Search results for " venous"
showing 10 items of 212 documents
Prognostic significance of central venous-to-arterial carbon dioxide difference during the first 24 hours of septic shock in patients with and withou…
2017
IF 6.238; International audience; Objective: To investigate the prognostic significance of central venous-to-arterial carbon dioxide difference (cv-art CO2 gap) during septic shock in patients with and without impaired cardiac function.Methods: We performed a prospective cohort study in 10 French intensive care units. Patients suffering from septic shock were assigned to the impaired cardiac function group (‘cardiac group’, n=123) if they had atrial fibrillation (AF) and/or left ventricular ejection fraction (LVEF) 0.9 kPa at 12 h had a higher risk of day 28 mortality (hazard ratio=3.18; P=0.0049). Among the 59 patients in the cardiac group with mean arterial pressure (MAP) ≥65 mm Hg, centr…
PiCCO plus: monitorización cardiopulmonar mínimamente invasiva
2008
Insertion of a central venous catheter and an arterial catheter would be indicated in hemodynamically unstable or severely hypoxic patients in critical care units. In this setting, cardiorespiratory monitoring by transpulmonary thermodilution (TPTD) can be considered minimally invasive given that only a single arterial thermodilution catheter and a single central venous catheter are required to be connected to a specific monitor (the PiCCO Plus, Pulsion Medical Systems, Munich, Germany). TDTP simultaneously measures cardiac output, preloading, and cardiac function in hemodynamically unstable patients and predicts the response to volume. The technique can be managed by any health care profes…
Comparison of heparin to citrate as a catheter locking solution for non-tunneled central venous hemodialysis catheters in patients requiring renal re…
2014
Background The incidence of acute kidney injury (AKI) is estimated at 10 to 20% in patients admitted to intensive care units (ICU) and often requires renal replacement therapy (RRT). ICU mortality in AKI patients can exceed 50%. Venous catheters are the preferred vascular access method for AKI patients requiring RRT, but carry a risk of catheter thrombosis or infection. Catheter lock solutions are commonly used to prevent such complications. Heparin and citrate locks are both widely used for tunneled, long-term catheters, but few studies have compared citrate versus heparin for patients with short-term, non-tunneled catheters. We aim to compare citrate 4% catheter lock solution versus hepar…
Analyzing central-line associated bloodstream infection prevention bundles in 22 countries: The results of ID-IRI survey
2022
International audience; BACKGROUND: Because central line-associated bloodstream infections (CLABSIs) are a significant complication of central venous access, it is critical to prevent CLABSIs through the use of central line bundles. The purpose of this study was to take a snapshot of central venous access bundles in various countries. METHODS: The participants in intensive care units (ICUs) completed a questionnaire that included information about the health center, infection control procedures, and central line maintenance. The countries were divided into 2 groups: those with a low or low-middle income and those with an upper-middle or high income. RESULTS: Forty-three participants from 22…
In vitro efficacy of a Hydrophilic Central Venous Catheter Loaded with Silver to Prevent Microbial Colonization
1998
A method was developed to load the surface of a central venous catheter with silver to prevent bacterial colonization. Silver confers a broad antimicrobial activity with a relatively low risk of resistance. Catheters were incubated with a silver nitrate solution in different concentrations. The solvent, incubation temperature and incubation period were varied to examine the influence on the catheter loading. With increasing incubation temperature, time and concentration of silver nitrate, higher rates of silver elution were observed by atomic absorption spectroscopy. Furthermore, by using ethanol-water as a solvent instead of pure water, the amount of silver bound to the catheter surface wa…
A rare case of sepsis due to Corynebacterium macginleyi from central venous catheter in an elderly woman
2011
Corynebacterium macginleyi is a gram positive rod that causes especially ocular infections: since now only six elderly cases of extraocular infection are described. A 76 years old bedridden woman with a central venous catheter was hospitalized for 10 days of persistent fever. She was treated before with vancomicin and then with imipenem. The clinical conditions improved and the patient was discharged after two weeks of hospitalization. Among recognised risk factors for this infection the advanced age, indwelling devices and immunosuppression seem the most important. On the other hand, the antibiotics of choice are glycopeptides while the association of another antibiotic is recommended in o…
Umbilical venous catheters placement evaluation on frontal radiogram: application of a simplified flow-chart for radiology residents
2017
Background: Umbilical Venous Catheter (UVC) are commonly used in neonatal period; they can be not correctly positioned and could be associated with complications. The purpose of this article is to suggest a flow-chart to evaluate the placement of UVC, testing it in young radiologists-in-training. Method: We developed a simple flow-chart to asses, steps by step, UVC placement considering its course and tip location (ideally placed in the atriocaval junction). We tested the flow-chart impact asking to 20 residents to evaluate the placement of 10 UVC before and after they familiarized with the flow-chart and the anatomical findings of a newborn. The agreement among the 20 students was evaluate…
A quality improvement study on the reduction of central venous catheter-associated bloodstream infections by use of self-disinfecting venous access c…
2020
Background Contamination of the catheter hub is an important source of central line-associated bloodstream infections (CLABSI); catheter hub caps incorporating a 70% isopropyl alcohol aim are designed to reduce contamination and hence CLABSI rates. Supporting data in high-risk hematological and oncological patients on the clinical effectiveness of this approach are sparse. Methods We conducted a before-after single center study accompanying the introduction of such caps at our department. Retrospective data from the year prior to the introduction were compared to 1 year of prospective data. Results The control and antiseptic barrier cap (ABC) groups consisted of 309 and 289 patients present…
Comparison of central venous catheterization with and without ultrasound guide
2003
Purpose: To compare the effectiveness, safety and time needed to perform central venous catheterization (CVC) in the presence or absence of an ultrasound (US) guide. Methods: Between January 1999 and February 2002 we performed CVCs in 196 patients: 105 patients received US guided CVC (group I) and 91 patients had CVC without US guide (group II). Results: The average time to perform CVC was shorter with US guide (4 vs 7min). The utilization of the US guide was also associated with improved success (98.09% vs 91.2%, p < 0.025) and lack of major complications (0% vs 9.8%, p < 0.001). Conclusions: US-guided CVC affords an easier, safer and more rapid cannulation of a central vein. It is especia…
Possible Pathomechanisms Responsible for Injury to the Central Nervous System in the Settings of Chronic Cerebrospinal Venous Insufficiency
2012
The discovery of stenoses in the azygous and internal jugular veins, the so-called chronic cerebrospinal venous insufficiency that accompanies multiple sclerosis, has enabled the reinterpretation of knowledge about this neurologic dis- ease. Pathologic venous outflow from the central nervous system appears to lead to two main problems. Firstly, it disas- sembles the blood-brain barrier and may allow the penetration of nervous parenchyma by glutamate and leukocytes. Sec- ondly, it may result in significant hypoperfusion of the brain and spinal cord. These two overlapping pathologies are likely to trigger plaques through caspase-1-driven pyroptosis of oligodendrocytes and to evoke neurodegene…