincial People’s Hospital Xi’an 710000Shanxi ProvinceChina

With the popularization of central venous catheterization in recent years,the problems arising from intravenous therapy have gradually *** sheath is the complication with the highest incidence rate in central venous catheterization,which has always been a major problem in intravenous *** the prevention and treatment of fibrin sheath has become a hot spot of research in recent ***,this paper summarizes the research on fibrin sheath in recent years.

关键词： central venous catheterization Fibrin sheath Clinical care

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Massive hemothorax following internal jugular vein catheterization under ultrasound guidance:A case report

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World Journal of Clinical Cases 2022年第17期10卷 5776-5782页

作者： Hyun Kang Soo Young Cho Eun Ha Suk Wan Ju Joon Yong Choi Department of Anesthesiology and Pain Medicine Kwangju Christian HospitalGwangju 61661South Korea

BACKGROUND Hemothorax is a rare but life-threatening complication of central venous *** reports suggest that ultrasound guidance may reduce complications however,it does not guarantee safety CASE SUMMARY A 75-year-old male patient was admitted for laparoscopic radical *** ultrasound guidance,right internal jugular vein catheterization was successfully achieved after failure to aspirate blood from the catheter in the first *** hypotension developed after surgical positioning and persisted until the end of the operation,lasting for about 4 *** the recovery room,a massive hemothorax was identified on chest radiography and computed *** patient recovered following chest tube drainage of 1.6 L *** Hemothorax must be suspected when unexplained hemodynamic instability develops after central venous catheterization despite ultrasound *** the proper use of ultrasound is important.

关键词： central venous catheterization Hemothorax Ultrasound guidance Internal jugular vein Case report

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Prospective Assessment of Catheter Migration in Implanted Vascular Access Devices for Adjuvant Colorectal Cancer Chemotherapy

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Journal of Cancer Therapy 2012年第6期3卷 920-925页

作者： Pia Osterlund Paivi Valta Soren Bondedstam Leena Lindgren Department of Oncology Helsinki University Central Hospital and University of HelsinkiHelsinkiFinland Department of Anaesthesiology Helsinki University Central HospitalJorvi HospitalEspooFinland Department of Radiology Helsinki University Central HospitalHelsinkiFinland Department of Anaesthesia Tampere University Hospital and University of TampereTampereFinland.

Background: Chemotherapy in colorectal cancer is usually administered as continuous infusion of 5-fluorouracil, often in combination with oxaliplatin or irinotecan. Targeted drugs are most efficient and tolerable in conjunction with continuous infusion dosing. Implanted venous access devices (VAD) are the prerequisite for continuous infusion administration. The reported catheter migration frequency with VAD is 0% - 3.5%. The purpose of this case-control study was to evaluate the predisposing factors of catheter migration. Methods: We inserted VADs in 88 radically operated colorectal cancer patients randomized to adjuvant 48-hour-infusion chemotherapy repeated every 14 days, altogether 12 times over 24 weeks. Three out of 88 patients (3.4%) had a symptomatic catheter migration from the superior caval vein into the internal jugular vein. The fourth case had chemotherapy for osteosarcoma. These 4 cases were compared with 12 controls from the same 88 patient study population, matched for age, sex, body mass index (BMI), physical activity level and right subclavian insertion site. Tip position, port model, complications, catheter length and material was studied. The post insertion catheter tip position in the chest X-ray was numbered from 1 (in subclavia) to 8 (in atrium). Results: The four cases, all male, had a median position of 3 (range 3 - 4) and controls 6 (range 4 - 8), P = 0.004, median difference 3 (CI95% 1 - 5). At notification of migration the patients had experienced discomfort in the neck region starting 5 to15 days before at strenuous upper extremities activity with Valsalva maneuvers. Conclusion: Optimal catheter tip position when sitting is in the right atrium or low in the superior vena cava to avoid migration. Patients with VADs should avoid strenuous activity with Valsalva maneuvers.

关键词： central venous catheterization Catheter Migration Complication Colorectal Cancer Vascular Access Device

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