The journal of vascular access
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Comparative Study Observational Study
A comparison of infections and complications in central venous catheters in adults with solid tumours.
The aim of this study is to compare the complication rates of three vascular access devices in patients with solid tumours having infusion chemotherapy. ⋯ In our study, we demonstrated that central venous ports and PICC lines in patients undergoing infusional chemotherapy had lower line infection rates than tunnelled catheters, and only ports have been shown to be almost complication-free. In addition, we found infection rates higher in CVCs s cared for by patient/carers rather than hospital only care, and higher in colorectal patients with stomas. Therefore, we recommend that central venous ports are a safe, acceptable CVC option for infusional chemotherapy for adults with solid tumours.
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An interventional vascular access unit is usually part of an interdisciplinary centre, including departments of nephrology, vascular surgery, angiology and interventional radiology. We present recommendations on quality control, equipment and diagnostic and interventional techniques for the treatment of vascular access insufficiency.
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Observational Study
Association between multiple IV attempts and perceived pain levels in the emergency department.
Intravenous (IV) access is the most commonly performed procedure in the emergency department (ED). Patients with difficult venous access require multiple needlesticks (MNS) for successful IV cannulation and may experience increased pain with many attempts. ⋯ Patients experience increased pain in association with multiple IV attempts.
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Peripherally inserted central venous catheters (PICCs) are being increasingly placed at the bedside by trained vascular access professional such as nurses. This is to increase the availability of the service, for cost containment, and to reduce the workload on the interventional radiologist. We describe a single institution experience with over 700 PICC lines placed by trained nurses at the bedside and determine the success rate, malposition rate of the PICC line , degree of support needed from the Interventional radiologist, and factors affecting a successful placement of a PICC line by the nurses. ⋯ Bedside placement of PICC line by trained vascular nurses is an effective method with a high success rate, low malposition rate and requires minimal support from interventional radiology.
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Randomized Controlled Trial Comparative Study
A prospective, randomized comparison of three different types of valved and non-valved peripherally inserted central catheters.
Few randomized studies have investigated the impact of valved and non-valved power-injectable peripherally inserted central catheters (PICCs) in terms of incidence of occlusion, infection, malfunction and venous thrombosis. ⋯ We found no clinical advantages of valved vs. non-valved PICCs.