The journal of vascular access
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A persistent left superior vena cava (PLSVC) is a rare, under-recognized congenital anomaly. The PLSVC is incidentally discovered during central venous access procedures when access is obtained from the left internal jugular vein. ⋯ This case review presents three cases which illustrate the viability and safety of a PLSVC for long-term central venous access in the setting of chemotherapy and hemodialysis. Ascertaining the drainage pattern of a PLSVC with venogram, echocardiography, computed tomography is paramount prior to long-term catheterization.
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Multicenter Study Observational Study
Peripheral intravenous cannulation: complication rates in the neonatal population: a multicenter observational study.
Neonates admitted to a neonatal intensive care unit (NICU) rely highly on intravenous (IV) therapy, for which the peripheral intravenous cannula (PIVC) is the preferred device to allow such therapies to proceed. Placement of a PIVC is a painful procedure and repeated attempts for successful insertion should therefore be limited. We aimed to quantify the incidence, complications, and factors associated with these complications. ⋯ In this study the majority of PIVCs were removed after the occurrence of a complication. The most common complication was infiltration. Strategies to identify and prevent infiltration in an NICU population are required. Future interventional studies should attempt to improve first-time insertion success and reduce PIVC failure from infiltration in the neonate. Based on the results of the present study, neonatologists and physician assistants are the preferential PIVC inserters. Advanced training of all members of vascular access specialist teams and ongoing monitoring of PIVC-related complications are recommended.
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This is a single-center, descriptive report of the management and complications of venous catheter use in 19 severely burned passengers from a bus fire that occurred on July 5, 2014, in Hangzhou. ⋯ Bedside ultrasound and professional IV team for CVC management are pivotal for massive burn victims. Their intervention helps control CVC-related infections and other complications. A. baumannii was the most frequent bacterial infection found in both CTC- and CRBSI-positive catheters. Several most important factors associated with catheter-related infections were concluded. This information alerts us to watch for patients with such warning factors.
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Case Reports
Dialysis catheter placement via the left internal jugular vein: risk of brachiocephalic vein perforation.
We discuss a case of a brachiocephalic vein (BCV) perforation after Tesio® central venous catheter insertion. ⋯ In spite of ultrasound guidance, fluoroscopy for guidewire and sheath advancement, venous blood aspiration and a normal appearing postoperative x-ray, traumatic central venous catheter placement is still possible. Tenting of the BCV wall during catheter advancement possibly caused the venous perforation. A 'how-to' for correct catheter placement via the IJV is provided and potential pitfalls during each procedural step are discussed.
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Observational Study
Prospective evaluation of the learning curve for ultrasound-guided peripheral intravenous catheter placement.
It is unclear how many ultrasound-guided peripheral intravenous catheters (USG PIVC) one must place to become proficient at the procedure. The objective of this study was to determine the learning curve associated with PIVC placement and determine how many attempts are required for non-physician learners to reach proficiency. ⋯ After placement of four USG PIVCs, new learners of the procedure are capable of a greater than 70% success rate. A success rate of greater than 88% is achieved after 15 to 26 attempts.