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Sample records for catheterization

  1. Urine culture - catheterized specimen

    Science.gov (United States)

    Culture - urine - catheterized specimen; Urine culture - catheterization; Catheterized urine specimen culture ... urinary tract infections may be found in the culture. This is called a contaminant. You may not ...

  2. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye will be injected into your ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  3. Infections following epidural catheterization

    DEFF Research Database (Denmark)

    Holt, MS; Andersen, SS; Andersen, Ove;

    1995-01-01

    of central nervous system infection of at least 0.7% at Odense University Hospital. This degree of infection is of the same magnitude as that reported for intravascular devices. We found that the patients with generalized symptoms of infection had been catheterized for a longer time, and were older than......Seventy-eight patients with culture-positive epidural catheters, were studied. Fifty-nine had symptoms of exit site infection and 11 patients had clinical meningitis, two of whom also had an epidural abscess. This corresponds to a local infection incidence of at least 4.3% and an incidence...... patients with only local symptoms of infection. The microorganisms isolated from the tips of the epidural catheters were coagulase-negative staphylococci (41%), Staphylococcus aureus (35%), Gram-negative bacilli (14%) and others (10%). The Gram-negative bacilli and S. aureus caused serious infections more...

  4. Nursing ultrasound examination in catheterization

    Directory of Open Access Journals (Sweden)

    Luca Romei

    2007-12-01

    Full Text Available Ultrasound (US examination of the bladder can precisely determine the bladder volume and is a useful tool in estimating the residual urine volume. Its application is consequently recommended as an alternative to catheterization for the determination of residual urine. Moreover it represents a simple, noninvasive method to predict the outcome of a voiding trial following acute urine retention based on intravesical prostatic protrusion and on the US pattern of the bladder content. In this article, the Authors review the implementation and results of a bladder US program developed for non-medical caregivers at one Emergency Department.

  5. Venous catheterization with ultrasound navigation

    Science.gov (United States)

    Kasatkin, A. A.; Urakov, A. L.; Nigmatullina, A. R.

    2015-11-01

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient's exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  6. Venous catheterization with ultrasound navigation

    Energy Technology Data Exchange (ETDEWEB)

    Kasatkin, A. A., E-mail: ant-kasatkin@yandex.ru; Nigmatullina, A. R. [Izhevsk State Medical Academy, Kommunarov street, 281, Izhevsk, Russia, 426034 (Russian Federation); Urakov, A. L., E-mail: ant-kasatkin@yandex.ru [Institute of Mechanics Ural Branch of Russian Academy of Sciences, T.Baramzinoy street 34, Izhevsk, Russia, 426067, Izhevsk (Russian Federation); Izhevsk State Medical Academy, Kommunarov street, 281, Izhevsk, Russia, 426034 (Russian Federation)

    2015-11-17

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient’s exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  7. Massive hydrothorax following subclavian vein catheterization

    OpenAIRE

    Omar, Hesham R.; fathy, Ahmad; Elghonemy, Mohamed; Rashad, Rania; Helal, Engy; Mangar, Devanand; Camporesi, Enrico

    2010-01-01

    Since the introduction of central venous catheterization for monitoring of the venous pressure, fluid infusion and hyperalimentation, the literature has been full of serious life-threatening complications. Of these complications is the false positioning of the central venous catheter and subsequent development of pleural effusion. In this report we are describing a case of iatrogenic massive pleural effusion following subclavian vein catheterization necessitating intercostal tube drainage and...

  8. Development of a Charge Adjustment Model for Cardiac Catheterization

    OpenAIRE

    Brennan, Andrew; Gauvreau, Kimberlee; Connor, Jean; O’Connell, Cheryl; David, Sthuthi; Almodovar, Melvin; DiNardo, James; Banka, Puja; Mayer, John E.; Marshall, Audrey C.; Bergersen, Lisa

    2014-01-01

    A methodology that would allow for comparison of charges across institutions has not been developed for catheterization in congenital heart disease. A single institution catheterization database with prospectively collected case characteristics was linked to hospital charges related and limited to an episode of care in the catheterization laboratory for fiscal years 2008–2010. Catheterization charge categories (CCC) were developed to group types of catheterization procedures using a combinati...

  9. Internal jugular versus subclavian vein catheterization for central venous catheterization in orthotopic liver transplantation.

    Science.gov (United States)

    Torgay, A; Pirat, A; Candan, S; Zeyneloglu, P; Arslan, G; Haberal, M

    2005-09-01

    The aim of this study was to compare incidence rates of mechanical and infectious complications associated with central venous catheterization via the internal jugular vein (IJV) versus the subclavian vein (SV) among 45 consecutive patients undergoing orthotopic liver transplantation (OLT) between January 2000 and June 2004. The subjects were divided into two groups according to the site of central venous catheterization (IJV or SV). We recorded each patient's physical characteristics, international normalized ratio (INR), partial thromboplastin time, platelet levels, number of puncture attempts, success/failure of central venous catheterization, duration of catheter placement, occurrence of catheter tip misplacement, arterial puncture, incidence of hematoma or pneumothorax, catheter-related infection, or bacterial colonization of the catheter. Senior staff anesthesiologists performed 22 SV and 23 IJV catheterizations for the 45 OLT procedures. The SV and IVJ groups both had minor coagulation abnormalities with slightly increased INR values at the time of catheterization. There were no significant differences between the groups with respect to success of central venous catheterization (100% for both), numbers of attempted punctures, duration of catheter placement, and incidence rates of mechanical and infectious complications. Both groups showed high frequencies of catheter tip misplacement, with right atrium as the site of misplacement in all cases. Two patients in the IJV group (8.7%) developed hematomas after accidental carotid artery puncture. The results suggest that, when performed by experienced anesthesiologists, central venous catheterization via the SV is an acceptable alternative to IJV catheterization for patients undergoing OLT.

  10. Iatrogenic intravascular pneumocephalus secondary to intravenous catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Yildiz, Altan; Oezer, Caner; Egilmez, Hulusi; Duce, Meltem Nass; Apaydin, Demir F.; Yalcinoglu, Orhan [Department of Radiology, Faculty of Medicine, Mersin University (Turkey)

    2002-03-01

    The presence of pneumocephalus without a history of intracranial or intrathecal procedures is a significant radiographic finding. Although pneumocephalus means a violation of the dural barrier or the presence of infection, intravascular pneumocephalus is different from intraparenchymal pneumocephalus and its benign nature must be known in the presence of intravenous catheterization. Herein, we present a case of iatrogenic intravascular pneumocephalus with CT findings. To our knowledge, there are only a few reported cases of iatrogenic intravascular pneumocephalus in the literature. Careful intravenous catheterization and diagnosis of the condition on imaging helps to prevent unnecessary treatment procedures. (orig.)

  11. Anaesthesia in the cardiac catheterization laboratory

    NARCIS (Netherlands)

    Braithwaite, Sue; Kluin, Jolanda; Buhre, Wolfgang F.; de Waal, Eric E. C.

    2010-01-01

    Purpose of review Interventions in the cardiac catheterization laboratory (CCL) requiring anaesthetic expertise are becoming routine. These interventions involve a heterogeneous patient population and take place in an offsite location. This review aims to give an insight into anaesthetic issues surr

  12. Bladder calculi complicating intermittent clean catheterization.

    Science.gov (United States)

    Amendola, M A; Sonda, L P; Diokno, A C; Vidyasagar, M

    1983-10-01

    Eight male patients on clean intermittent catheterization programs for neurogenic bladder dysfunction developed vesical calculi around pubic hairs inadvertently introduced into the bladder, acting as a nidus for incrustation. In three patients, the radiographic appearance of serpentine calcifications in the pelvis was highly consistent with calcareous deposits on strands of hair. Familiarity with this radiologic appearance should suggest the diagnosis in the appropriate clinical setting and help avoid misinterpretation of these calcifications, atypical of usual bladder stones.

  13. Entrapment of guidewire during central venous catheterization

    Directory of Open Access Journals (Sweden)

    Tarun S.

    2016-07-01

    Full Text Available Central venous catheterization (CVC is common in the setting of ICU for various reasons like monitoring of CVP, fluid administration and vasopressor or drug infusions. Guidewires are routinely used in the Seldinger technique during central venous catheter placement CVC placement is not innocuous as numerous complications may occur, with varying frequency and severity. [Int J Res Med Sci 2016; 4(7.000: 3080-3081

  14. [Heart catheterization in Mexico. Results of the 1996 census of heart catheterization services by the Mexican Society of Cardiology].

    Science.gov (United States)

    Gaspar H, J; Guadalajara Boo, J F; de la Llata Romero, M

    1996-01-01

    The findings of the 1996 Cardiac Catheterization Laboratory Survey of the Sociedad Mexicana de Cardiología are presented. There are 52 cardiac catheterization laboratory departments distributed in 16 cities of which Mexico City has 20, Guadalajara 6 and Monterrey 5. Ninety-six percent are in hospitals where heart surgery can be performed and 8 (17%) have a training program in cardiac catheterization. Only two (3.8%) are exclusively dedicated to pediatric cardiac catheterization. In 1995, 19,214 diagnostic procedures and 2,429 PTCAs were done. A total of 270 physicians were reported to have privileges to perform cardiac catheterization. The geographical distribution of the cath labs, procedure volumes and number of physicians performing catheterization are discussed.

  15. Current Trends in the Management of Difficult Urinary Catheterizations

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    Paul A Willette

    2012-12-01

    Full Text Available Routine urinary catheter placement may cause trauma and poses a risk of infection. Male catheterization, in particular, can be difficult, especially in patients with enlarged prostate glands or other potentially obstructive conditions in the lower urinary tract. Solutions to problematic urinary catheterization are not well known and when difficult catheterization occurs, the risk of failed catheterization and concomitant complications increase. Repeated and unsuccessful attempts at urinary catheterization induce stress and pain for the patient, injury to the urethra, potential urethral stricture requiring surgical reconstruction, and problematic subsequent catheterization. Improper insertion of catheters also can significantly increase healthcare costs due to added days of hospitalization, increased interventions, and increased complexity of follow-up evaluations. Improved techniques for catheter placement are essential for all healthcare personnel involved in the management of the patient with acute urinary retention, including attending emergency physicians who often are the first physicians to encounter such patients. Best practice methods for blind catheter placement are summarized in this review. In addition, for progressive clinical practice, an algorithm for the management of difficult urinary catheterizations that incorporates technology enabling direct visualization of the urethra during catheter insertion is presented. This algorithm will aid healthcare personnel in decision making and has the potential to improve quality of care of patients.

  16. Suprapubic compared with transurethral bladder catheterization for gynecologic surgery: a systematic review and meta-analysis.

    LENUS (Irish Health Repository)

    Healy, Eibhlín F

    2012-09-01

    Suprapubic catheterization is commonly used for postoperative bladder drainage after gynecologic procedures. However, recent studies have suggested an increased rate of complications compared with urethral catheterization. We undertook a systematic review and meta-analysis of randomized controlled trials comparing suprapubic catheterization and urethral catheterization in gynecologic populations.

  17. A novel cannulation technique for difficult urethral catheterization

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    Mehmet Kaynar

    2016-03-01

    Full Text Available Introduction: To propose a novel cannulation technique for difficult urethral catheterization procedures. Technique: The sheath tip of an intravenous catheter is cut off, replaced to the needle tip and pushed through the distal drainage side hole to Foley catheter tip, and finally withdrawn for cannulation. In situations making urethral catheterization difficult, a guide wire is placed under direct vision. The modified Foley catheter is slid successfully over the guide wire from its distal end throughout the urethral passage into the bladder. Results: The modified Foley catheter was used successfully in our clinic in cases requiring difficult urethral catheterization. Conclusions: This easy and rapid modification of a Foley catheter may minimize the potential complications of blind catheter placement in standard catheterization.

  18. Acute urinary retention and the difficult catheterization: current emergency management.

    Science.gov (United States)

    Sliwinski, Ania; D'Arcy, Frank T; Sultana, Ron; Lawrentschuk, Nathan

    2016-04-01

    Acute urinary retention (AUR) is a common presentation to emergency departments. This article updates the reader on the appropriate management, investigations and guidelines for AUR. It looks at the mechanism of normal micturition and describes the theories of AUR. It outlines urethral catheterization techniques for difficult cases, reviews suprapubic catheterization procedures and describes the management of AUR in polytrauma. Although emergency management is by bladder drainage, key points in the history and examination may expose significant, latent pathologies.

  19. Clean intermittent self-catheterization in neuro-urology.

    Science.gov (United States)

    Di Benedetto, P

    2011-12-01

    Neurogenic lower urinary tract dysfunction (NLUTD) is commonly encountered in rehabilitation settings, and is caused by a variety of pathologies. The management of spinal cord injury (SCI) has been the model of reference for the management of other pathologies with NLUTD. The introduction of intermittent catheterization (IC) led to decline in renal related mortality in SCI patients and allowed an improvement of quality of life (QoL) in all neurogenic patients with NLUTD. IC could be sterile, aseptic or clean. Sterile intermittent catheterization (SIC) is the preferred method of bladder drainage in emergency medicine units and during spinal shock in SCI patients, but it is costly and time-consuming. Catheterizations performed in institutions, such as rehabilitation hospitals and nursing homes, are done aseptically. Clean intermittent catheterization (CIC), i.e. self-catheterization (CISC) or third party catheterization, represents the "gold standard" method for bladder emptying in all neuropathic patients with NLUTD: the technique is safe and effective and results in improved kidney and upper urinary tract status, lessening of vesico-ureteral reflux and amelioration of urinary continence. CISC is mandatory in patients with NLUTD secondary to detrusor areflexia/hypocontractility and in patients suffering from neurogenic detrusor overactivity with detrusor external sphincter dyssynergia and high post void residual of urine, often in combination with antimuscarinics/bladder relaxants. The review summarizes the most important aspects of IC and CISC. Attention was focused on the history of urethral catheterization, aims, materials, advantages, indications, and present-day techniques of CISC, emphasizing the importance of teaching in order to perform correctly the catheterization technique.

  20. Paediatric cardiac catheterization: an information sheet.

    Science.gov (United States)

    Bonnet, Caroline; Greffier, Angelique

    2013-04-01

    The need to inform patients using validated scientific data is acknowledged internationally. The obligation to inform patients is based on a fundamental principle of French law: the principle of the unavailability of the human body. Before engaging in diagnostic or therapeutic strategies such as paediatric cardiac catheterization, the healthcare professional must explain the disease, the advantages and drawbacks of each treatment strategy and their foreseeable benefit/risk ratio in order to help older children and their parents come to a decision. To obtain this required consent and before the care is provided, the infant and their legal representative must have received clear, accurate and understandable information. An information sheet cannot substitute for verbal information. Guidelines for good practices on the delivery of information have been established by the Health Authorities and officially recognized in a decree from the Ministry of Health. These documents allow professionals to draft a written information document for patients and healthcare users. This document must help the patient to take part in decisions that concern them. The law of 4th March 2002 regarding the rights of patients and the quality of the healthcare system states that 'in cases of litigation, it is the responsibility of the professional or the healthcare establishment to provide proof that the information was given to the person concerned in the conditions set out in the present article. This proof can be brought by any means'.

  1. Using central venous catheter for suprapubic catheterization in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Bilehjani E

    2017-01-01

    Full Text Available Eissa Bilehjani,1 Solmaz Fakhari2 1Department of Cardiovascular Anesthesia, Tabriz University of Medical Sciences, Madani Heart Hospital, 2Department of Anesthesiology, Tabriz University of Medical Sciences, Madani Heart Hospital, Tabriz, Iran Abstract: Suprapubic catheterization is an alternative method for urinary drainage that is used when transurethral catheterization fails. Traditionally, inserted large-bore suprapubic catheters may cause fatal complications. During the past decade, we used a small central venous catheter (CVC suprapubicly in 16 male patients for the purpose of urinary drainage, when transurethral catheterization failed. The procedure is performed in no more than 10 minutes. Success rate was 100% and this approach did not lead to any complications. In conclusion, placing a CVC for suprapubic drainage is a safe method with a high success rate and we recommend it in patients with failed transurethral catheterization after a few attempts (2–3 attempts. Keywords: suprapubic catheterization complication, urethral catheterization, central venous catheter, Seldinger’s technique, cardiac surgery

  2. Cardiac catheterization in children with pulmonary hypertensive vascular disease.

    Science.gov (United States)

    Bobhate, Prashant; Guo, Long; Jain, Shreepal; Haugen, Richard; Coe, James Y; Cave, Dominic; Rutledge, Jennifer; Adatia, Ian

    2015-04-01

    The risks associated with cardiac catheterization in children with pulmonary hypertension (PH) are increased compared with adults. We reviewed retrospectively all clinical data in children with PH [mean pulmonary artery pressure (mean PAp) ≥25 mmHg and pulmonary vascular resistance index (PVRI) ≥3 Wood units m(2)] undergoing cardiac catheterization between 2009 and 2014. Our strategy included a team approach, minimal catheter manipulation and sildenafil administration prior to extubation. Adverse events occurring within 48 h were noted. Seventy-five patients (36 males), median age 4 years (0.3-17) and median weight 14.6 kg (2.6-77 kg), underwent 97 cardiac catheterizations. Diagnoses included idiopathic or heritable pulmonary arterial hypertension (PAH) (29 %), PAH associated with congenital heart disease (52 %), left heart disease (5 %) and lung disease (14 %). Mean PAp was 43 ± 19 mmHg; mean PVRI was 9.7 ± 6 Wood units m(2). There were no deaths or serious arrhythmias. No patient required cardiac massage. Three patients who suffered adverse events had suprasystemic PAp (3/3), heritable PAH (2/3), decreased right ventricular function (3/3), and pulmonary artery capacitance index <1 ml/mmHg/m(2) (3/3) and were treatment naïve (3/3). No patient undergoing follow-up cardiac catheterization suffered a complication. In 45 % of cases, the data acquired from the follow-up cardiac catheterization resulted in an alteration of therapy. Three percent of children with PH undergoing cardiac catheterization suffered adverse events. However, there were no intra or post procedural deaths and no one required cardiac massage or cardioversion. Follow-up cardiac catheterization in patients receiving pulmonary hypertensive targeted therapy is safe and provides useful information.

  3. A Forgotten Guidewire: Complication of Central Venous Catheterization

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    Funda Gümüş

    2011-08-01

    Full Text Available Central venous catheterization is an invasive procedure commonly preferred for hemodynamic monitorization, total parenteral nutrition, cardiac pacemaker implantation, long-term use of vasoactive or irritating agents and hemodialysis. We present a 19-year-old woman with acute renal failure scheduled for hemodialysis catheterization. A catheter guidewire extending from the right internal jugular vein to the right external iliac vein was detected in the chest X-ray, taken two hours following catheterization after occurrence of arrhythmia and hypotension. Catheteter guidewire was extracted noninvasively without any complications. Most common reasons for this complication are stated to be attention deficits, lack of experience, overtired staff, and inadequate supervision of trainees. In this paper, we discussed this complication’s causes and preventive methods. (Journal of the Turkish Society Intensive Care 2011; 9:64-7

  4. Indwelling versus Intermittent Urinary Catheterization following Total Joint Arthroplasty: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    Full Text Available The purpose of this study is to compare the rates of urinary tract infection (UTI and postoperative urinary retention (POUR in patients undergoing lower limb arthroplasty after either indwelling urinary catheterization or intermittent urinary catheterization.We conducted a meta-analysis of relevant randomized controlled trials (RCT to compare the rates of UTI and POUR in patients undergoing total joint arthroplasty after either indwelling urinary catheterization or intermittent urinary catheterization. A comprehensive search was carried out to identify RCTs. Study-specific risk ratios (RR with 95% confidence intervals (CI were pooled. Additionally, a meta-regression analysis, as well as a sensitivity analysis, was performed to evaluate the heterogeneity.Nine RCTs with 1771 patients were included in this meta-analysis. The results showed that there was no significant difference in the rate of UTIs between indwelling catheterization and intermittent catheterization groups (P>0.05. Moreover, indwelling catheterization reduced the risk of POUR, versus intermittent catheterization, in total joint surgery (P<0.01.Based on the results of the meta-analysis, indwelling urinary catheterization, removed 24-48 h postoperatively, was superior to intermittent catheterization in preventing POUR. Furthermore, indwelling urinary catheterization with removal 24 to 48 hours postoperatively did not increase the risk of UTI. In patients with multiple risk factors for POUR undergoing total joint arthroplasty of lower limb, the preferred option should be indwelling urinary catheterization removed 24-48 h postoperatively.Level I.

  5. Cardiac Catheterization in Thoraco-Omphalocardiopagus Twins: A Case Report

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    Minati Choudhury

    2008-01-01

    literature on the anaesthetic management of these cases is sparse. The following case report details the expert and vigilant anaesthetic management leading to successful diagnostic cardiac catheterization. The report emphasizes the importance of synchronous ventilation, teamwork and communication required in cases such as this. This case report also details the difficulties encountered and how to overcome them during the prolonged procedure.

  6. Urethral catheterization:The need for adequate undergraduate exposure

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    E.V. Ezenwa

    2017-03-01

    Conclusion: Newly recruited interns have poor practical exposure to urethral catheterization. Efforts should be made to improve the quality of supervised training given to medical undergraduates so as to avoid complications that could arise if this procedure is not properly done when they qualify.

  7. Endothelial Progenitor Cells in Peripheral Blood of Cardiac Catheterization Personnel

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    Soheir Korraa1, Tawfik M.S.1, Mohamed Maher 2 and Amr Zaher

    2014-07-01

    Full Text Available Background: The aim of the present study was to evaluate the rejuvenation capacity among cardiac catheterization technicians occupationally exposed to ionizing radiation. Subjects and methods: The individual annual collective dose information was measured by thermoluminscent personal dosimeters (TLD for those technicians and found to be ranging between 2.16 and 8.44 mSv/y. Venous blood samples were obtained from 30 cardiac catheterization technicians exposed to X-ray during fluoroscopy procedures at the National Heart Institute in Embaba. The control group involved 25 persons not exposed to ionizing radiation and not working in hospitals in addition to 20 persons not exposed to ionizing radiation and working in hospitals. Blood samples were assayed for total and differential blood counts, micronucleus formation (FMN plasma stromal derived growth factor-1α (SDF-1 α and cell phenotype of circulating endothelial progenitor cells (EPCs, whose surface markers were identified as the CD34, CD133 and kinase domain receptors (KDR. Results: SDF-1α (2650± 270 vs. 2170 ± 430 pg/ml and FMN (19.9 ± 5.5 vs. 2.8 ± 1.4/1000 cells were significantly higher among cardiac catheterization staff compared to those of the controls respectively. Similarly, EPCs: CD34 (53 ± 3.9 vs. 48 ± 8.5/105 mononuclear cells, CD133 (62.4 ± 4.8 vs. 54.2 ± 10.6 /105 mononuclear cells KDR (52.7 ± 10.6 vs.43.5± 8.2 /105 mononuclear cells were also significantly higher among cardiac catheterization staff compared to the values of controls respectively. Smoking seemed to have a positive effect on the FMN and SDF-1 but had a negative effect on EPCs. It was found that among cardiac catheterization staff, the numbers of circulating progenitor cells had increased and accordingly there was an increased capacity for tissue repair. Conclusion: In conclusion, the present work shows that occupational exposure to radiation, well within permissible levels, leaves a genetic mark on the

  8. Urinary catheterization in gynecological surgery: When should it be removed?

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    Adly N.A. Fattah

    2013-08-01

    Full Text Available Background: The aim of this study was to determine the most appropriate time for urinary catheter removal following a gynecological surgery.Methods: Critical appraisal of clinical trial articles were conducted. It was aimed to answer our clinical question whether 24-hour postoperative urinary catheter removal is superior compared to other durations in avoiding postoperative urinary retention (PUR and urinary tract infection (UTI. The search was conducted on the Cochrane Library® and PubMed® using keywords “postoperative urinary retention”, “postoperative catheterization” and “urinary retention AND catheterization”. Reference lists of relevant articles were searched for other possibly relevant trials.Results: Seven articles were available as full text, then appraisals of six prospective RCTs involving 846 women underwent hysterectomy and vaginal prolapse surgery were performed finding at the re-catheterization and UTI rate. Subjects in earlier-removal groups were 3 to 4 times more likely to have re-catheterization (OR = 3.10-4.0 compared to later-removal groups, while they who have it removed on 5th day were 14 times more likely to develop UTI compared with immediate group (OR = 14.786, 95% CI 3.187- 68.595.Conclusion: The 24-hour catheterization policy in hysterectomy and vaginal prolapse surgery remains most appropriate although associated with an increased risk of re-catheterization. The removal of catheter before 24 hour (6 or 12 hour could be considered to be used as one of interventions in further RCT(s to find out the best duration which would result in lowest incidence in both of UTI and  PUR. (Med J Indones. 2013;22:183-8. doi: 10.13181/mji.v22i3.589Keywords: Catheter, hysterectomy, prolapse, urinary tract infection

  9. Candiduria in catheterized intensive care unit patients : Emerging microbiological trends

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    Manisha Jain

    2011-01-01

    Full Text Available Objectives: Urinary tract infection (UTI as a result of Candida spp. is becoming increasingly common in hospitalized setting. Clinicians face dilemma in differentiating colonization from true infection and whether to treat candiduria or not. The objective of the present study was to look into the significance of candiduria in catheterized patients admitted in the ICUs and perform microbiological characterization of yeasts to guide treatment protocols. Materials and Methods: One hundred consecutive isolates of Candida spp. from the urine sample of 70 catheterized patients admitted in the ICU were collected and stocked for further characterization. A proforma was maintained containing demographic and clinical details. Blood cultures were obtained from all these 70 patients and processed. Species identification of yeasts was done on VITEK. Results: Candiduria was more common at extremes of age. The mean duration of catheter days was 11.1 ± 6 days. Other associated risk factors such as diabetes mellitus and antibiotic usage were seen in 38% and 100% of our study group. Concomitant candidemia was seen in 4.3% of cases. Non-albicans Candida spp. (71.4% emerged as the predominant pathogen causing nosocomial UTI. Conclusion: The present study reiterates the presence of candiduria in catheterized patients, especially in the presence of diabetes and antibiotic usage. Non-albicans Candida spp. are replacing Candida albicans as the predominant pathogen for nosocomial UTI. Hence, we believe that surveillance for nosocomial candiduria should be carried out in hospitalized patients.

  10. New puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery

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    Saltzmann, J.; Probst, P.

    1987-02-01

    Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guide-wire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced.

  11. Complication of Right Subclavian Vein Catheterization: Superior Vena Cava Perforation

    OpenAIRE

    ÇELİK, B.; KOCAMANOĞLU, S.; BÜYÜKKARABACAK, Y. B.; SARIHASAN, E.

    2013-01-01

    Central venous catheterization is an invasive approach which is routinely used in thoracic surgery operations. Pneumothorax and hemothorax are among the most frequent complications. Vena cava superior (VCS) perforation (0.5 %) is very rarely observed. A 65-year-old male patient was admitted to the hospital with the complaint of cough. With the examinations performed, he was diagnosed with epidermoid lung cancer located in the right lower lobe of the lung (Stage IB, T2N0M0). To prepare the pat...

  12. Two cases of chronic radiodermatitis caused by cardiac catheterization

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    Ishikawa, Makiko; Soh, Inketsu; Sueki, Hirohiko; Iijima, Masafumi [Showa Univ., Tokyo (Japan). School of Medicine; Hayashi, Ken; Wakugawa, Motoshi

    1999-12-01

    Coronary angiography (CAG) and percutaneous transluminal coronary angioplasty (PTCA) associated with fluoroscopy and cineradiography deliver higher radiation doses than any other conventional methods and, as a result, expose patients to ionizing radiation. We herein report two cases of radiodermatitis caused by cardiac catheterization whose irradiation dose could be retrospectively calculated. One sixty-year-old female and one sixty eight-year-old female who had suffered from myocardial infarction and angina pectoris, respectively, developed erythematous plaques on the right submammary area and the lesions were initially diagnosed to be fixed drug eruptions. The lesions of submammary area gradually showed the findings of poikiloderma and finally demonstrated ulceration, however, we could not make an accurate diagnosis at that time, due to our lack of knowledge about these radiologic examinations. The cumulative irradiation dose of these cases was calculated to be 58.5 Gy and 45.5 Gy, respectively, and both cases were finally diagnosed to have chronic radiodermatitis as a result of cardiac catheterization. (author)

  13. Prevalence of renal artery stenosis in patients undergoing cardiac catheterization.

    Science.gov (United States)

    Marcantoni, Carmelita; Carmelita, Marcantoni; Rastelli, Stefania; Stefania, Rastelli; Zanoli, Luca; Luca, Zanoli; Tripepi, Giovanni; Giovanni, Tripepi; Di Salvo, Marilena; Marilena, Di Salvo; Monaco, Sergio; Sergio, Monaco; Sgroi, Carmelo; Carmelo, Sgroi; Capodanno, Davide; Davide, Capodanno; Tamburino, Corrado; Corrado, Tamburino; Castellino, Pietro; Pietro, Castellino

    2013-08-01

    To investigate the prevalence of significant renal artery stenosis (RAS ≥50%), and to identify clinical predictors for significant RAS in patients with an elevated cardiovascular risk, such as those affected by ischemic heart disease. In patients with an elevated cardio-vascular risk, both atherosclerotic renovascular disease and coronary artery disease (CAD) are likely to occur. Prospectively from April 2007 to March 2008, all consecutive patients with ischemic heart disease undergoing non-emergent cardiac catheterization were also evaluated for atherosclerotic RAS by renal arteriography. A RAS ≥50% was considered as significant. A total of 1,298 patients underwent cardiac and renal angiography. Significant RAS was found in 70 out of 1,298 patients (5.4%). The presence of peripheral vascular disease, eGFR 66 years, dyslipidemia, CAD severity and pulse pressure >52 mmHg were independent clinical predictors of significant RAS, and jointly produced a ROC AUC of 0.79 (95% CI 0.73-0.85, P < 0.001). Based on these data, a prediction rule for significant RAS was developed, and it showed an adequate predictive performance with 64% sensitivity and 82% specificity. In a large cohort of patients undergoing coronary angiography, significant RAS is a relatively rare comorbidity (5.4%). A model based on simple clinical variables may be useful for the clinical identification of high CV risk patients who may be suitable for renal arteriography at the time of cardiac catheterization.

  14. One-day versus 3-day suprapubic catheterization after vaginal prolapse surgery : a prospective randomized trial

    NARCIS (Netherlands)

    Van der Steen, Annemarie; Detollenaere, Renee; Den Boon, Jan; Van Eijndhoven, Hugo

    2011-01-01

    For prolonged catheterization after vaginal prolapse surgery with anterior colporrhaphy, the optimal duration to prevent overdistention of the bladder remains unknown. We designed this study to determine the optimal length of catheterization. We conducted a prospective randomized trial in which 179

  15. Ultrasound-guided subclavian catheterization in pediatric patients with a linear probe: a case series

    OpenAIRE

    Park, Sang Il; Kim, Yoon Hee; So, Sang Young; Kim, Myoung Joong; Kim, Hyun Joong; Kim, Jae Kook

    2013-01-01

    Central venous catheterization (CVC) can be difficult, especially with pediatric patients in critical care. Accessing the subclavian vein (SCV) can cause serious complications, including pneumothorax, arterial puncture, and hemothorax. Recently, the ultrasonographic (USG) technique has gained popularity, but its efficiency is not yet confirmed. Subclavian venous catheterization (SCVC) through the supraclavicular approach (SCA) with USG or accessing the brachiocephalic vein through the infracl...

  16. Urinary retention and the role of indwelling catheterization following total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    P. Kumar

    2006-02-01

    Full Text Available INTRODUCTION: We aimed to investigate the rate of urinary retention after knee arthroplasty, the various factors involved in predicting those at risk for retention and to assess the impact of retention and catheterization on joint sepsis. MATERIALS AND METHODS: A retrospective review was conducted of all available case notes of patients undergoing total knee arthroplasty in a consecutive 2-year period (2000-2002. Adequate data was available for 142 patients. RESULTS: 142 patients underwent total knee arthroplasty. 19 patients were catheterized preoperatively for monitoring urine output. 123 patients were not catheterized. Urinary retention occurred in 19.7% (28/142. The mean day of catheterization for retention was 0.66. The mean duration of catheterization in patients developing retention was 3.58 days and was 3 days in the patients catheterized pre - or perioperatively. Deep joint sepsis occurred in 2.1% (3/142 - only one had been catheterized and that was preoperatively. No case of infection had urinary retention or had a symptomatic urinary tract infection. The only factors predicting those at significant risk of retention following knee arthroplasty was a past medical history of urinary retention (p = 0.049 and postoperative morphine requirement (p = 0.035. No patients required urological surgical intervention at mean follow up of 1.97 years. CONCLUSIONS: This study supports the use of indwelling urinary catheterization for patients developing urinary retention after total knee arthroplasty.

  17. The present and future of interventional catheterization for congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Over the past decade, the focus of the pediatric catheterization laboratory has changed dramatically from its primary function of providing diagnosis to offering treatment.Since Rashkind first described the technique for atrial septostomy in the setting of complete transposition of the great arteries in 1966, therapeutic catheterization techniques have replaced conventional surgery, including both corrective and palliative surgeries, for many lesions. Interventional catheterization has become an important modality in the treatment of congenital heart disease. In addition, in the staged management of complex congenital heart disease, better outcomes have been acquired by combined surgical and interventional catheterization strategies. Although great advances have been made in the therapeutic catheterization for congenital heart disease in some Chinese medical centers, there is considerable difference in both clinical applications and basic researches between China and other developed countries. Thus, it is very important to expand this advanced technique aggressively but carefully.

  18. Postoperative Urinary Catheterization Thresholds of 500 versus 800 ml after Fast-track Total Hip and Knee Arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Hornum, Ulla; Troldborg, Charlotte;

    2016-01-01

    BACKGROUND: No evidence-based threshold exists for postoperative urinary bladder catheterization. The authors hypothesized that a catheterization threshold of 800 ml was superior to 500 ml in reducing postoperative urinary catheterization and urological complications after fast-track total hip ar...

  19. Reengineering the Cardiac Catheterization Lab Processes: A Lean Approach

    Directory of Open Access Journals (Sweden)

    Venkatesh Raghavan

    2010-01-01

    Full Text Available This paper presents a cross-functional effort in a US community hospital for an overall process improvement in its Cardiac Catheterization Lab (CCL. One of the key system performance metrics identified was the patient turnaround time. The objective of this study was to identify the sources of delays in the system that lead to prolonged patient turnaround time using a structured lean approach. A set of qualitative recommendations were proposed and implemented. Quantification of some of these recommendations and certain additional ‘what-if’ scenarios were evaluated using Discrete Event Simulation (DES. The simulation results showed that significant reduction in patient turnaround time could be achieved if the proposed recommendations were implemented. This study demonstrated the benefits of adopting the lean philosophy in the continuous process improvement journey in the healthcare delivery arena.

  20. Radiation Dose Estimation for Pediatric Patients Undergoing Cardiac Catheterization

    Science.gov (United States)

    Wang, Chu

    Patients undergoing cardiac catheterization are potentially at risk of radiation-induced health effects from the interventional fluoroscopic X-ray imaging used throughout the clinical procedure. The amount of radiation exposure is highly dependent on the complexity of the procedure and the level of optimization in imaging parameters applied by the clinician. For cardiac catheterization, patient radiation dosimetry, for key organs as well as whole-body effective, is challenging due to the lack of fixed imaging protocols, unlike other common X-ray based imaging modalities. Pediatric patients are at a greater risk compared to adults due to their greater cellular radio-sensitivities as well as longer remaining life-expectancy following the radiation exposure. In terms of radiation dosimetry, they are often more challenging due to greater variation in body size, which often triggers a wider range of imaging parameters in modern imaging systems with automatic dose rate modulation. The overall objective of this dissertation was to develop a comprehensive method of radiation dose estimation for pediatric patients undergoing cardiac catheterization. In this dissertation, the research is divided into two main parts: the Physics Component and the Clinical Component. A proof-of-principle study focused on two patient age groups (Newborn and Five-year-old), one popular biplane imaging system, and the clinical practice of two pediatric cardiologists at one large academic medical center. The Physics Component includes experiments relevant to the physical measurement of patient organ dose using high-sensitivity MOSFET dosimeters placed in anthropomorphic pediatric phantoms. First, the three-dimensional angular dependence of MOSFET detectors in scatter medium under fluoroscopic irradiation was characterized. A custom-made spherical scatter phantom was used to measure response variations in three-dimensional angular orientations. The results were to be used as angular dependence

  1. Teaching practices of thoracic epidural catheterizations in different grade of anesthesia residents

    Directory of Open Access Journals (Sweden)

    Ali Alagoz

    2016-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: In this study, we aimed to clarify the importance of residency grade and other factors which influence the success of thoracic epidural catheterization in thoracotomy patients. METHODS: After the ethical committee approval, data were recorded retrospectively from the charts of 415 patients. All patients had given written informed consent. The thoracic epidural catheterization attempts were divided into two groups as second-third year (Group I and fourth year (Group II according to residency grade. We retrospectively collected demographic data, characteristics of thoracic epidural catheterization attempts, and all difficulties and complications during thoracic epidural catheterization. RESULTS: Overall success rate of thoracic epidural catheterization was similar between the groups. Levels of catheter placement, number and duration of thoracic epidural catheterization attempts were not different between the groups (p > 0.05. Change of needle insertion level was statistically higher in Group II (p = 0.008, whereas paresthesia was significantly higher in Group I (p = 0.007. Dural puncture and postdural puncture headache rates were higher in Group I. Higher body mass index and level of the insertion site were significant factors for thoracic epidural catheterization failure and postoperative complication rate and those were independence from residents' experience (p < 0.001, 0.005. CONCLUSION: Body mass index and level of insertion site were significant on thoracic epidural catheterization failure and postoperative complication rate. We think that residents' grade is not a significant factor in terms overall success rate of thoracic epidural catheterization, but it is important for outcome of these procedures.

  2. Association Between Endovascular Performance in a Simulated Setting and in the Catheterization Laboratory

    DEFF Research Database (Denmark)

    Räder, Sune B E W; Abildgaard, Ulrik; Jørgensen, Erik;

    2014-01-01

    INTRODUCTION: Simulation-based assessment studies have related simulator performance to clinical experience instead of actual clinical performance. This study validates a novel rating scale for coronary angiography (CA) performance and at the same time explores the association between CA...... in the catheterization laboratory. The correlation between operators' previous clinical experience in CA and CARS scores was R = 0.65 (P = 0.005) in the catheterization laboratory and R = 0.11 (P = 0.353) in the simulated setting. CONCLUSIONS: The association between CA performance in a simulated setting and actual...... performance in a simulated setting and in the catheterization laboratory. METHODS: Ten cardiologists and cardiology residents with varying degrees of CA experience performed 2 CAs in the catheterization laboratory and 2 CAs in a simulated setting. The residents had prior simulator experience opposite...

  3. Predicting patient volume in cardiac catheterization laboratory to improve resource management.

    Science.gov (United States)

    Liu, Jianhua; Santangelo, Jennifer; James, Randy; Watters, Coyt D; Orsini, Anthony; Mekhjian, Hagop; Kamal, Jyoti

    2008-11-06

    Using historical data within the Information Warehouse of the Ohio State University Medical Center, prediction on daily patient volume to catheterization laboratory was attempted to facilitate resource management and planning.

  4. Antibiotic Prophylaxis for Urinary Tract Infections in Children With Spina Bifida on Intermittent Catheterization

    NARCIS (Netherlands)

    Zegers, Bas; Uiterwaal, Cuno; Kimpen, Jan; van Gool, Jan; de Jong, Tom; Winkler-Seinstra, Pauline; Houterman, Saskia; Verpoorten, Carla; van Steenwijk, Catharine de Jong-de Vos

    2011-01-01

    Purpose: Antibiotic prophylaxis (low dose chemoprophylaxis) has been prescribed since the introduction of clean intermittent catheterization in children with spina bifida. We hypothesized that stopping low dose chemoprophylaxis does not increase the number of urinary tract infections in these patien

  5. Right Cardiac Catheterization Using the Antecubital Fossa Vein in Korean Patients

    Science.gov (United States)

    Lee, Sang Hyun; Lee, Dae Sung; Lee, Soo Yong; Hwang, Jongmin; Chon, Min Ku; Hwang, Ki Won; Kim, Jeong Su; Park, Yong Huyn; Kim, June Hong

    2016-01-01

    Background and Objectives Right heart catheterization is traditionally performed using a femoral vein approach that involves admission, bed rest, and risks of bleeding and hematoma. Recent studies have confirmed safety of the use of forearm vein for right cardiac catheterization. In the present study, we evaluated the feasibility of right cardiac catheterization via the antecubital fossa vein in Korean patients. Subjects and Methods The medical records of all patients who underwent right heart catheterization at our hospital between January 2003 and December 2014 were reviewed retrospectively. Right cardiac catheterizations via the antecubital fossa vein and the femoral vein were compared in terms of demographic data (age, sex, weight, height, and body mass index), indications for right cardiac catheterization, and procedural and outcome data (initial success rate, procedure time, compression to ambulation time, and complications). Results We reviewed 132 cases (antecubital fossa vein approach, n=37; femoral vein approach, n=95). The demographic data, initial success rate (100% vs. 100%) and procedure time (21.6±16.8 min vs. 25.6±12.6 min, p=0.14) were similar in both groups. The antecubital fossa vein group had a shorter mean compression to ambulation time than the femoral vein group (0.0 min vs. 201.2±48.1 min, p<0.01). No complications were observed in either group. Conclusion Our study indicated the ease of performance of right cardiac catheterization via the antecubital fossa vein. Thus, the antecubital fossa vein can be an alternative access site for right cardiac catheterization in Korean patients. PMID:27014351

  6. Bilateral hydrothorax and cardiac tamponade after right subclavian vein catheterization -A case report-

    OpenAIRE

    Kim, Myoung Hwa; Lee, Dong-Jun; Kim, Mun Chul

    2010-01-01

    Central venous catheterization is typically used for the anesthetic management of patients undergoing a major surgery or care of patients in Intensive Care Unit (ICU). The occurrence of complications associated with central venous catheterization such as pneumothorax or vascular injury have decreased, while delayed complications such as hydrothorax, hydromediastinum, or cardiac tamponade have risen recently. We report a case of complications of bilateral hydrothorax with cardiac tamponade by ...

  7. Radiation Dose Reduction during Radial Cardiac Catheterization: Evaluation of a Dedicated Radial Angiography Absorption Shielding Drape

    OpenAIRE

    Andrew Ertel; Jeffrey Nadelson; Adhir R. Shroff; Ranya Sweis; Dean Ferrera; Vidovich, Mladen I.

    2012-01-01

    Objectives. Radiation scatter protection shield drapes have been designed with the goal of decreasing radiation dose to the operators during transfemoral catheterization. We sought to investigate the impact on operator radiation exposure of various shielding drapes specifically designed for the radial approach. Background. Radial access for cardiac catheterization has increased due to improved patient comfort and decreased bleeding complications. There are concerns for increased radiation exp...

  8. Development of Needle Insertion Manipulator for Central Venous Catheterization

    Science.gov (United States)

    Kobayashi, Yo; Hong, Jaesung; Hamano, Ryutaro; Hashizume, Makoto; Okada, Kaoru; Fujie, Masakatsu G.

    Central venous catheterization is a procedure, which a doctor insert a catheter into the patient’s vein for transfusion. Since there are risks of bleeding from arterial puncture or pneumothorax from pleural puncture. Physicians are strictly required to make needle reach up into the vein and to stop the needle in the middle of vein. We proposed a robot system for assisting the venous puncture, which can relieve the difficulties in conventional procedure, and the risks of complication. This paper reports the design structuring and experimental results of needle insertion manipulator. First, we investigated the relationship between insertion force and angle into the vein. The results indicated that the judgment of perforation using the reaction force is possible in case where the needling angle is from 10 to 20 degree. The experiment to evaluate accuracy of the robot also revealed that it has beyond 0.5 mm accuracy. We also evaluated the positioning accuracy in the ultrasound images. The results displays that the accuracy is beyond 1.0 mm and it has enough for venous puncture. We also carried out the venous puncture experiment to the phantom and confirm our manipulator realized to make needle reach up into the vein.

  9. [Central venous catheterization complication by a guide wire].

    Science.gov (United States)

    Araki, Yoshiyuki; Fukuda, Isao; Hirano, Masato; Matsuoka, Nobuhiro; Kazama, Tomiei

    2009-03-01

    Central venous catheterization using the Seldinger technique is a well known and often used method. On the other hand, there are also well known complications by needle puncture or by indwelling catheter, there are few reports about a guide wire which got hung up around the tricuspid valve. We report a case in which a guide wire got hung up to the chordae tendineae of the tricuspid valve. To insert the AVA 3Xi (Edwards life science Co. Iervine) from the right internal jugular vein, we inserted a guide wire without ease. Resistance appeared when we tried to remove the wire for 20 cm from the inserted state. The X-ray and the transesophageal echocardiography, showed the guide wire in the right ventricle. As actions to be taken, we advanced the central vein catheter of the EXCV catheter kit (Nippon Sherwood Medical Industries Co., Ltd.) to the tip, and a the guide wire was easily removed. There are many reports of the complication by the central venepuncture, but there are few reports about the guide wire which was entrapped in the vicinity of a tricuspid valve. The tip of the guide wire in this case was bent excessively, but the cause of the damage did not become clear by investigation. When a guide wire became hard to withdraw, we should never withdraw a guide wire blindly, but should search a cause and we should use the material which was matched with the cause.

  10. Ultrasound-guided central venous catheterization in prone position

    Directory of Open Access Journals (Sweden)

    Sofi Khalid

    2010-01-01

    Full Text Available Central venous catheterization (CVC is a commonly performed intraoperative procedure. Traditionally, CVC placement is performed blindly using anatomic landmarks as a guide to vessel position. Real-time ultrasound provides the operator the benefit of visualizing the target vein and the surrounding anatomic structures prior to and during the catheter insertion, thereby minimizing complications and increasing speed of placement. A 22-year-old male underwent open reduction and internal fixation of acetabulum fracture in prone position. Excessive continuous bleeding intraoperatively warranted placement of CVC in right internal jugular vein (IJV, which was not possible in prone position without the help of ultrasound. Best view of right IJV was obtained and CVC was placed using real-time ultrasound without complications. Ultrasound-guided CVC placement can be done in atypical patient positions where traditional anatomic landmark technique has no role. Use of ultrasound not only increases the speed of placement but also reduces complications known with the traditional blind technique.

  11. Intravesical oxybutinin chloride in children with intermittent catheterization: sonographic findings.

    Science.gov (United States)

    Zerin, J M; DiPietro, M A; Ritchey, M L; Bloom, D A

    1994-01-01

    The sonographic findings in the bladder are presented in four children with myelomeningocele and neurogenic dysfunction of the bladder, who were treated with intermittent self-catheterization and intravesical oxybutinin chloride. All were referred for routine sonography of the urinary tract. Each had infused a crushed tablet of oxybutinin chloride intravesically 30-120 min before the examination. In two children, brightly echogenic, non-shadowing particles were suspended in the bladder urine. In one of these, the particles swirled giving the impression of a "snowstorm"; in the other, most of the particles gradually settled forming an irregular clump on the bladder base. In the remaining two children, the urine appeared diffusely hazy with innumerable tiny particles giving the impression of a fine mist filling the bladder. The sonographic appearance of the urine in the bladder after intravesical instillation of crushed tablets can be dramatic and can simulate pus, blood, fungus, or other debris in the bladder lumen. In the absence of clinical symptoms or hematuria, a history of recent infusion of medication into the bladder should be sought.

  12. Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment

    Science.gov (United States)

    Rousseau, Matthieu; Goh, H.M. Sharon; Holec, Sarah; Albert, Matthew L.; Williams, Rohan B.H.; Ingersoll, Molly A.; Kline, Kimberly A.

    2016-01-01

    Catheter-associated urinary tract infections (CAUTI) are the most common hospital-associated infections. Here, we report that bladder catheterization initiated a persistent sterile inflammatory reaction within minutes of catheter implantation. Catheterization resulted in increased expression of genes associated with defense responses and cellular migration, with ensuing rapid and sustained innate immune cell infiltration into the bladder. Catheterization also resulted in hypersensitivity to Enterococcus faecalis and uropathogenic Escherichia coli (UPEC) infection, in which colonization was achieved using an inoculum 100-fold lower than the ID90 for infection of an undamaged urothelium with the same uropathogens. As the time of catheterization increased, however, colonization by the Gram-positive uropathogen E. faecalis was reduced, whereas catheterization created a sustained window of vulnerability to infection for Gram-negative UPEC over time. As CAUTI contributes to poorer patient outcomes and increased health care expenditures, we tested whether a single prophylactic antibiotic treatment, concurrent with catheterization, would prevent infection. We observed that antibiotic treatment protected against UPEC and E. faecalis bladder and catheter colonization as late as 6 hours after implantation. Thus, our study has revealed a simple, safe, and immediately employable intervention, with the potential to decrease one of the most costly hospital-incurred infections, thereby improving patient and health care economic outcome. PMID:27699248

  13. Pharmacotherapy in the cardiac catheterization laboratory: evolution and recent developments

    Directory of Open Access Journals (Sweden)

    Thind GS

    2014-10-01

    Full Text Available Guramrinder S Thind,1 Raunak Parida,1 Nishant Gupta2 1SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India; 2University of Texas at Houston, Houston, TX, USAAbstract: Many recent innovations have been made in developing new antiplatelet and ­anticoagulant drugs in the last few years, with a total of nine new antithrombotic drugs approved by the Food and Drug Administration after the year 2000. This has revolutionized the medical therapy given to manage acute coronary syndrome and support cardiac catheterization. The concept of dual antiplatelet therapy has been emphasized, and clopidogrel has emerged as the most-popular second antiplatelet drug after aspirin. Newer P2Y12 inhibitors like prasugrel and ticagrelor have been extensively studied and compared to clopidogrel. The role of glycoprotein (Gp IIb/IIIa inhibitors is being redefined. Other alternatives to unfractionated heparin have become available, of which enoxaparin and bivalirudin have been studied the most. Apart from these, many more drugs with novel therapeutic targets are being studied and are currently under development. In this review, current evidence on these drugs is presented and analyzed in a way that would facilitate decision making for the clinician. For this analysis, various high-impact clinical trials, pharmacological studies, meta-analyses, and reviews were accessed through the MEDLINE database. Adopting a unique interdisciplinary approach, an attempt has been made to integrate pharmacological and clinical evidence to better understand and appreciate the pros and cons of each of these classes of drugs. Keywords: acute coronary syndrome, anticoagulants, antiplatelets, percutaneous coronary intervention

  14. A Prospective, Randomized, Crossover, Multicenter Study Comparing Quality of Life Using Compact versus Standard Catheters for Intermittent Self-Catheterization

    DEFF Research Database (Denmark)

    Chartier-Kastler, Emmanuel; Amarenco, Gérard; Lindbo, Lena

    2013-01-01

    Intermittent catheterization is the recommended standard treatment for neurogenic bladder dysfunction. However, standard intermittent catheters can be unwieldy, difficult to use and carry discreetly. This can influence patient ability to perform catheterization efficiently, discreetly and private......, therefore, affecting patient quality of life. We evaluated whether the discreet design of the compact catheter would improve quality of life in intermittent catheterization users compared with standard catheters....

  15. [Injuries of the pleural cupula and lung apex during catheterization of the subclavian vein, and their prevention].

    Science.gov (United States)

    Barskiĭ, A V; Makharadze, N L

    1983-03-01

    In the clinic 1442 catheterizations were performed, 1156 of them being catheterizations of the subclavian vein. Dangerous complications such as punctures of the posterior wall of the subclavian vein in combination with injuries of the pleura cupola and apex pulmonis were observed three times. Hemo-, hydro- and pneumothorax accompanying these complications in different combinations are contraindications to repeated puncture and catheterization of the subclavian vein both in the left and in the right. Recommendations are given to reduced possible complications.

  16. Urinary Tract Infections Due to Catheterization and Drug Resistance Patterns of Isolated Bacteria

    Directory of Open Access Journals (Sweden)

    M. Mosavian

    2004-07-01

    Full Text Available UTI is the most common infection in all ages and urinary catheters especially long-term catheterization are important predisposing factors of UTI. Urinary catheters are used in different hospital wards as a complementary curative method for the patients who are undergone various surgical procedures, such as : cesarean, hysterectomy , laparotomy, etc and they who are unable to control their voided urine . 226 urine specimens were collected from 119 catheterized patients which had been hospitalized in seven wards of Razi and Golestan hospitals in Ahwas city . At least two urine specimens were collected from each patient , before and after the insertion of the catheter . All of the specimens were inoculated to suitable Media, after transportation to the Microbiology Lab . Isolated colonies were identified and their resistance patterns were determined by the standard disk diffusion method (Kirby –Bauer procedure to 8 different antibiotics. 38 cases (43.6% out of 87 patients showed Bacteriuria in the end of catheterization . They had no bacteriuria symptoms or sign before the catheterization. The most cases(28.9% of bacteriuria occured in 30-39 years group and the lowest cases (2.6 % of them occured in 60-69 years group. Out of 50 bacterial strains isolated from urine cultures , E.coil (with 17 cases was the highest (34% and Staphylococcus aureus , Klebsiella pneumoniae , Edwardsiella tarda , Enterobacter sakazakii (with 2% for each were the lowest cases. E.coli, Enterobacter and Kl. rhinoscleromatis , showed the most resistance to Ampicillin, Penicillin , Cephalexin , and the lowest rate to Nalidixic acid, Gentamicin and Nitrofurantoin . Staphylococcus epidermidis isolates ,also,showed the most resistance (100% to Penicillin and Ampicillin , and the lowest rate to Gentamicin (with 66.7%, Cotrimoxazol and Nitrofurantoin (with 50% .The results of this study suggested that catheterization , especially long- term catheterization causes the rise of

  17. Permanent catheterization of the carotid artery induces kidney infection and inflammation in the rat

    DEFF Research Database (Denmark)

    Fonseca, Uno Nicolas Kjærup; Nielsen, Sanne Gram; Hau, Jann

    2010-01-01

    Catheterization of the carotid artery and the jugular vein is one of the most commonly applied techniques used to gain intravascular access in pharmacology studies on rodents. We catheterized 10 rats by conventional clean techniques, 10 rats by aseptic techniques and 10 rats by conventional clean...... techniques using a heparin-coated catheter rather than an ordinary non-coated polyvinyl chloride catheter. In all groups, approximately 80% of the rats developed kidney infection and 10-30% of the rats were septicaemic. Clinical chemistry did not indicate severe kidney damage, but serum haptoglobin and body...

  18. Chronic impairment of leg muscle blood flow following cardiac catheterization in childhood. [/sup 133/Xe clearance measurements

    Energy Technology Data Exchange (ETDEWEB)

    Skovranek, J.; Samanek, M.

    1979-01-01

    In 99 patients with congenital heart defects or chronic respiratory disease without clinical symptoms of disturbances in peripheral circulation, resting and maximal blood flow in the anterior tibial muscle of both extremities were investigated 2.7 yrs (average) after cardiac catheterization. The method used involved /sup 133/Xe clearance. Resting blood flow was normal and no difference could be demonstrated between the extremity originally used for catheterization and the contralateral control extremity. No disturbance in maximal blood flow could be proved in the extremity used for catheterization by the venous route only. Maximal blood flow was significantly lower in that extremity where the femoral artery had been catheterized or cannulated for pressure measurement and blood sampling. The disturbance in maximal flow was shown regardless of whether the arterial catheterization involved the Seldinger percutaneous technique, arteriotomy, or mere cannulation of the femoral artery. The values in the involved extremity did not differ significantly from the values in a healthy population.

  19. Urinary catheterization diary – A useful tool in tracking causes of non-deflating Foley catheter

    Directory of Open Access Journals (Sweden)

    C.O. Okorie

    2015-06-01

    Conclusions: Most urinary catheters marketed in developing countries are unidentifiable after unpacking. A catheterization diary is a useful tool for solving catheter-related problems, and its application in health-care facilities should be encouraged. Companies marketing Foley catheters should print the catheter name on both the catheter packaging and on the catheter itself.

  20. Subclavian artery pseudoaneurysm: a rare and serious complication of central venous catheterization in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Koklu, Esad; Poyrazoglu, Hakan [Erciyes University School Medicine, Department of Paediatrics, Division of Paediatric Intensive Care Unit, Kayseri (Turkey); Yikilmaz, Ali [Erciyes University, Department of Radiology, Kayseri (Turkey); Canpolat, Mehmet; Konuskan, Bahadir [Erciyes University, Department of Paediatrics, Kayseri (Turkey)

    2008-02-15

    Serious complications of central venous access occur in 0.4-9.9% of patients undergoing attempted central venepuncture. We report an unusual case of an 18-month-old infant in whom a right subclavian artery pseudoaneurysm developed rapidly after attempted subclavian vein catheterization without US guidance failed. (orig.)

  1. [Transradial percutaneous approach for cardiac catheterization in patients with previous brachial artery cutdown].

    Science.gov (United States)

    Magariños, Eduardo; Solioz, Germán; Cermesoni, Gabriel; Koretzky, Martín; Carnevalini, Mariana; González, Daniel

    2013-01-01

    The percutaneous punction of the radial artery for catheterization procedures has gained acceptance lately. This was a consequence of achieving results similar to the femoral approach, with the benefits of a lower rate of complications and increased comfort for the patients post procedure. Recently it has gained an additional impulse with the better prognosis obtained in acute coronary syndromes. In this trial we have evaluated if the feasibility, results and advantages related with the use of the radial artery percutaneous approach to perform catheterization procedures, continues when used in patients who have had a previous brachial artery cutdown. Out of a total of 1356 percutaneous radial accesses, 53 were in patients with previous brachial artery cutdown. Through this access 71 catheterization procedures were performed, achieving access success in 96.2% (51/53) of the punctions. Once the access success was obtained, 93.6% (44/47) of the diagnostic procedures and 100% (24/24) of the therapeutics procedures were successful. During hospitalization, in this group of patients, no major adverse cardiac events occurred and there was a 1.4% (1/71) rate of minor events. At seven days follow up, no new complications were recorded. Although this is a small group, we believe that it is enough to show that percutaneous punctions of the radial artery to perform catheterization procedures, in patients with previous brachial artery cutdown, are feasible, allowing high access and procedure success rates, with a low frequency of complications.

  2. Adipose tissue metabolism in humans determined by vein catheterization and microdialysis techniques

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Madsen, J

    1994-01-01

    glucose load. In addition a technique using microdialysis for measurement of tissue oxygen and carbon dioxide tensions is described. Microdialysis and vein catheterization were performed in the same region on the abdomen, and the subcutaneous adipose tissue blood flow was measured by the local 133Xe...

  3. Adipose tissue metabolism in humans determined by vein catheterization and microdialysis techniques

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Madsen, J

    1994-01-01

    A technique for catheterization of a vein draining abdominal subcutaneous tissue and a microdialysis technique that allows measurements of intercellular water concentrations in adipose tissue in humans have recently been described. In the present study, we compare the two techniques during an ora...... assumptions on which calculations of venous concentrations from microdialysis data are based. Advantages and disadvantages of the two techniques are discussed....

  4. Escherichia coli Isolates Causing Asymptomatic Bacteriuria in Catheterized and Noncatheterized Individuals Possess Similar Virulence Properties

    DEFF Research Database (Denmark)

    Watts, Rebecca E; Hancock, Viktoria; Ong, Cheryl-lynn Y

    2010-01-01

    Urinary tract infections (UTIs) are among the most common infectious diseases of humans, with Escherichia coli being responsible for >80% of all cases. Asymptomatic bacteriuria (ABU) occurs when bacteria colonize the urinary tract without causing clinical symptoms and can affect both catheterized...

  5. Phenolic Acids from Wheat Show Different Absorption Profiles in Plasma: A Model Experiment with Catheterized Pigs

    DEFF Research Database (Denmark)

    Nørskov, Natalja; Hedemann, Mette Skou; Theil, Peter Kappel;

    2013-01-01

    The concentration and absorption of the nine phenolic acids of wheat were measured in a model experiment with catheterized pigs fed whole grain wheat and wheat aleurone diets. Six pigs in a repeated crossover design were fitted with catheters in the portal vein and mesenteric artery to study the ...

  6. [Thrombosis of the right atrium after umbilical venous catheterization. Favourable outcome after early thrombectomy].

    Science.gov (United States)

    Paupe, A; Lenclen, R; Blanc, P; Chassevent, J; Hoenn, E; Molho, M; Zannier, D; Olivier-Martin, M

    1992-02-01

    A case of right atrial thrombosis after venous umbilical catheterization in a 21 day-old premature newborn is reported. The initiating factors of such an accident and its clinical signs are evocated. The authors emphasize the value of a systematic ultrasonographic supervision of newborns with central catheters for a long period of time and the value of surgical thrombectomy.

  7. A within-subjects comparison of learning and memory performance before and after cardiac catheterization.

    NARCIS (Netherlands)

    Verwey, B.; Derikx, R.L.; Waarde, J.A. van; Essink, G.; Rooij, I.A.L.M. van; Zitman, F.G.

    2007-01-01

    OBJECTIVE: To investigate the influence of stress on the recall of neutral information in a clinical setting, a prospective study was performed on patients who were admitted to the hospital for cardiac catheterization. METHODS: During their hospital stay, 39 cardiac patients were tested for verbal r

  8. Acute kidney injury after using contrast during cardiac catheterization in children with heart disease.

    Science.gov (United States)

    Hwang, Young Ju; Hyun, Myung Chul; Choi, Bong Seok; Chun, So Young; Cho, Min Hyun

    2014-08-01

    Acute kidney injury (AKI) is closely associated with the mortality of hospitalized patients and long-term development of chronic kidney disease, especially in children. The purpose of our study was to assess the evidence of contrast-induced AKI after cardiac catheterization in children with heart disease and evaluate the clinical usefulness of candidate biomarkers in AKI. A total of 26 children undergoing cardiac catheterization due to various heart diseases were selected and urine and blood samples were taken at 0 hr, 6 hr, 24 hr, and 48 hr after cardiac catheterization. Until 48 hr after cardiac catheterization, there was no significant increase in serum creatinine level in all patients. Unlike urine kidney injury molecule-1, IL-18 and neutrophil gelatinase-associated lipocalin, urine liver-type fatty acid-binding protein (L-FABP) level showed biphasic pattern and the significant difference in the levels of urine L-FABP between 24 and 48 hr. We suggest that urine L-FABP can be one of the useful biomarkers to detect subclinical AKI developed by the contrast before cardiac surgery.

  9. Radiation Dose Reduction during Radial Cardiac Catheterization: Evaluation of a Dedicated Radial Angiography Absorption Shielding Drape.

    Science.gov (United States)

    Ertel, Andrew; Nadelson, Jeffrey; Shroff, Adhir R; Sweis, Ranya; Ferrera, Dean; Vidovich, Mladen I

    2012-01-01

    Objectives. Radiation scatter protection shield drapes have been designed with the goal of decreasing radiation dose to the operators during transfemoral catheterization. We sought to investigate the impact on operator radiation exposure of various shielding drapes specifically designed for the radial approach. Background. Radial access for cardiac catheterization has increased due to improved patient comfort and decreased bleeding complications. There are concerns for increased radiation exposure to patients and operators. Methods. Radiation doses to a simulated operator were measured with a RadCal Dosimeter in the cardiac catheterization laboratory. The mock patient was a 97.5 kg fission product phantom. Three lead-free drape designs were studied. The drapes were placed just proximal to the right wrist and extended medially to phantom's trunk. Simulated diagnostic coronary angiography included 6 minutes of fluoroscopy time and 32 seconds of cineangiography time at 4 standard angulated views (8 s each), both 15 frames/s. ANOVA with Bonferroni correction was used for statistical analysis. Results. All drape designs led to substantial reductions in operator radiation exposure compared to control (P radiation exposure (72%) was with the L-shaped design. Conclusions. Dedicated radial shielding drapes decrease radiation exposure to the operator by up to 72% during simulated cardiac catheterization.

  10. Teaching children clean intermittent self-catheterization (CISC) in a group setting.

    NARCIS (Netherlands)

    Cobussen-Boekhorst, H.J.; Kuppenveld, J. van; Verheij, P.P.; Jong, L.W.A.M. de; Gier, R.P.E. de; Kortmann, B.B.M.; Feitz, W.F.J.

    2010-01-01

    OBJECTIVE: To teach children to perform clean intermittent self-catheterization (CISC) at our institution, the nurse practitioner uses a step-by-step approach in combination with an instruction model in an outpatient setting. For a small group of children the procedure remains difficult to learn. Fo

  11. Ketofol versus sevoflurane for maintenance of aesthesia in paediatric cardiac catheterization: A prospec

    Directory of Open Access Journals (Sweden)

    Shahira El Metainy

    2016-07-01

    Conclusions: Both propofol–ketamine and sevoflurane provided effective sedation and analgesia during pediatric cardiac catheterization. But propofol–ketamine combination was superior to sevoflurane because the incidence of agitation, nausea and vomiting in patients given sevoflurane was significantly higher than in ketofol group.

  12. Prevention of urethral stricture recurrence using clean intermittent self-catheterization

    DEFF Research Database (Denmark)

    Kjaergaard, B; Walter, S; Bartholin, J;

    1994-01-01

    OBJECTIVE: To investigate the effect of clean intermittent catheterization (CIC) on prevention of urethral stricture recurrence after internal urethrotomy. PATIENTS AND METHODS: Of 55 men who were randomly selected, 43 completed the investigation. Of these, 21 patients performed CIC weekly for 1...

  13. Increasing accuracy and decreasing latency during clean intermittent self-catheterization procedures with young children.

    OpenAIRE

    McComas, J J; Lalli, J S; Benavides, C.

    1999-01-01

    We examined the effects of simulation training on performance of clean intermittent self-catheterization procedures with 2 young girls. Simulation training was conducted, after which independent performance was assessed within a multiple baseline design. The training resulted in increased accuracy and decreased latency for both girls.

  14. Correlations Between Echocardiographic Systolic and Diastolic Function with Cardiac Catheterization in Biventricular Congenital Heart Patients.

    Science.gov (United States)

    Nadorlik, H; Stiver, C; Khan, S; Miao, Y; Holzer, R; Cheatham, J P; Cua, C L

    2016-04-01

    Newer echocardiographic techniques may allow for more accurate assessment of left ventricular (LV) function. Adult studies have correlated these echocardiographic measurements with invasive data, but minimal data exist in the pediatric congenital heart population. Purpose of this study was to evaluate which echocardiographic measurements correlated best with LV systolic and diastolic catheterization parameters. Patients with two-ventricle physiology who underwent simultaneous echocardiogram and cardiac catheterization were included. Images were obtained in the four-chamber view. LV systolic echocardiographic data included ejection fraction, displacement, tissue Doppler imaging (TDI) s' wave, global longitudinal strain, and strain rate (SR) s' wave. Diastolic echocardiographic data included mitral E and A waves, TDI e' and a' waves, and SRe' and SRa' waves. E/TDI e', TDI e'/TDI a', E/SRe', and SRe'/SRa' ratios were also calculated. Catheterization dP/dt was used as a marker for systolic function, and LV end-diastolic pressure (EDP) was used as a marker for diastolic function. Correlations of the echocardiographic and catheterization values were performed using Pearson correlation. Twenty-nine patients were included (14 females, 15 males). Median age at catheterization was 3.4 years (0.04-17.4 years). dP/dt was 1258 ± 353 mmHg/s, and LVEDP was 10.8 ± 2.4 mmHg. There were no significant correlations between catheterization dP/dt and systolic echocardiographic parameters. LVEDP correlated significantly with SRe' (r = -0.4, p = 0.03), SRa' (r = -0.4, p = 0.03), and E/SRe' (r = 0.5, p = 0.004). In pediatric congenital heart patients, catheterization dP/dt did not correlate with echocardiographic measurements of LV systolic function. Further studies are needed to determine which echocardiographic parameter best describes LV systolic function in this population. Strain rate analysis significantly correlated with LVEDP. Strain rate analysis should be considered as an

  15. A multi-region assessment of population rates of cardiac catheterization and yield of high-risk coronary artery disease

    Directory of Open Access Journals (Sweden)

    Clement Fiona M

    2011-11-01

    Full Text Available Abstract Background There is variation in cardiac catheterization utilization across jurisdictions. Previous work from Alberta, Canada, showed no evidence of a plateau in the yield of high-risk disease at cardiac catheterization rates as high as 600 per 100,000 population suggesting that the optimal rate is higher. This work aims 1 To determine if a previously demonstrated linear relationship between the yield of high-risk coronary disease and cardiac catheterization rates persists with contemporary data and 2 to explore whether the linear relationship exists in other jurisdictions. Methods Detailed clinical information on all patients undergoing cardiac catheterization in 3 Canadian provinces was available through the Alberta Provincial Project for Outcomes Assessment in Coronary Heart (APPROACH disease and partner initiatives in British Columbia and Nova Scotia. Population rates of catheterization and high-risk coronary disease detection for each health region in these three provinces, and age-adjusted rates produced using direct standardization. A mixed effects regression analysis was performed to assess the relationship between catheterization rate and high-risk coronary disease detection. Results In the contemporary Alberta data, we found a linear relationship between the population catheterization rate and the high-risk yield. Although the yield was slightly less in time period 2 (2002-2006 than in time period 1(1995-2001, there was no statistical evidence of a plateau. The linear relationship between catheterization rate and high-risk yield was similarly demonstrated in British Columbia and Nova Scotia and appears to extend, without a plateau in yield, to rates over 800 procedures per 100,000 population. Conclusions Our study demonstrates a consistent finding, over time and across jurisdictions, of linearly increasing detection of high-risk CAD as population rates of cardiac catheterization increase. This internationally-relevant finding

  16. To reduce catheter-related bloodstream infections: is the subclavian route better than the jugular route for central venous catheterization?

    Science.gov (United States)

    Nagashima, Goro; Kikuchi, Toshiki; Tsuyuzaki, Hitomi; Kawano, Rumiko; Tanaka, Hiroyuki; Nemoto, Hiroshi; Taguchi, Kazumi; Ugajin, Kazuhisa

    2006-12-01

    The most important targets of hospital-acquired infection control are to reduce the incidence of surgical-site, catheter-related, and ventilator-associated infections. In this report, we address previously presented infection-control strategies for central venous (CV) line catheterization, using a CV catheter-related infection surveillance system. Data concerning CV catheter insertion were collected from all facilities in our 650-bed hospital, excluding the operating and hemodialysis wards. Collected data included the insertion method, purpose, length of catheter inserted, duration of catheterization, infection rate, and complication rate. Catheter-related infection was diagnosed based on bacteriological examinations from blood cultures. The total number of catheterizations was 806 a year, and average duration of catheterization was 9.8 days. The purpose of catheterization was nutritional support in 210 cases, hemodialysis in 96 cases, cardiac support in 174 cases, and other treatments in 260 cases. In 66 cases, the purpose of CV catheter was not specified. The rate of positive cultures was 7.1%, and complications other than infection occurred in 0.5%. The main causative organisms were methicillin-resistant Staphylococcus aureus (MRSA) in 38.6%, coagulase-negative Staphylococcus epidermidis (CNS) in 33.3%, and S. aureus in 12.3% of infections. Infection rates were 3.8 per 1000 catheter-days in subclavian, 6.1 in jugular, and 15.7 in femoral vein catheterization. In high-risk departments (intensive care unit [ICU] and emergency departments) the infection rate was 5.4 for subclavian and 10.2 for jugular catheterization, whereas it was 3.6 for subclavian and 4.6 for jugular catheterization in noncritical-care departments. Considering complications such as pneumothorax, CV catheterization of the jugular vein is recommended in certain situations.

  17. Clinical feasibility and safety of a novel miniature mobile cardiac catheterization laboratory in diagnosis and treatment for coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Liang Ming; Han Yaling; Wang Geng; Yao Tianming; Sun Jingyang; Li Fei; Xu Kai

    2014-01-01

    Background The lack of medical facilities causes delayed diagnosis and treatment of coronary heart disease in remote mountainous area and/or at disaster site.The miniature mobile cardiac catheterization laboratory was developed to be an intervention platform for coronary heart disease diagnosis and treatment by our team.Pre-clinical research indicated that the miniature mobile cardiac catheterization laboratory performed well in the rescue of critical cardiovascular diseases,even ST-segment elevation myocardial infarction.The present study aimed to evaluate the clinical safety and timeliness of the miniature mobile cardiac catheterization laboratory for emergent coronary interventional diagnosis and treatment.Methods X-ray radiation safety and disinfection efficacy in the miniature mobile cardiac catheterization laboratory were tested during working status.Coronary angiography and/or percutaneous coronary intervention were performed in remote mountainous areas on patients who were first diagnosed as having coronary heart disease by senior interventional cardiologists.The percutaneous coronary intervention procedures and results from patients in the miniature mobile cardiac catheterization laboratory were compared with patients who were treated in the hospital catheter lab.Results The X-ray radiation dosages in the miniature mobile cardiac catheterization laboratory were 39.55 μGy/s,247.4 μGy/h,90.3 μGy/h and 39.4 μGy/h which were corresponded to 0 m,1 m,2 m and 3 m away from the tube central of the medium C-arm.And the radiation dosages used in the miniature mobile cardiac catheterization laboratory were less than the corresponding positions in the hospital catheter lab.The numbers of bacteria colonies in the miniature mobile cardiac catheterization laboratory in different environments range from (60±8) cfu/m3 to (120±10) cfu/m3 and met the demands of percutaneous coronary intervention.A total of 17 patients who received angiography in the miniature mobile

  18. Modification of the right subclavian vein catheterization and its anatomic basis and techniques

    Institute of Scientific and Technical Information of China (English)

    LUO Guang-hui; LI Wen-jian; ZHONG Shi-zhen; LI Zhong-hua; FANG Ji

    2005-01-01

    Background Several million subclavian-vein catheters are placed in patients each year to enable caregivers to administer chemotherapy, total parenteral nutrition, or long-term antibiotics or to manage preoperative fluids. Subclavian venipuncture requires the position of a deep vein to be identified with only surface landmarks. But the traditional right subclavian vein (RSV) catheterization (primitive procedures) is not the answer for all patients. The precise location of the vein is not known, and it is important to select the most appropriate method to achieve central venous access safely in any given patient. To modify the primitive procedures of the RSV catheterization for greater success and reduce the complications, anatomic studies and ultrasonography were conducted and clinical applications were validated.Methods Anatomical observation and measurement of the RSV and its adjacent structures were performed on 20 adult cadavers according to modified procedures. The RSV catheterization of 2900 cases was carried out by the modified procedure, 500 of these cases were observed by ultrasonography after the operation.Results The anatomical studies and clinical application showed that the insertion point differs from the bodily form of fatness or leptosome. The clinical data revealed that in the 2900 cases which were performed with the modified approach, the success rate was 98.90% (2868 cases), the failure rate was 1.10% (32 cases), and the complication rate is 0.79% (23 cases), and the catheterization time is (31.2±10.5) minutes. Five hundred and sixty cases of the RSV catheterization were carried out by the recommended insertion procedure; the results were compared with the modified approach and the traditional approach. The successful rate of the traditional approach was 73.0%, of which the complication rate was 6.1%; the two approaches were significantly different (successful rate: χ2=626.642, P<0.01; complication rate: χ2=80.708, P<0.01).Conclusions The

  19. Catheterization of the AbioCor™ Implantable Replacement Heart: Evaluation of the Unique Physiology Created by the Device

    OpenAIRE

    Delgado, Reynolds M.; Nawar, Mohamad; Loghin, Catalin; Myers, Timothy J.; Gregoric, Igor D.; Pool, Toni; Scroggins, Nancy; Radovancevic, Branislav; Frazier, O. H.

    2006-01-01

    We performed the 1st catheterization of an AbioCor™ implantable replacement heart, in a patient who had developed high right-sided pump pressures, to determine whether the high pressures were caused by graft kinking or obstruction.

  20. Right subclavian vein catheterism complication due to a 'foreign body': a case report

    Directory of Open Access Journals (Sweden)

    Vasconcelos Paula

    2010-10-01

    Full Text Available Abstract Introduction Central venous access devices are widely used in hospital practice. Complications associated with their use are well described and reviewed. In this paper, we report a former complication that in turn created a new complication during a standardized procedure. Case presentation We report the case of an 81-year-old Caucasian woman requiring total parenteral nutrition due to a high-debt enterocutaneous fistula. In a previous right subclavian catheterization a fragmentation of the tip of the catheter, probably not recognized at the time, provoked an extrinsic compression of the vessel. Conclusion Fragmentation of a central venous catheter is a possible complication of catheterization and can be missed. Control of a catheter is imperative after its removal, even if not always practiced.

  1. [Correlation of the transaortic gradient determined with doppler echocardiography versus catheterization in patients with aortic stenosis].

    Science.gov (United States)

    Illescas, J; Enciso, R; Vidrio, M; de la Torre, N; Baduí, E

    1991-01-01

    The purpose of this report is to evaluate the reliability of a non-invasive estimation of a transaortic gradient in patients with valvular aortic stenosis by doppler echocardiography. We compared the transvalvular gradients obtained by cardiac catheterization (invasive) versus the estimation by non-invasive technique such as continuous-wave doppler in 30 consecutive patients with valvular aortic stenosis. When compared the peak velocity (Vmax) of the aortic jet versus the gradient obtained by cardiac catheterization we found a correlation coefficient (r) of 0.83 and when compared the gradient obtained by both methods we found an r value of 0.85. These results show that the calculations of aortic gradient by echo-doppler, are reliable. Besides this method allowed us to establish the correct diagnosis and to follow up these patients.

  2. Catheterization-associated complications of intraperitoneal chemotherapy in advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Meng Ye; Hong-Ming Pan; Hai-Yun Wang; Fang Lou; Wei Jin; Yu Zheng; Jin-Ming Wu

    2004-01-01

    AIM: To assess the catheterization-associated complications during intraperitoneal chemotherapy (IPCT) for advanced gastric cancer.METHODS: From 1998 to 2002, 80 patients with advanced gastric cancer received a total of 320 courses of IPCT using a large bore central venous catheter and associated complications were analyzed.RESULTS: Catheterization-associated complications occurred in 11 of the 80 patients (13.8%), including abdominal pain caused by catheter in 2 cases (0.63%), insertion failure in 2 cases (0.63%), bowel perforation in 1 case (0.31%)and abdominal pain during chernotherapy in 6 cases (1.88%).No serious complications required surgical intervention.CONCLUSION: IPCT using central venous catheters can be performed safely and simply without severe associated complications.

  3. Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review

    Directory of Open Access Journals (Sweden)

    Natany da Costa Ferreira

    2015-12-01

    Full Text Available ABSTRACT Objective: to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization. Method: this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients' anxiety, and the results obtained. Results: the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure was found. Other strategies identified in this review were educational videos, massage, and palm therapy. Conclusion: the results found suggest that anxiety can be reduced using non-pharmacological strategies.

  4. Cateterismo retrógrado em neuro-radiologia Retrograde catheterization in Neuro-radiology

    Directory of Open Access Journals (Sweden)

    Sérgio F. Raupp

    1970-06-01

    Full Text Available The bases and technical cares for the neuro-radiological study of the aorto-cervical and spinal vessels employing the retrograde catheterization according to Seldinger technic and with the Odman-Ledin catheters are reported. The authors recommend type II neuroleptanalgesia as anesthesical sedative and the use of percutaneous punction of the femoral artery or, by choice, of the axilar or humeral artery. For the selective catheterization by femoral via, they make previously an aortography, in order to know the anatomy of the supra-aortic vessels, with control through the image-inten-sifier or fluoroscopy. They employ manual injection for the study of the supra-aortic vessels and a Gidlung injector for the contrast of the ascending aorta. Complications are discussed.

  5. Compliance With Guideline Statements for Urethral Catheterization in an Iranian Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Negar Taleschian-Tabrizi

    2015-12-01

    Full Text Available Background It is believed that healthcare staff play an important role in minimizing complications related to urethral catheterization. The purpose of this study was to determine whether or not healthcare staff complied with the standards for urethral catheterization. Methods This study was conducted in Imam Reza teaching hospital, Tabriz, Iran, from July to September 2013. A total of 109 catheterized patients were selected randomly from surgical and medical wards and intensive care units (ICUs. A questionnaire was completed by healthcare staff for each patient to assess quality of care provided for catheter insertion, while catheter in situ, draining and changing catheter bags. Items of the questionnaire were obtained from guidelines for the prevention of infection. Data analysis was performed with SPSS 16. Results The mean age of the patients was 50.54 ± 22.13. Of the 109 patients, 56.88% were admitted to ICUs. The mean duration of catheter use was 15.86 days. Among the 25 patients who had a urinalysis test documented in their hospital records, 11 were positive for urinary tract infection (UTI. The lowest rate of hand-washing was reported before bag drainage (49.52%. The closed drainage catheter system was not available at all. Among the cases who had a daily genital area cleansing, in 27.63% cases, the patients or their family members performed the washing. In 66.35% of cases, multiple-use lubricant gel was applied; single-use gel was not available. The rate of documentation for bag change was 79%. Conclusion The majority of the guideline statements was adhered to; however, some essential issues, such as hand hygiene were neglected. And some patients were catheterized routinely without proper indication. Limiting catheter use to mandatory situations and encouraging compliance with guidelines are recommended.

  6. X-Ray of One-Sided “White Lung” after Central Venous Catheterization

    Directory of Open Access Journals (Sweden)

    Michel Casanova

    2014-01-01

    Full Text Available Complications during insertion of a subclavian central venous line are rare but potentially serious. This case report describes the radiological abnormality of a one-sided pleural effusion during a routine control directly after a difficult central venous catheterization. We illustrate the findings, the initial emergency management, and our procedure to rule out an iatrogenic hemothorax. Possible differential diagnoses and strategies for management of a suspected complication are discussed.

  7. A new model for suprapubic catheterization: the MediPlus Seldinger suprapubic catheter.

    Science.gov (United States)

    Mohammed, Aza; Khan, Azhar; Shergill, Iqbal S; Gujral, Sandy S

    2008-11-01

    Insertion of a suprapubic catheter is one of the essential skills that all surgeons should master. It provides an alternative way to drain the bladder in cases where urethral catheterization is contraindicated or deemed difficult. It also has a role in elective cases where long-term drainage of the bladder is required. In this article, we discuss the MediPlus suprapubic catheter kit, which offers a new and potentially promising technique for safe introduction of the catheter into the bladder.

  8. SU-E-P-10: Imaging in the Cardiac Catheterization Lab - Technologies and Clinical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Fetterly, K [Mayo Clinic, Rochester, MN (United States)

    2014-06-01

    Purpose: Diagnosis and treatment of cardiovascular disease in the cardiac catheterization laboratory is often aided by a multitude of imaging technologies. The purpose of this work is to highlight the contributions to patient care offered by the various imaging systems used during cardiovascular interventional procedures. Methods: Imaging technologies used in the cardiac catheterization lab were characterized by their fundamental technology and by the clinical applications for which they are used. Whether the modality is external to the patient, intravascular, or intracavity was specified. Specific clinical procedures for which multiple modalities are routinely used will be highlighted. Results: X-ray imaging modalities include fluoroscopy/angiography and angiography CT. Ultrasound imaging is performed with external, trans-esophageal echocardiography (TEE), and intravascular (IVUS) transducers. Intravascular infrared optical coherence tomography (IVOCT) is used to assess vessel endothelium. Relatively large (>0.5 mm) anatomical structures are imaged with x-ray and ultrasound. IVUS and IVOCT provide high resolution images of vessel walls. Cardiac CT and MRI images are used to plan complex cardiovascular interventions. Advanced applications are used to spatially and temporally merge images from different technologies. Diagnosis and treatment of coronary artery disease frequently utilizes angiography and intra-vascular imaging, and treatment of complex structural heart conditions routinely includes use of multiple imaging modalities. Conclusion: There are several imaging modalities which are routinely used in the cardiac catheterization laboratory to diagnose and treat both coronary artery and structural heart disease. Multiple modalities are frequently used to enhance the quality and safety of procedures. The cardiac catheterization laboratory includes many opportunities for medical physicists to contribute substantially toward advancing patient care.

  9. Clinical features and outcome of eight patients with mediastinal and neck hematoma after transradial cardiac catheterization approach

    Institute of Scientific and Technical Information of China (English)

    杨伟宪

    2014-01-01

    Objective The clinical features of patients with mediastinal and/or neck hematoma after transradial cardiac catheterization were reviewed and analyzed to help the clinicians to recognize this complication,and try their best to avoid the complication and treat the complication properly.Methods A total of 8 patients with mediastinal and/or neck hematoma after right transradial cardiac catheterization in Fuwai hospital from January 1,2005 to the end of 2012 were included in this study.Among

  10. New Development in Urethral Catheterization%导尿技术的新进展

    Institute of Scientific and Technical Information of China (English)

    张欣然; 王东华; 逯建娥; 张国清

    2001-01-01

    导尿是临床常用的基础护理技术操作。为预防因导尿引起的泌尿系感染,复习有关文献并结合自己的临床实践,总结导尿困难的常用对策,同时从预防感染角度提出了尿管及导尿途径的选择及导尿与拔管最佳时机的把握,以尽量减少患者的痛苦。%Urethral catheterization is a common clinical manipulation in basic nursing. By summarizing their clinical experience and reviewing the related literathre,the authors emphasize the importance of the material and type of catheter and option for the way of catheterization in preventing infection. In addition, optimal opportunity for catheterization and decatheterization is also important in reducing patient's suffering.

  11. Effect of Rosa aromatherapy on anxiety before cardiac catheterization: A randomized controlled trial

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    Atye Babaii

    2015-09-01

    Full Text Available Background and Objectives: Most patients experience moderate to severe anxiety before cardiac catheterization. This study aimed to investigate the effect of Rosa aromatherapy on anxiety before cardiac catheterization. Methods: In this randomized controlled trial, 60 patients who met the inclusion criteria were conveniently sampled and randomly allocated to the experimental and control groups. Patients in the control group received routine care. In the experimental group, patients received routine care and Rosa aromatherapy for eighteen minutes. The level of anxiety was measured immediately before, and after the treatment. Results: In the stages before and after the study, there were no significant differences between the two groups in the terms of the mean scores of state and total anxiety. However, the mean score of trait anxiety in the experimental group was significantly lower than the control group. Furthermore, there was no significant difference between pre- and post-treatment in both groups. Conclusion: Most of the patients experience moderate to severe anxiety before cardiac catheterization. The findings of this study demonstrate that aromatherapy, as administered in this study, is not beneficial.

  12. Possibility of analytical finding of glycerol caused by self-catheterization in doping control.

    Science.gov (United States)

    Okano, Masato; Nishitani, Yasunori; Kageyama, Shinji

    2014-01-01

    Glycerol is listed on the World Anti-Doping Agency (WADA) prohibited list as a masking agent principally because the administration of glycerol increases plasma volume and decreases the concentration of haemoglobin and the value of haematocrit in blood. Glycerol is a naturally occurring substance; therefore, the threshold is set as 1.0 mg/mL in the WADA technical document (WADA TD2013DL). In a WADA-accredited doping control laboratory, three doping control urine specimens collected from impaired athletes were determined to contain a high concentration of glycerol (>1.0 mg/mL); two of these specimens were considered adverse analytical findings (AAFs). Self-catheterization is necessary for athletes with neurological disorders such as neurogenic bladder dysfunction. We conducted a simple simulation of self-catheterization as an experimental test using urethral catheters with an antiseptic agent containing glycerol to confirm the influence of this antiseptic agent on the quantitative value of glycerol in doping control analysis. Some users employ a catheter with glycerol solution (ca. 1 mL) to avoid pain during use. The urine sample passed through such a catheter exhibited a glycerol concentration (4.94 mg/mL) greater than the threshold level. In September 2014, the threshold for glycerol will change from 1.0 to 4.3 mg/mL (WADA TD2014DL); however, a possibility exists for the quantitative value of glycerol in doping control analysis to exceed the threshold because of the use of an antiseptic agent containing glycerol for self-catheterization. The AAF for glycerol for impaired athletes, particularly those who participate in Paralympic sports, should account for the use of a catheter with glycerol.

  13. Comparison of propofol effect with Ketamine for sedation induction in pediatric patients who underwent cardiol catheterization

    Directory of Open Access Journals (Sweden)

    Houshang Shahryari

    2010-04-01

    Full Text Available Background: The goals for sedation in pediatric patients scheduled to undergo cardiac catheterization include immobility, analgesia, cardiovascular and respiratory stability. We investigated the effects of Propofol and Ketamine on hemodynamic, respiratory status, sedation level, pain score and recovery period in pediatric patients undergoing cardiac catheterization. Methods: We preformed a randomized clinical trial study on 40 pediatric patients. The patients were randomly assigned to two groups, so that 20 patients received Ketamine and 20 patients received Propofol. In all patients, sedation was started with Midazolam (0.03mg/kg, then followed by Propofol in the first group and Ketamine in the second one. The hemodynamic responses, respiratory parameters, recovery characteristics (Ramsey scale, pain score VAS and relevant adverse effects of the two groups were recorded. Data was analyzed using Paired T Test, ANOVA and Stearman correlation coefficient. Results: Five patients in the Propofol group andon patients in the Ketamine group experienced a transient decrease in mean systolic blood pressure greater than 10% of baseline(p=0.034. Time to full recovery (mean ± SD was not significantly different in the Propofol group and Ketamine group (1.8 min vs. 2.9 min, P > 0.05. Pain scores were significantly different in both groups (P= 0.010. Patients’ heart rates were significantly higher in Ketamine group(P=0.029. No significant difference in respiratory rate was recorded in both groups(p›0.05. Conclusion: Both Ketamine and Propofol are useful and safe in pediatric patients undergoing cardiac catheterization but it seems that it is better to use Propofol in stable hemodynamic pediatric patients under continuous blood pressure monitoring.

  14. Effects of oral premedication on cognitive status of elderly patients undergoing cardiac catheterization

    Institute of Scientific and Technical Information of China (English)

    Javed M Ashraf; Marc Schweiger; Neelima Vallurupalli; Sandra Bellantonio; James R Cook

    2015-01-01

    Background Sedatives and analgesics are often administered to achieve conscious sedation for diagnostic and therapeutic procedures. Appropriate concerns have been raised regarding post procedure delirium related to peri-procedural medication in the elderly. The objective of this study was to investigate the effect of premedication on new onset delirium and procedural care in elderly patients. Methods Patients≥70 years old and scheduled for elective cardiac catheterization were randomly assigned to receive either oral diphenhydramine and diaze-pam (25 mg/5 mg) or no premedication. All patients underwent a mini mental state exam and delirium assessment using confusion assess-ment method prior to the procedure and repeated at 4 h after the procedure and prior to discharge. Patients’ cooperation during the procedure and ease of post-procedure were measured using Visual Analog Scale (VAS). The degree of alertness was assessed immediately on arrival to the floor, and twice hourly afterwards using Observer’s Assessment of Alertness/Sedation Scale (OAA/S). Results A total of 93 patients were enrolled. The mean age was 77 years, and 47 patients received premedication prior to the procedure. None of the patients in either group developed delirium. Patients’ cooperation and the ease of procedure was greater and pain medication requirement less both during and after the procedure in the pre-medicated group (P < 0.05 for both). Nurses reported an improvement with patient management in the pre-medicated group (P=0.08). Conclusions In conclusion, premedication did not cause delirium in elderly patients undergoing cardiac catheterization. The reduced pain medication requirement, perceived procedural ease and post procedure management favors premedication in elderly patients undergoing cardiac catheterization.

  15. Ultrasound-guided catheterization of the portal vein in 11 cows using the Seldinger technique.

    Science.gov (United States)

    Braun, U; Camenzind, D; Ossent, P

    2003-02-01

    Catheterization of the portal vein using the Seldinger technique [Acta Radiol. (1958) 38, 368] was performed in 11 cows. Ultrasound-guided percutaneous portocentesis, using a 25-cm, 14-gauge steel cannula, was performed from the 10th, 11th or 12th intercostal space on the right side. A stylet was placed through the cannula, which was then removed, and a polyurethane balloon-tipped catheter was advanced over the stylet into the portal vein and sutured to the skin (Seldinger, 1952). Blood samples were collected from the catheter at least once daily. The catheter was removed 9-15 days later when blood could no longer be aspirated. The cows were then slaughtered and a post-mortem examination was performed. During the study, appetite remained normal in nine of 11 cows. In three cows, the general behaviour and demeanour were mildly, but transiently, abnormal. Four cows had leucopoenia. The most frequently encountered problem was occlusion of the catheter, which usually was resolved by flushing with heparinized saline. The most common post-mortem lesion observed was an increase in fibrous connective tissue at the site of cannulation. In nine of 11cows, there was a thrombus in the portal vein at the site of catheterization. Generally, the severity of the lesions was mild. The results of this study demonstrated that ultrasound-guided percutaneous catheterization of the portal vein, using the Seldinger technique, is possible in cows. The catheter may be left in place for collection of blood samples for up to 15 days.

  16. Medicolegal characteristics of cardiac catheterization litigation in the United States, 1985 to 2009.

    Science.gov (United States)

    Kim, Candice; Vidovich, Mladen I

    2013-11-15

    There are few assessments of patterns of medicolegal cases involving cardiac catheterizations. This descriptive study reviews the patterns of liability and medical outcomes involving cardiac catheterization litigation from the LexisNexis Academic database and the Physician Insurers Association of America registry. From 1985 to 2009, the Physician Insurers Association of America registry documented 1,361 closed coronary angiography claims. The cardiovascular disease specialty was involved in 699 with other specialties involved in the remaining cases. Of the 1,361 closed claims, 301 (22%) resulted in payments to the plaintiff (average indemnity of $230,987). The most common alleged error was for improper performance (35.4%; average indemnity of $255,542). The alleged error with the highest average indemnity of $270,916 was errors in diagnosis. Not performing an indicated procedure had the highest ratio of paid to closed claims (41%) with an average indemnity of $246,988. In regard to the severity of injury, death was the most common outcome (44%). The highest ratio of paid to total closed claims (43%) was for grave injuries (highest average indemnity of $555,625). Of the 116 LexisNexis cases, litigation against physicians occurred in 90.5% of cases with judgments in favor of the patients in 29.5%. When death was the outcome (31% of cases), physicians were highly likely to be sued (97%) and the judgment was more likely in the plaintiffs' favor (44%). In conclusion, in litigation related to cardiac catheterizations, most cases are due to medical malpractice and physicians are sued in a high percentage of cases. Cardiologists should recognize these patterns of litigation as these may impact and improve processes of care.

  17. Acute Aortic Dissection Mimicking STEMI in the Catheterization Laboratory: Early Recognition Is Mandatory

    Directory of Open Access Journals (Sweden)

    Alessio Arrivi

    2012-01-01

    Full Text Available Coronary malperfusion due to type A aortic dissection is a life-threatening condition where timely recognition and treatment are mandatory. A 77-year-old woman underwent an acute evolving type A aortic dissection mimicking acute myocardial infarction. Two pathophysiologic mechanisms are discussed: either thrombosis migrating from a previously treated giant aneurism of proximal left anterior descending or a local arterial complication due to left main stenting. Recognition of these occurrences in the catheterization laboratory is important to look immediately for surgery.

  18. Cardiac catheterization

    Science.gov (United States)

    ... doctor can: Collect blood samples from the heart Measure pressure and blood flow in the heart's chambers and in the large arteries around the heart Measure the oxygen in different parts of your heart ...

  19. Catheterization and embolization of a replaced left hepatic artery via the right gastric artery through the anastomosis: a case report

    Directory of Open Access Journals (Sweden)

    Miyazaki Masaya

    2011-08-01

    Full Text Available Abstract Introduction Conversion of multiple hepatic arteries into a single vascular supply is a very important technique for repeat hepatic arterial infusion chemotherapy using an implanted port catheter system. Catheterization of a replaced left hepatic artery arising from a left gastric artery using a percutaneous catheter technique is sometimes difficult, despite the recent development of advanced interventional techniques. Case presentation We present a case of a 70-year-old Japanese man with multiple hepatocellular carcinomas in whom the replaced left hepatic artery arising from the left gastric artery needed to be embolized. After several failed procedures, the replaced left hepatic artery was successfully catheterized and embolized with a microcatheter and microcoils via the right gastric artery through the anastomosis. Conclusion A replaced left hepatic artery arising from a left gastric artery can be catheterized via a right gastric artery by using the appropriate microcatheter and microguidewires, and multiple hepatic arteries can be converted into a single supply.

  20. The Comparison of Pulse Oximetry and Cardiac Catheterization in Managing the Treatment of Children with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    R Abbasi

    2015-03-01

    Full Text Available Bachground & aim: Pulse oximetry and cardiac catheterization are concerned in the treatment of children with congenital heart disease. Diagnosis of arterial oxygen saturation in patients with congenital heart disease (CHD can be used to assess and manage their effecacy. The purpose of this study was to compare pulse oximetry and cardiac catheterizations in treatment manage of children with congenital heart disease. Methods: In the present cross sectional study, 110 patients with cyanic and non syani heart disease were studied undergoing right and left heart catheterization by pulse oximetry of index finger and simultaneously, oxygen saturation was measured by cardiac catheterization. Data were analyzed with SPSS software by using Pearson correlation and linear regression. Results: A significant correlation was seen between arterial oxygen saturation measured by pulse oximetry and arterial oxygen saturation (p<0.0001 as well as heart rate, electrocardiogram and pulse oximetry (p<0.0001 respectively. Furthermore, the presence of cyanosis (p=0.001, digital clubbing of the fingers ((p=0.001, low oxygen saturation in the superior vena cava and right atrium (p=0.002 can reduce the accuracy of pulse oximetry for detection of arterial oxygen saturation. The mean right atrial pressure can effect on accuracy of pulse oximetry to detect heartbeat (p=0.034. Maximum sensitivity and specificity for detection of pulse oximetry oxygen saturation was 88 % and 88 heart rate per minute. Conclusion: Pulse oximetric is a useful tool for estimating the arterial oxygen saturation and heart rate in children with congenital heart disease (CHD and is a non-invasive method in comparison with cardiac catheterization. Key words: Pulse oximeter, Congenital Heart Disease, Cardiac Catheterization

  1. In situ cephalic vein bypasses from axillary to the brachial artery after catheterization injuries.

    Science.gov (United States)

    Hudorovic, Narcis; Lovricevic, Ivo; Ahel, Zaky

    2010-07-01

    The need to bypass to the brachial artery is rare. Over a five-year period, 16 patients had suffered iatrogenic post-catheterization injuries of the upper extremity. We have performed 16 bypasses, in 16 patients, mean age was 65 years (range 47-75), to the brachial artery originating from an artery proximal to the shoulder joint. In all cases, the axillary artery was the donor artery. All bypasses were created by using the cephalic vein with the in situ technique and distal anastomoses were made to a distance-free section of brachial artery. No operative mortality, neurological complications or major upper-extremity amputation was associated with the procedure. Life-long-conduit analysis showed 75% patency in the five-year period. After iatrogenic post-catheterization trauma of arterial system of upper extremity, bypasses from axillary to brachial artery with the cephalic vein with the in situ technique is a safe operation with satisfactory long-term patency.

  2. Insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations

    Energy Technology Data Exchange (ETDEWEB)

    Kotsikoris, Ioannis, E-mail: gkotsikoris@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Zygomalas, Apollon, E-mail: azygomalas@upatras.gr [Department of General Surgery, University Hospital of Patras (Greece); Papas, Theofanis, E-mail: pfanis@otenet.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Maras, Dimitris, E-mail: dimmaras@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Pavlidis, Polyvios, E-mail: polpavlidis@yahoo.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Andrikopoulou, Maria, E-mail: madric@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Tsanis, Antonis, E-mail: atsanis@gmail.com [Department of Interventional Radiology, “Erythros Stauros” General Hospital (Greece); Alivizatos, Vasileios, E-mail: valiviz@hol.gr [Department of General Surgery and Artificial Nutrition Unit, “Agios Andreas” General Hospital of Patras (Greece); Bessias, Nikolaos, E-mail: bessias@otenet.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece)

    2012-09-15

    Introduction: Central venous catheter placement is an effective alternative vascular access for dialysis in patients with chronic renal failure. The purpose of this study was to evaluate the insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations in terms of efficacy of the procedure and early complications. Materials and methods: Between 2008 and 2010, the vascular access team of our hospital placed 409 central venous catheters in patients with chronic renal failure. The procedure was performed using the Seldinger blind technique. In 18 (4.4%) cases it was impossible to advance the guidewire, and so the patients were transported to the angiography suite. Results: Using the angiographic technique, the guidewire was advanced in order to position the central venous catheter. The latter was inserted into the subclavian vein in 12 (66.6%) cases, into the internal jugular vein in 4 (22.2%) and into the femoral vein in 2 (11.1%) cases. There was only one complicated case with severe arrhythmia in 1 (5.5%) patient. Conclusion: Our results suggest that insertion of central venous catheters using angiographic techniques in hemodialysis patients with previous multiple catheterizations is a safe and effective procedure with few complications and high success rates.

  3. Simultaneous ramp right heart catheterization and echocardiography in a ReliantHeart left ventricular assist device

    Science.gov (United States)

    Banerjee, Dipanjan; Dutt, Debleena; Duclos, Sebastien; Sallam, Karim; Wheeler, Matthew; Ha, Richard

    2017-01-01

    Many clinicians caring for patients with continuous flow left ventricular assist devices (CF-LVAD) use ramp right heart catheterization (RHC) studies to optimize pump speed and also to troubleshoot CF-LVAD malfunction. An investigational device, the ReliantHeart Heart Assist 5 (Houston, TX), provides the added benefit of an ultrasonic flow probe on the outflow graft that directly measures flow through the CF-LVAD. We performed a simultaneous ramp RHC and echocardiogram on a patient who received the above CF-LVAD to optimize pump parameters and investigate elevated flow through the CF-LVAD as measured by the flow probe. We found that the patient’s hemodynamics were optimized at their baseline pump speed, and that the measured cardiac output via the Fick principle was lower than that measured by the flow probe. Right heart catheterization may be useful to investigate discrepancies between flow measured by a CF-LVAD and a patient’s clinical presentation, particularly in investigational devices where little clinical experience exists. More data is needed to elucidate the correlation between the flow measured by an ultrasonic probe and cardiac output as measured by RHC. PMID:28163837

  4. Echocardiography to magnetic resonance image registration for use in image-guided cardiac catheterization procedures

    Energy Technology Data Exchange (ETDEWEB)

    Ma Yingliang; Penney, Graeme P; Razavi, Reza; Rhode, Kawal S [Division of Imaging Sciences, King' s College, London SE1 7EH (United Kingdom); Rinaldi, C Aldo; Cooklin, Mike [Department of Cardiology, Guy' s and St Thomas' NHS Foundation Trust, London, SE1 7EH (United Kingdom)], E-mail: y.ma@kcl.ac.uk

    2009-08-21

    We present a robust method to register three-dimensional echocardiography (echo) images to magnetic resonance images (MRI) based on anatomical features, which is designed to be used in the registration pipeline for overlaying MRI-derived roadmaps onto two-dimensional live x-ray images during cardiac catheterization procedures. The features used in image registration are the endocardial surface of the left ventricle and the centre line of the descending aorta. The MR-derived left ventricle surface is generated using a fully automated algorithm, and the echo-derived left ventricle surface is produced using a semi-automatic segmentation method provided by the QLab software (Philips Healthcare) that it is routinely used in clinical practice. We test our method on data from six volunteers and four patients. We validated registration accuracy using two methods: the first calculated a root mean square distance error using expert identified anatomical landmarks, and the second method used catheters as landmarks in two clinical electrophysiology procedures. Results show a mean error of 4.1 mm, which is acceptable for our clinical application, and no failed registrations were observed. In addition, our algorithm works on clinical data, is fast and only requires a small amount of manual input, and so it is applicable for use during cardiac catheterization procedures.

  5. Percutaneous Treatment of a Primary Pancreatic Hydatid Cyst Using a Catheterization Technique

    Energy Technology Data Exchange (ETDEWEB)

    Karaman, Bulent; Ustunsoz, Bahri; Ugurel, Sahin [Gulhane Military Medical School, Ankara (Turkmenistan)

    2012-03-15

    Primary pancreatic hydatid cysts are rare and its percutaneous treatment and catheterization technique has, to the best of our knowledge, not been published in literature. A 33-year-old male patient who presented with abdominal pain was evaluated by ultrasonography (US) and computed tomography examinations. Both examinations revealed a cyst in the neck of the pancreas. After the administration of albendazole chemoprophylaxis, the patient underwent diagnostic puncture showing high pressure spring water which harbored the scoleces and was treated percutaneously by the catheterization technique. In this technique, first the cyst was punctured, the fluid content aspirated, the radiocontrast material injected to see possible fistulisation, and then re-aspirated. The 20% hypertonic saline solution was injected and re-aspiration was performed to the best of our abilities, followed by the insertion of a catheter for drainage of the remaining non-aspiratable fluid content. At follow-up examination, the cyst was not visible on US after 6 months. There was no evidence of cyst recurrence or dissemination after 18 months at serologic and imaging follow-up.

  6. MONTI as continent catheterized stoma using serosal-lined trough "Ghoneim Abolenin" technique in ileocystoplasty

    Directory of Open Access Journals (Sweden)

    Mohammed T Sammour

    2011-01-01

    Full Text Available It is a great challenge to select and perform continent mechanism in a stoma for urinary reservoir. A new technique by combining MONTI ileal conduit with the serosal lined trough in order to achieve continent catheterizable stoma to the umbilicus as a part of augmentation ileocystoplasty. We applied serosal-lined trough as a continent mechanism with MONTI ileal tube in 12 years smart girl underwent ileocystoplasty for neuropathic bladder due to meylomeningocele in whom continence failed to be achieved by using Mitrofanoff with submucosal tunnel of the bladder as continent mechanism before, also the previous operation included left to right transuretero-ureterostomy, ureterocystoplasty and reimplantation of the right ureter. The patient became completely continent; she was able to do self-catheterization easily through the umbilical stoma using 16-French catheter and was able to wash the mucous easily. The capacity of the augmented bladder was 300ccs. She became independent from her mother and stopped using diapers, anticholinergic and antibiotics. Combining MONTI conduit with serosal-lined extramural valve trough (The Ghoneim technique is an effective continent technique and gives wider channel for catheterization and washing out the mucous.

  7. Home screening for bacteriuria in children with spina bifida and clean intermittent catheterization

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    Zegers Bas SHJ

    2012-10-01

    Full Text Available Abstract Background Significant bacteriuria (SBU and urinary tract infections (UTIs are common in patients with spina bifida and neuropathic detrusor sphincter dysfunction. Laboratory agar plated culture is the gold standard to establish SBU. It has the disadvantage of diagnostic and subsequent therapeutic delay. Leukocyte esterase tests (LETs and dip slides proved to be useful in the general populations to exclude SBU and UTI. The aim of this study was to evaluate the reliability of LET and dip slide in children with spina bifida without symptoms of UTI. The reliability in children with asymptomatic SBU was not studied before. Methods In one hundred and twelve children with spina bifida on clean intermittent catheterization LETs and dip slides were compared with laboratory cultures. Both tests and agar plated cultures were performed on catheterized urine samples. The hypothesis was that the home tests are as accurate as laboratory cultures. Results A SBU was found in 45 (40% of the 112 laboratory cultures. A negative LET excluded SBU (negative predictive value 96%, while a positive LET had a positive predictive value of 72%. The false positive rate was 28%. Dip slide determination of bacterial growth had no added value, other than serving as transport medium. Conclusions In spina bifida children, leukocyte esterase testing can be used to exclude significant bacteriuria at home, while dip slide tests have no added value to diagnose or exclude significant bacteriuria.

  8. Non-inferiority of short-term urethral catheterization following fistula repair surgery: study protocol for a randomized controlled trial

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    Barone Mark A

    2012-03-01

    Full Text Available Abstract Background A vaginal fistula is a devastating condition, affecting an estimated 2 million girls and women across Africa and Asia. There are numerous challenges associated with providing fistula repair services in developing countries, including limited availability of operating rooms, equipment, surgeons with specialized skills, and funding from local or international donors to support surgeries and subsequent post-operative care. Finding ways of providing services in a more efficient and cost-effective manner, without compromising surgical outcomes and the overall health of the patient, is paramount. Shortening the duration of urethral catheterization following fistula repair surgery would increase treatment capacity, lower costs of services, and potentially lower risk of healthcare-associated infections among fistula patients. There is a lack of empirical evidence supporting any particular length of time for urethral catheterization following fistula repair surgery. This study will examine whether short-term (7 day urethral catheterization is not worse by more than a minimal relevant difference to longer-term (14 day urethral catheterization in terms of incidence of fistula repair breakdown among women with simple fistula presenting at study sites for fistula repair service. Methods/Design This study is a facility-based, multicenter, non-inferiority randomized controlled trial (RCT comparing the new proposed short-term (7 day urethral catheterization to longer-term (14 day urethral catheterization in terms of predicting fistula repair breakdown. The primary outcome is fistula repair breakdown up to three months following fistula repair surgery as assessed by a urinary dye test. Secondary outcomes will include repair breakdown one week following catheter removal, intermittent catheterization due to urinary retention and the occurrence of septic or febrile episodes, prolonged hospitalization for medical reasons, catheter blockage, and

  9. Catheterization during adrenal vein sampling for primary aldosteronism: failure to use (1-24) ACTH may increase apparent failure rate.

    Science.gov (United States)

    Kline, Gregory A; So, Benny; Dias, Valerian C; Harvey, Adrian; Pasieka, Janice L

    2013-07-01

    "Successful" adrenal vein catheterization in primary aldosteronism (PA) is often defined by a ratio of >3:1 of cortisol in the adrenal vein vs the inferior vena cava. Non-use of corticotropin (ACTH) during sampling may increase the apparent failure rate of adrenal vein catheterization due to lower cortisol levels. A retrospective study was performed on all patients with confirmed unilateral PA between June 2005 and August 2011. Adrenal vein sampling (AVS) included simultaneous bilateral baseline samples with repeat sampling 15 minutes after intravenous infusion of 250 μg of Cortrosyn (ACTH-S). Successful catheter placement was judged as adrenal cortisol:IVC cortisol of >3:1, applied to both baseline and ACTH-S samples and lateralization of aldosteronism was judged as normalized aldosterone/cortisol (A/C) ratio >3 times the contralateral A/C ratio. In ACTH-S samples, 94% of right-sided catheterizations were biochemically successful with 100% success on the left. Among baseline samples, only 47% of right- and 44% of left-sided samples met the 3:1 cortisol criteria. However, 95% of apparent "failed" baseline cortisol sets still showed lateralization of A/C ratios that matched the ultimate pathology. Non-ACTH-stimulated samples may be incorrectly judged as failed catheter placement when a 3:1 ratio is used. ACTH-stimulated sampling is the preferred means to confirm catheterization during AVS.

  10. Avoidable iatrogenic complications of urethral catheterization and inadequate intern training in a tertiary-care teaching hospital.

    LENUS (Irish Health Repository)

    Thomas, Arun Z

    2009-10-01

    To examine the magnitude of potentially avoidable iatrogenic complications of male urethral catheterization (UC) within a tertiary-care supra-regional teaching hospital, and to evaluate risk factors and subjective feeling of interns in our institution on the adequacy of training on UC.

  11. Role of duration of catheterization and length of hospital stay on the rate of catheter-related hospital-acquired urinary tract infections

    Directory of Open Access Journals (Sweden)

    Al-Hazmi H

    2015-03-01

    Full Text Available Hamdan Al-HazmiDivision of Urology, Department of Surgery, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi ArabiaObjective: Our aim is to prove that duration of catheterization and length of hospital stay (LOS are associated with the rate of hospital-acquired urinary tract infections (UTI, while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis on admission, associated comorbidities, age, sex, precautions that should be taken to avoid UTI, and comparison with other studies.Methods: The study was done in a university teaching hospital with a 920-bed capacity; this hospital is a tertiary care center in Riyadh, Saudi Arabia. The study was done on 250 selected patients during the year 2010 as a retrospective descriptive study. Patients were selected as purposive sample, all of them having been exposed to urinary catheterization; hospital-acquired UTI were found in 100 patients. Data were abstracted from the archived patients' files in the medical record department using the annual infection control logbook prepared by the infection control department. The data collected were demographic information about the patients, clinical condition (diagnosis and the LOS, and possible risk factors for infection such as duration of catheterization, exposure to invasive devices or surgical procedures, and medical condition.Results: There was a statistically significant association between the rate of UTI and duration of catheterization: seven patients had UTI out of 46 catheterized patients (15% at 3 days of catheterization, while 30 patients had UTI out of 44 catheterized patients (68% at 8 days of catheterization (median 8 days in infected patients versus 3 days in noninfected patients; P-value <0.05, which means that the longer the duration of catheterization, the higher the UTI rate. There was a statistically significant association between the rate of UTI and LOS

  12. Role of duration of catheterization and length of hospital stay on the rate of catheter-related hospital-acquired urinary tract infections

    Science.gov (United States)

    Al-Hazmi, Hamdan

    2015-01-01

    Objective Our aim is to prove that duration of catheterization and length of hospital stay (LOS) are associated with the rate of hospital-acquired urinary tract infections (UTI), while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis on admission, associated comorbidities, age, sex, precautions that should be taken to avoid UTI, and comparison with other studies. Methods The study was done in a university teaching hospital with a 920-bed capacity; this hospital is a tertiary care center in Riyadh, Saudi Arabia. The study was done on 250 selected patients during the year 2010 as a retrospective descriptive study. Patients were selected as purposive sample, all of them having been exposed to urinary catheterization; hospital-acquired UTI were found in 100 patients. Data were abstracted from the archived patients’ files in the medical record department using the annual infection control logbook prepared by the infection control department. The data collected were demographic information about the patients, clinical condition (diagnosis and the LOS), and possible risk factors for infection such as duration of catheterization, exposure to invasive devices or surgical procedures, and medical condition. Results There was a statistically significant association between the rate of UTI and duration of catheterization: seven patients had UTI out of 46 catheterized patients (15%) at 3 days of catheterization, while 30 patients had UTI out of 44 catheterized patients (68%) at 8 days of catheterization (median 8 days in infected patients versus 3 days in noninfected patients; P-value <0.05), which means that the longer the duration of catheterization, the higher the UTI rate. There was a statistically significant association between the rate of UTI and LOS: three patients had UTI out of 37 catheterized patients (8%) at 10 days LOS, while 42 patients had UTI out of 49 catheterized patients (85.7%) at 18 days LOS. The longer

  13. Mycotic Saccular Abdominal Aortic Aneurysm in an Infant after Cardiac Catheterization: A Case Report.

    Science.gov (United States)

    Benrashid, Ehsan; McCoy, Christopher C; Rice, Henry E; Shortell, Cynthia K; Cox, Mitchell W

    2015-10-01

    Abdominal aortic aneurysms (AAAs) are a rare entity in the pediatric population. Children with mycotic (infectious) AAA in particular are at risk of life-threatening rupture due to their rapid expansion coupled with aortic wall thinning and deterioration. Here, we present the case of a 10-month-old infant with prior 2-staged repair for hypoplastic left heart syndrome that was incidentally discovered to have a mycotic AAA on abdominal ultrasound (US) for evaluation of renovascular hypertension. Before the time of evaluation with US, the infant had developed methicillin-resistant Staphylococcus aureus bacteremia 3 days after cardiac catheterization with percutaneous thoracic aortic balloon angioplasty. She had normal aortic contours on contrasted computed tomography scan of the abdomen approximately 2 weeks before the aforementioned US evaluation. This infant subsequently underwent open aneurysmorrhaphy with cryopreserved vein patch angioplasty with resolution of her aneurysmal segment.

  14. Cardiac catheterization in patients with unstable angina. Recent onset vs crescendo pattern.

    Science.gov (United States)

    Plotnik, G D; Fisher, M L; Carliner, N H; Becker, L C

    1980-08-01

    Among patients with unstable angina pectoris, those with crescendo angina seem to be at high risk for death and myocardial infarction. We reviewed the clinical, arteriographic, and hemodynamic findings in 218 consecutive catheterized patients with unstable angina. Unstable angina was defined as ischemic cardiac pain at rest associated with transient ECG changes but no evidence for acute myocardial infarction. Patients were divided into two groups according to the duration of symptoms: 134 patients with crescendo angina (new, or increasing, rest pain with previous ischemic symptoms present for more than three months) and 84 with recent onset angina (symptoms present for less than three months). Compared with patients with recent onset symptoms, patients with crescendo angina had more extensive coronary disease and lower ejection fractions, which may explain their poor prognosis.

  15. Predictors of Unattempted Central Venous Catheterization in Septic Patients Eligible for Early Goal-directed Therapy

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    David R. Vinson

    2014-02-01

    Full Text Available Introduction: Central venous catheterization (CVC can be an important component of the management of patients with severe sepsis and septic shock. CVC, however, is a time- and resource-intensive procedure associated with serious complications. The effects of the absence of shock or the presence of relative contraindications on undertaking central line placement in septic emergency department (ED patients eligible for early goal-directed therapy (EGDT have not been well described. We sought to determine the association of relative normotension (sustained systolic blood pressure >90 mmHg independent of or in response to an initial crystalloid resuscitation of 20 mL/kg, obesity (body mass index [BMI] ≥30, moderate thrombocytopenia (platelet count <50,000 per μL, and coagulopathy (international normalized ratio ≥2.0 with unattempted CVC in EGDT-eligible patients. Methods: This was a retrospective cohort study of 421 adults who met EGDT criteria in 5 community EDs over a period of 13 months. We compared patients with attempted thoracic (internal jugular or subclavian CVC with those who did not undergo an attempted thoracic line. We also compared patients with any attempted CVC (either thoracic or femoral with those who did not undergo any attempted central line. We used multivariate logistic regression analysis to calculate adjusted odd ratios (AORs. Results: In our study, 364 (86.5% patients underwent attempted thoracic CVC and 57 (13.5% did not. Relative normotension was significantly associated with unattempted thoracic CVC (AOR 2.6 95% confidence interval [CI], 1.6-4.3, as were moderate thrombocytopenia (AOR 3.9; 95% CI, 1.5-10.1 and coagulopathy (AOR 2.7; 95% CI, 1.3-5.6. When assessing for attempted catheterization of any central venous site (thoracic or femoral, 382 (90.7% patients underwent attempted catheterization and 39 (9.3% patients did not. Relative normotension (AOR 2.3; 95% CI, 1.2-4.5 and moderate thrombocytopenia (AOR 3.9; 95

  16. Percutaneous transhepatic portal catheterization guided by ultrasound technology for islet transplantation in rhesus monkey

    Institute of Scientific and Technical Information of China (English)

    FengGao; Shao-DongAi; ShengLiu; Wen-BinZeng; WeiWang

    2012-01-01

    BACKGROUND: Pig islet xenotransplantation has the potential to overcome the shortage of donated human islets for islet cell transplantation in type 1 diabetes. Testing in non-human primate models is necessary before clinical application in humans. Intraportal islet transplantation in monkeys is usually performed by surgical infusion during laparotomy or laparoscopy. In this paper, we describe a new method of percutaneous transhepatic portal catheterization (PTPC) as an alternative to current methods of islet transplantation in rhesus monkeys. METHODS: We performed ultrasound-guided PTPC in five adult rhesus monkeys weighing 7-8 kg, with portal vein catheterization confirmed by digital subtraction angiography. We monitored for complications in the thoracic and abdominal cavity. To evaluate the safety of ultrasound-guided PTPC, we recorded the changes in portal pressure throughout the microbead transplantation procedure. RESULTS:  Ultrasound-guided PTPC and infusion of 16 000 microbeads/kg body weight into the portal vein was successful in all five monkeys. Differences in the hepatobiliary anatomy of rhesus monkeys compared to humans led to a higher initial complication rate. The first monkey died of abdominal hemorrhage 10 hours post-transplantation. The second suffered from a mild pneumothorax but recovered fully after taking only conservative measures. After gaining experience with the first two monkeys, we decreased both the hepatic puncture time and the number of puncture attempts required, with the remaining three monkeys experiencing no complications. Portal pressures initially increased proportional to the number of transplanted microbeads but returned to pre-infusion levels at 30 minutes post-transplantation. The changes in portal pressures occurring during the procedure were not significantly different. CONCLUSIONS: Ultrasound-guided PTPC is an effective, convenient, and minimally invasive method suitable for use in non-human primate models of

  17. INDICATIONS AND COMPLICATIONS OF CENTRAL VENOUS CATHETERIZATION IN CRITICALLY ILL CHILDREN IN INTENSIVE CARE UNIT

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    Shwetal Bhatt

    2012-02-01

    Full Text Available Background: Nothing can be more difficult, time consuming and frustrating than obtaining vascular access in critically ill pediatric patient1 .Central venous catheters are widely used in the care of critically ill patients. Methodology: This paper reviews our experience with central lines in 28 critically ill patients including neonates and non-neonates, in a study period of October 2008 to October 2009. Of the total 28 patients, central venous catheterizations was more in those who were more than a month age and of female sex. Results: The route of insertion was femoral in approximately 89% of our patients and insertion was successful in 24 patients. The most common indication we observed for catheter use was, venous access in shock (37.1% in neonates and for monitoring the central venous pressure (32% in non neonate patients of ARDS with pulmonary edema and Shock. The central line was removed in majority of patients (60% within 24-48hrs of insertion and was kept for maximum of six days in just one patient. Organism most frequently isolated was Acinetobacter. Recommendations made include, use strict aseptic measures by restricted number of skilled operators while inserting and during maintaining central line, routine confirmatory x-ray or fluoroscopy to check the position of central line before catheter use, if possible, use for central pressure monitoring recommended. Conclusion: We concluded that central venous catheterization is a safe and effective measure so we recommend timely and judicious use of percutaneous central venous catheter in paediatric critically ill patients of PICU and NICU. [National J of Med Res 2012; 2(1.000: 85-88

  18. Radiation exposure to personnel in cardiac catheterization laboratories; Strahlenexposition des Personals im Herzkatheterlabor

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    Boetticher, H. von [Inst. fuer Radiologie, Zentralkrankenhaus Links der Weser, Bremen (Germany); Meenen, C. [Abt. Praevention, Unfallkasse Freie Hansestadt Bremen, Bremen (Germany); Lachmund, J. [Inst. fuer Radiologie, Zentralkrankenhaus Links der Weser, Bremen (Germany); Bremer Inst. fuer Praeventionsforschung, Sozialmedizin und Epidemiologie (BIPSE) (Germany); Hoffmann, W. [Inst. fuer Community Medicine, Ernst-Moritz-Arndt-Univ. Greifswald (Germany); Enge, H.J. [Klinik fuer Kardiologie, Zentralkrankenhaus Links der Weser, Bremen (Germany)

    2003-07-01

    Radiation exposure in personnel of cardiac catheterization units is based on local dosimetry during patient investigations. In the present study, dose rates were measured at various heights in representative locations, with and without fixed radiation protection shields in place. To determine the effective dose values, TLD measurements were performed using an Alderson phantom to generate radiation scatter and a second phantom in the position of the cardiologist performing the catheterization. Various types of personal radiation protection garment and fixed shields were considered in the calculations. Our results indicate on one hand that good protective standards can be achieved with effective doses below 1 mSv/year under optimized conditions. On the other hand, inappropriate radiation protection equipment can cause substantial increase of radiation doses. Alone the lack of a thyroid shield increases the effective dose of the cardiologist by a factor of 3. For the personnel, effective doses were generally higher than personal doses by a factor between 1.5 and 4.8 depending on the radiation protection situation. (orig.) [German] Die Strahlenexposition des Personals im Herzkatheterlabor wird auf der Basis von Messungen der Ortsdosisleistung waehrend Patientenuntersuchungen ermittelt. Dabei werden Werte in verschiedenen Hoehen an repraesentativen Aufenthaltsorten mit und ohne Dauerschutzeinrichtungen bestimmt. Zur Bestimmung der effektiven Dosen werden TLD-Messungen mit einem Alderson-Phantom als Streukoerper und einem zweiten als Untersucher durchgefuehrt. Unterschiedliche Ausfuehrungen von persoenlichen Schutzausruestungen und die Auswirkungen der Dauerschutzeinrichtungen werden rechnerisch einbezogen. Es wird gezeigt, dass einerseits unter optimierten Bedingungen ein guter Strahlenschutz mit effektiven Dosen unter 1 mSv/Jahr realisiert werden kann, andererseits aber Maengel in der Schutzausruestung zu erheblichen Dosiserhoehungen fuehren. Allein das Fehlen eines

  19. DIAGNOSTIC CARDIAC CATHETERIZATION USING THE MEDRAD AVANTA FLUID MANAGEMENT SYSTEM AS COMPARED TO THE TRADITIONAL MANUAL INJECTION METHOD

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    Winniford, Michael D

    2013-02-08

    Nearly 4 million patient procedures performed annually in US cardiac catheterization laboratories utilize contrast media to achieve vessel opacification. The amount of contrast media used is variable and depends on the complexity of the procedure, the method of contrast delivery as well as the skill-level of the operator. Since the total amount of contrast used for each procedure can have both patient safety and economic implications, it is essential for cardiologists to have the ability to control contrast delivery such that optimal angiographic image quality is achieved using the least amount of contrast. Although the complication rate associated with cardiac catheterization remains low, the most common serious complication, contrast-induced nephropathy (CIN), is associated with poor prognosis and a high mortality rate. Numerous interventional strategies for preventing and reducing the severity of CIN have demonstrated varying degrees of clinical benefit, but none has been shown to reliably prevent this serious complication. To date, the most effective approach for reducing the risk of CIN is to properly hydrate the patient and to minimize the amount of contrast media administered. Automated injection systems are intended for use in virtually all cardiac catheterization procedures and have numerous features which can provide potential advantages over traditional methods. With automated injection technology the operator is able to control and precisely monitor contrast delivery. Additionally, the MEDRAD Avanta Fluid Management Injection System utilizes a sterile contrast reservoir which eliminates the need to discard unused contrast in individual opened containers following each procedure. Considering that an average of 50% of opened contrast media is wasted using manual injection methods, this savings can provide a substantial economic benefit. Automated systems also facilitate the use of smaller (5 French) catheter sizes. Precise flow control and the use of

  20. Use of optimized ultrasound axis along with marked introducer needle to prevent mechanical complications of internal jugular vein catheterization

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    Tanmoy Ghatak

    2013-01-01

    Full Text Available Internal jugular vein (IJV catheterization is a routine technique in the intensive care unit. Ultrasound (US guided central venous catheter (CVC insertion is now the recommended standard. However, mechanical complications still occur due to non-visualization of the introducer needle tip during US guidance. This may result in arterial or posterior venous wall puncture or pneumothorax. We describe a new technique of (IJV catheterization using US, initially the depth of the IJV from the skin is measured in short-axis and then using real time US long-axis view guidance a marked introducer needle is advanced towards the IJV to the defined depth measured earlier in the short axis and the IJV is identified, assessed and cannulated for the CVC insertion. Our technique is simple and may reduce mechanical complications of US guided CVC insertion.

  1. Three-dimensional magnetic resonance imaging overlay to assist with percutaneous transhepatic access at the time of cardiac catheterization

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    Wendy Whiteside

    2015-01-01

    Full Text Available Multimodality image overlay is increasingly used for complex interventional procedures in the cardiac catheterization lab. We report a case in which three-dimensional magnetic resonance imaging (3D MRI overlay onto live fluoroscopic imaging was utilized to safely obtain transhepatic access in a 12-year-old patient with prune belly syndrome, complex and distorted abdominal anatomy, and a vascular mass within the liver.

  2. Three-dimensional magnetic resonance imaging overlay to assist with percutaneous transhepatic access at the time of cardiac catheterization.

    Science.gov (United States)

    Whiteside, Wendy; Christensen, Jason; Zampi, Jeffrey D

    2015-01-01

    Multimodality image overlay is increasingly used for complex interventional procedures in the cardiac catheterization lab. We report a case in which three-dimensional magnetic resonance imaging (3D MRI) overlay onto live fluoroscopic imaging was utilized to safely obtain transhepatic access in a 12-year-old patient with prune belly syndrome, complex and distorted abdominal anatomy, and a vascular mass within the liver.

  3. Measurement of oxygen consumption in children undergoing cardiac catheterization: comparison between mass spectrometry and the breath-by-breath method.

    Science.gov (United States)

    Guo, Long; Cui, Yong; Pharis, Scott; Walsh, Mark; Atallah, Joseph; Tan, Meng-Wei; Rutledge, Jennifer; Coe, J Y; Adatia, Ian

    2014-06-01

    Accurate measurement of oxygen consumption (VO2) is important to precise calculation of blood flow using the Fick equation. This study aimed to validate the breath-by-breath method (BBBM) of measuring oxygen consumption VO2 compared with respiratory mass spectroscopy (MS) for intubated children during cardiac catheterization. The study used MS and BBBM to measure VO2 continuously and simultaneously for 10 min in consecutive anesthetized children undergoing cardiac catheterization who were intubated with a cuffed endotracheal tube, ventilated mechanically, and hemodynamically stable, with normal body temperature. From 26 patients, 520 data points were obtained. The mean VO2 was 94.5 ml/min (95 % confidence interval [CI] 65.7-123.3 ml/min) as measured by MS and 91.4 ml/min (95 % CI 64.9-117.9 ml/min) as measured by BBBM. The mean difference in VO2 measurements between MS and BBBM (3.1 ml/min; 95 % CI -1.7 to +7.9 ml/min) was not significant (p = 0.19). The MS and BBBM VO2 measurements were highly correlated (R (2) = 0.98; P measure VO2 in anesthetized intubated children undergoing cardiac catheterization. The two methods demonstrated excellent agreement. However, BBBM may be more suited to clinical use with children.

  4. Validation of the severity index by cardiac catheterization and Doppler echocardiography in patients with aortic sclerosis and stenosis

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    Rosales Joseph

    2006-03-01

    Full Text Available Abstract The severity index is a new echocardiographic measure that is thought to be an accurate indicator of aortic leaflet pathology in patients with AS. However, it has not been validated against cardiac catheterization or Doppler echocardiographic measures of AS severity nor has it been applied to patients with aortic sclerosis. The purposes of this study were to compare the severity index to invasive hemodynamics and Doppler echocardiography across the spectrum of calcific aortic valve disease, including aortic sclerosis and AS. 48 patients with aortic sclerosis and AS undergoing echocardiography and cardiac catheterization comprised the study population. The aortic valve leaflets were assessed for mobility (scale 1 to 6 and calcification (scale 1 to 4 and the severity index was calculated as the sum of the mobility and calcification scores according to the methods of Bahler et al. The severity index increased with increasing severity of aortic valve disease; the severity indices for patients with aortic sclerosis, mild to moderate AS and severe AS were 3.38 ± 1.06, 6.45 ± 2.16 and 8.38 ± 1.41, respectively. The aortic jet velocity by echocardiography and the square root of the maximum aortic valve gradient by cardiac catheterization correlated well with the severity index (r = 0.84, p

  5. Who is teaching and supervising our junior residents' central venous catheterizations?

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    Roberts James M

    2011-04-01

    Full Text Available Abstract Background The extent to which medical residents are involved in the teaching and supervision of medical procedures is unknown. This study aims to evaluate the teaching and supervision of junior residents in central venous catheterization (CVC by resident-teachers. Methods All PGY-1 internal medicine residents at two Canadian academic institutions were invited to complete a survey on their CVC experience, teaching, and supervision prior to their enrolment in a simulator CVC training curriculum. Results Of the 69 eligible PGY-1 residents, 32 (46% consenting participants were included in the study. There were no significant baseline differences between participants from the two institutions in terms of sex, number of ICU months completed, previous CVC training received, number of CVCs observed and performed. Only 16 participants (50% received any CVC training at baseline. Of those who received any training, 63% were taught only by senior resident-teachers. A total of 81 CVCs were placed by 17 participants. Thirty-two CVCs (45% were supervised by resident-teachers. Conclusions Resident-teachers play a significant role both in the teaching and supervision of CVCs placed by junior residents. Educational efforts should focus on preparing residents for their role in teaching and supervision of procedures.

  6. The value of ultrasonography in the diagnosis of portal vein thrombosis by umbilical venous catheterization

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    Lee, Kwang Keun; Kim, Young Tong; Kim, Il Young [Chonan Hospital, Soonchunhyang University, Chonan (Korea, Republic of)

    2000-12-15

    To evaluate the usefulness of ultrasonography for diagnosis of portal vein thrombosis (PVT) associated with the umbilical venous catheterization (UVC). We reviewed the abnormal ultrasonography of 54 patients with UVC. We observed echogenic thrombus in the portal vein by ultrasonography which has a 5-10 MHz linear transducer. We evaluated the frequency of PVT, the relationship between PVT and duration of UVC, and the location of catheter tip (Group I (n=41): above the diaphragm, Group II (n=9): between the diaphragm and the liver, Group III (n=4): below the liver), the location of thrombus on US, and the change of PVT on the follow-up ultrasonography. PVT was identified in the 7 neonates (13%) among the 54 neonates with UVC. The frequency of PVT was 5% on group I, 45% on group II and 25% on group III. The 6 cases among the 7 cases(86%) of PVT were localized to the umbilical portion of the left portal vein, and there were completely resolved (n=4) or regressed (n=1) on the follow-up ultrasonography(n=5). Remaining one case of PVT was located in the right, left, and main portal veins with collateral formation, and cavernous transformation occurred on the follow-up. Most PVTs by UVC are localized to the umbilical portion of left portal vein. Ultrasonography is a useful modality to diagnose PVT by UVC.

  7. Validity of ICD-9-CM codes for the identification of complications related to central venous catheterization.

    Science.gov (United States)

    Tukey, Melissa H; Borzecki, Ann M; Wiener, Renda Soylemez

    2015-01-01

    Two complications of central venous catheterization (CVC), iatrogenic pneumothorax and central line-associated bloodstream infection (CLABSI), have dedicated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Despite increasing use of ICD-9-CM codes for research and pay-for-performance purposes, their validity for detecting complications of CVC has not been established. Complications of CVCs placed between July 2010 and December 2011 were identified by ICD-9-CM codes in discharge records from a single hospital and compared with those revealed by medical record abstraction. The ICD-9-CM code for iatrogenic pneumothorax had a sensitivity of 66.7%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 99.5%. The ICD-9-CM codes for CLABSI had a sensitivity of 33.3%, specificity of 99.0%, PPV of 28.6%, and NPV of 99.2%. The low sensitivity and variable PPV of ICD-9-CM codes for detection of complications of CVC raise concerns about their use for research or pay-for-performance purposes.

  8. Internal Jugular Vein Catheterization with Seldinger Technique, previous Needle Puncture: Complications

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    Carrizo G

    2016-06-01

    Full Text Available Central venous catheterization (CVC is a common procedure performed daily for its outnumbered indications, complication rates range are up to 15%. The previous puncture with a fine needle with the Seldinger technique can reduce even more the possible complications, guaranteeing a high percentage of success. The objective was to determine the number of CVC per puncture with Seldinger technique performed by general surgery residents and identify number and type of mechanical complications, related to the residence year. A descriptive transversal cut study has been carried out, between March and November of 2014. A number of 243 patients were evaluated, observing that 41% of the cases were to measure CVP and hemodynamic monitoring; 76% of the punctures were done by 1º and 2º year residents, presenting only 10% on mechanic complications, most frequently on arterial puncture. In conclusion, previous puncture with needle with the Seldinger technique is safer, more secure, lower cost, and reduces the number of complications, it is a variant puncture under ultrasound guidance.

  9. Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility

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    Lee, Tain; Tsai, I.C.; Chen, Min-Chi [Taichung Veterans General Hospital, 407 Department of Radiology, Taichung (Taiwan); Medical College of Chung Shan Medical University, Faculty of Medicine, Taichung (Taiwan); National Yang Ming University School of Medicine, Department of Medicine, Taipei (Taiwan); Fu, Yun-Ching; Jan, Sheng-Lin [Taichung Veterans General Hospital, Department of Paediatrics, Taichung (Taiwan); National Yang-Ming University, Institute of Clinical Medicine, Taipei (Taiwan); Wang, Chung-Chi; Chang, Yen [Taichung Veterans General Hospital, Section of Cardiovascular Surgery, Department of Surgery, Taichung (Taiwan)

    2006-12-15

    Echocardiography is the first-line modality for the investigation of neonatal congenital heart disease. Diagnostic cardiac catheterization, which has a small but recognized risk, is usually performed if echocardiography fails to provide a confident evaluation of the lesions. To verify the technical and clinical feasibilities of replacing diagnostic cardiac catheterization with multidetector-row CT (MDCT) in neonatal complex congenital heart disease. Over a 1-year period we prospectively enrolled all neonates with complex congenital heart disease referred for diagnostic cardiac catheterization after initial assessment by echocardiography. MDCT was performed using a 40-detector-row CT scanner with dual syringe injection. A multidisciplinary congenital heart disease team evaluated the MDCT images and decided if further diagnostic cardiac catheterization was necessary. The accuracy of MDCT in detecting separate cardiovascular anomalies and bolus geometry of contrast enhancement were calculated. A total of 14 neonates were included in the study. No further diagnostic cardiac catheterization was needed in any neonate. The accuracy of MDCT in diagnosing separate cardiovascular anomalies was 98% (53/54) with only one atrial septal defect missed in a patient with coarctation syndrome. The average cardiovascular enhancement in evaluated chambers was 471 HU. No obvious beam-hardening artefact was observed. The technical and clinical feasibility of MDCT in complex congenital heart disease in neonates is confirmed. After initial assessment with echocardiography, MDCT could probably replace diagnostic cardiac catheterization for further anatomical clarification in neonates. (orig.)

  10. Validation of high-resolution echocardiography and magnetic resonance imaging vs. high-fidelity catheterization in experimental pulmonary hypertension.

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    Urboniene, Dalia; Haber, Idith; Fang, Yong-Hu; Thenappan, Thenappan; Archer, Stephen L

    2010-09-01

    High-frequency echocardiography and high-field-strength magnetic resonance imaging (MRI) are new noninvasive methods for quantifying pulmonary arterial hypertension (PAH) and right ventricular (RV) hypertrophy (RVH). We compared these noninvasive methods of assessing the pulmonary circulation to the gold standard, cardiac catheterization (micromanometer-tipped catheters), in rats with monocrotaline-induced PAH and normal controls. Closed-chest, Sprague-Dawley rats were anesthetized with inhaled isoflurane (25 monocrotaline, 6 age-matched controls). Noninvasive studies used 37.5-MHz ultrasound (Vevo 770; VisualSonics) or a 9.4-T MRI (Bruker BioSpin). Catheterization used a 1.4-F micromanometer-tipped Millar catheter and a thermodilution catheter to measure cardiac output (CO). We compared noninvasive measures of pulmonary artery (PA) pressure (PAP) using PA acceleration time (PAAT) and CO, using the geometric PA flow method and RV free wall (RVFW) thickness/mass with cardiac catheterization and/or autopsy. Blinded operators performed comparisons using each method within 2 days of another. In a subset of rats with monocrotaline PAH, weekly echocardiograms, catheterization, and autopsy data assessed disease progression. Heart rate was similar during all studies (>323 beats/min). PAAT shortened, and the PA flow envelope displayed systolic "notching," reflective of downstream vascular remodeling/stiffening, within 3 wk of monocrotaline. MRI and echocardiography measures of PAAT were highly correlated (r(2) = 0.87) and were inversely proportional to invasive mean PAP (r(2) = 0.72). Mean PAP by echocardiography was estimated as 58.7 - (1.21 x PAAT). Invasive and noninvasive CO measurement correlated well (r(2) >or= 0.75). Noninvasive measures of RVFW thickness/mass correlated well with postmortem measurements. We conclude that high-resolution echocardiography and MRI accurately determine CO, PAP, and RV thickness/mass, offering similar results as high-fidelity right heart

  11. Comparing the cost-effectiveness of simulation modalities: a case study of peripheral intravenous catheterization training.

    Science.gov (United States)

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-05-01

    While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three simulation-based programs. Medical students (n = 15 per group) practiced in one of three 2-h intravenous catheterization skills training programs: low-fidelity (virtual reality), high-fidelity (mannequin), or progressive (consisting of virtual reality, task trainer, and mannequin simulator). One week later, all performed a transfer test on a hybrid simulation (standardized patient with a task trainer). We used a net benefit regression model to identify the most cost-effective training program via paired comparisons. We also created a cost-effectiveness acceptability curve to visually represent the probability that one program is more cost-effective when compared to its comparator at various 'willingness-to-pay' values. We conducted separate analyses for implementation and total costs. The results showed that the progressive program had the highest total cost (p willingness-to-pay value, the progressive training program was generally most educationally- and cost-effective. Our analyses suggest that a progressive program that strategically combines simulation modalities provides a cost-effective solution. More generally, we have introduced how a cost-effectiveness analysis may be applied to simulation training; a method that medical educators may use to investment decisions (e.g., purchasing cost-effective and educationally sound simulators).

  12. Progression of isolated aortic stenosis: analysis of 29 patients having more than 1 cardiac catheterization.

    Science.gov (United States)

    Nestico, P F; DePace, N L; Kimbiris, D; Hakki, A H; Khanderia, B; Iskandrian, A S; Segal, B

    1983-11-01

    Factors related to progression of nonrheumatic aortic stenosis (AS) were analyzed in 29 adult patients who underwent serial hemodynamic studies over a mean of 71 months. AS was congenital in 8 patients and degenerative in 21. The patients were divided into 2 groups on the basis of the change in aortic valve area between the 2 studies. Twelve patients had a greater than or equal to 25% reduction in aortic valve area (Group I) and 17 patients had less than 25% decrease in aortic valve area (Group II). There were no significant differences between the 2 groups in age, interval between studies, cardiac output, left ventricular end-diastolic pressure, left ventricular peak systolic pressure and origin of AS (congenital or degenerative). Group I patients had significantly larger initial aortic valve areas than did Group II patients (1.3 +/- 0.9 cm2 versus 0.8 +/- 0.4 cm2, p = 0.02). Also, the initial peak transaortic pressure gradients were lower in Group I than in Group II (27 +/- 19 versus 58 +/- 38 mm Hg, p = 0.01). Group I patients had a significantly greater increase in pressure gradient and a greater reduction in cardiac output than did Group II patients (24 +/- 21 mm Hg in Group I versus -0.1 +/- 24.5 mm Hg in Group II, p = 0.01, and -1.0 +/- 1.3 liters/min in Group I versus 0.10 +/- 1.4 liters/min in Group II, p = 0.03). Thus, AS progressed in 41% of a selected group of patients who underwent repeated cardiac catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Sperm evaluation and biochemical characterization of cat seminal plasma collected by electroejaculation and urethral catheterization.

    Science.gov (United States)

    Zambelli, Daniele; Raccagni, Ramona; Cunto, Marco; Andreani, Giulia; Isani, Gloria

    2010-11-01

    This paper aimed to evaluate cat seminal plasma protein profile (with SDS-page) and determine differences in seminal plasma composition from ejaculates obtained using urethral catheterization after pharmacological induction (UrCaPI) and electroejaculation (EE). In addition, this study evaluates whether the recovery method affected seminal plasma protein and zinc concentrations. A single ejaculation was collected from 17 mixed-breed cats by EE (5/21) or UrCaPI (12/21), while 4/21 cats underwent four sperm collections once every four days using EE and UrCaPI techniques alternately. The semen parameters evaluated were: volume, percentage of motility and progressive motility, morphology, and sperm concentration. After centrifugation, the seminal plasma obtained was stored at -80 °C and later used to measure protein and zinc concentrations, and to determine protein profile by SDS-polyacrylamide gel electrophoresis (PAGE). The results obtained indicate that cat seminal plasma protein profile is characterized by many protein bands (>30) with a molecular weight ranging from 3.5 to 200 kDa, and that the recovery method influences the seminal plasma protein profile: EE is related to the absence of two proteins (P55 and P14), and alters three protein bands (P200, P80, P28). The collection technique also affected zinc concentration (mg/dL) and protein concentration (g/dL) which were significantly higher (P < 0.01) in samples collected by UrCaPI; on the contrary the total Zn and protein amount/ejaculate were not significantly different in samples collected by both technique (P < 0.05).

  14. Novel miniature mobile cardiac catheterization laboratory for critical cardiovascular disease following natural disasters: a feasibility study

    Institute of Scientific and Technical Information of China (English)

    HAN Ya-ling; MENG Wei-hong; LIANG Zhuo; YAO Tian-ming; SUN Jing-yang; LIANG Ming; HUO Yu; WANG Geng; WANG Xiao-zeng; LIANG Yan-chun

    2012-01-01

    Background Natural disasters have been frequent in recent years.Effective treatment of patients with cardiovascular disease following natural disasters is an unsolved problem.We aimed to develop a novel miniature mobile cardiac catheterization laboratory (Mini Mobile Cath Lab) to provide emergency interventional services for patients with critical cardiovascular disease following natural disasters.A feasibility study was performed by testing the Mini Mobile Cath Lab on dogs with ST-elevation myocardial infarction (STEMI) model in a hypothetical natural-disaster-stricken area.Methods The Mini Mobile Cath Lab was transported to the hypothetical natural-disaster-stricken area by truck.Coronary angiography and primary percutaneous coronary intervention (PCI) were performed on six dogs with STEMI model.The transportation and transformation of the Mini Mobile Cath Lab were monitored and its functioning was evaluated through the results of animal experiments.Results The Mini Mobile Cath Lab could be transpdrted by truck at an average speed of 80 km/h on mountain roads during daytime in the winter,under conditions of light snow (-15℃ to -20℃/-68°F to -59°F).The average time required to prepare the Mini Mobile Cath Lab after transportation,in a wetland area,was 30 minutes.Coronary angiography,and primary PCI were performed successfully.Conclusion This preliminary feasibility study of the use of the Mini Mobile Cath Lab for emergency interventional treatment of dogs with STEMI indicated that it may perform well in the rescue of critical cardiovascular disease following natural disasters.

  15. Central Venous Catheterization Complication: Delayed Diagnosis of Venous Perforation and Hemothorax

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    Murat Bağcı

    2015-12-01

    Full Text Available Mechanical complications of central venous catheterization (CVC include artery puncture, vein injuries, catheter malposition (CM, pneumothorax, hemothorax, air embolism, subcutaneous hematoma and arrhythmia. This report was aimed to present the case developing hemothorax due to multilumen catheter (MLC malposition following venous perforation which is overlooked during CVC. A 21-year old female patient was planned urgent surgery due to a sharp object injury on the right arm. MLC was inserted to left internal jugular vein (IJV using the seldinger technique in the second attempt. Despite administration of erythrocyte suspension, fluid and noradrenaline infusion through the MLC, patient’s Hct did not increase, hypotension and tachycardia were continued. Catheter was not used and peripheral venous vascular access was used for replacement and infusions. Postoperatively, opacity covering the left hemithorax was detected on the chest radiograph, marked pleural effusion and pneumothorax on the left side was detected on thorax computed tomography. MLC was removed and tube thoracostomy drainage was administered. Hemorrhagic fluid was drained from thorax. Conservative treatment was deemed appropriate since stable vital signs after chest tube application. The complication rate is low and success rate is high in CVC from IJV. Malposition is rare in CVC application from right IJV than in CVC application from left IJV. There is a sharp curve in CVC from the left IJV, which frequently leads to malposition of the MLC. CM should be suspected with no aspiration of blood through catheter or aspiration of another substance such as air, chylous fluid, etc. and non-pulsatile blood flow. If dyspnea, tachycardia, tachypnea, hypotension and desaturation develop after catheter administration we should be alert.

  16. Cardiac catheterization: impact of face and neck shielding on new estimates of effective dose.

    Science.gov (United States)

    von Boetticher, Heiner; Lachmund, Jörn; Hoffmann, Wolfgang

    2009-12-01

    Optimization of radiation protection devices for the operator is achieved by minimizing the effective dose (E) on the basis of the recommendations of Publications 60 and 103 of the International Commission on Radiological Protection (ICRP). Radiation exposure dosimetry was performed with thermoluminescence dosimeters using one Alderson phantom in the patient position and a second one in the typical position of the operator. Various types of protective clothing as well as fixed leaded shieldings (table mounted shielding and overhead suspended shields) were considered calculating E. Shielding factors for protective equipment can readily be misinterpreted referring to the reduction of the effective dose because fixed protective barriers as well as radiation protection clothing are shielding only parts of the body. With the ICRP 103 approach relative to the exposure without lead protection, a lead apron of 0.35 or 0.5 mm thickness reduces E to 14.4 or 12.3%, respectively; by using an additional thyroid collar, these values are reduced to 9.7 or 7.5%. A thyroid collar reduces the effective dose by more than an increase of the lead equivalency of the existing apron. Wearing an apron of 0.5 mm lead-equivalent with a thyroid collar and using an additional side shield, E decreases to 6.8%. Using both a fixed side and face shield decreases E to 2.0%. For protective garments including thyroid protection, the values of the effective dose in cardiac catheterization are 47-106% higher with ICRP 103 than with ICRP 60 recommendations. This is essentially caused by the introduction of new factors for organs in the head and neck region in ICRP 103.

  17. Balloon valvuloplasty as destination therapy in elderly with severe aortic stenosis:a cardiac catheterization study

    Institute of Scientific and Technical Information of China (English)

    Vasileios Kamperidis; Georgios K Efthimiadis; Georgios Parcharidis; Haralambos Karvounis; Stavros Hadjimiltiades; Antonios Ziakas; Georgios Sianos; Georgios Kazinakis; George Giannakoulas; Sophia-Anastasia Mouratoglou; Athanasia Sarafidou; Ioannis Ventoulis

    2015-01-01

    Background In the current era of transcatheter aortic valve replacement, there is renewed interest in balloon aortic valvuloplasty (BAV) and invasive hemodynamic evaluation of aortic stenosis (AS). The current report aimed to study the invasive hemodynamics of se-vere AS patients treated with BAV as destination therapy and to identify factors associated with better hemodynamic outcome and prognosis. Methods From 2009 to 2012, 63 high risk elderly patients were treated with BAV as destination therapy for symptomatic severe AS and were all prospectively included in the study. Their hemodynamics were invasively evaluated during catheterization, pre-and post-BAV at the same session. All Post-BAV patients were regularly followed-up. Results The patients (82 ± 6 years, 52%male) had post-BAV aortic valve area index (AVAi) significantly increased and mean pressure gradient (MPG) significantly reduced. During the follow-up of 0.9 (maximum 3.3) years, those with post-BAV AVAi<0.6 cm2/m2 compared with the AVAi≥0.6 cm2/m2 group had significantly higher mortality (60%vs. 28%, log-rank P=0.02), even after adjusting for age, gender, atrial fibrillation, chronic kidney disease, diabetes mellitus, coronary artery disease and EuroSCORE [HR:5.58, 95%confidence interval (CI):1.62−19.20, P=0.006]. The only independent predictor of moderate AS post-BAV was the pre-BAV AVAi increase by 0.1cm2/m2 (OR:3.81, 95%CI:1.33−10.89, P=0.01). Pre-BAV AVAi≥0.39 cm2/m2 could predict with sensitivity 84%and specificity 70%the post-BAV hemodynamic outcome. Conclusions BAV as destination therapy for se-vere AS offered immediate and significant hemodynamic improvement. The survival was significantly better when a moderate degree of AS was present.

  18. Effectiveness of the implementation of a simple radiation reduction protocol in the catheterization laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Jurado-Román, Alfonso, E-mail: alfonsojuradoroman@gmail.com [Unidad de Hemodinámica, Servicio de Cardiología, Hospital General Universitario de Ciudad Real (Spain); Sánchez-Pérez, Ignacio; Lozano Ruíz-Poveda, Fernando; López-Lluva, María T.; Pinilla-Echeverri, Natalia; Moreno Arciniegas, Andrea [Unidad de Hemodinámica, Servicio de Cardiología, Hospital General Universitario de Ciudad Real (Spain); Agudo-Quilez, Pilar [Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid (Spain); Gil Agudo, Antonio [Servicio de Radiofísica y Protección Radiológica, Hospital General Universitario de Ciudad Real (Spain)

    2016-07-15

    Background and purpose: A reduction in radiation doses at the catheterization laboratory, maintaining the quality of procedures is essential. Our objective was to analyze the results of a simple radiation reduction protocol at a high-volume interventional cardiology unit. Methods: We analyzed 1160 consecutive procedures: 580 performed before the implementation of the protocol and 580 after it. The protocol consisted in: the reduction of the number of ventriculographies and aortographies, the optimization of the collimation and the geometry of the X ray tube-patient-receptor, the use of low dose-rate fluoroscopy and the reduction of the number of cine sequences using the software “last fluoroscopy hold”. Results: There were no significant differences in clinical baseline features or in the procedural characteristics with the exception of a higher percentage of radial approach (30.7% vs 69.6%; p < 0.001) and of percutaneous coronary interventions of chronic total occlusions after the implementation of the protocol (2.1% vs 6.7%; p = 0,001). Angiographic success was similar during both periods (98.3% vs 99.2%; p = 0.2). There were no significant differences between both periods regarding the overall duration of the procedures (26.9 vs 29.6 min; p = 0.14), or the fluoroscopy time (13.3 vs 13.2 min; p = 0.8). We observed a reduction in the percentage of procedures with ventriculography (80.9% vs 7.1%; p < 0.0001) or aortography (15.4% vs 4.4%; p < 0.0001), the cine runs (21.8 vs 6.9; p < 0.0001) and the dose–area product (165 vs 71 Gyxcm{sup 2}; p < 0.0001). Conclusions: With the implementation of a simple radiation reduction protocol, a 57% reduction of dose–area product was observed without a reduction in the quality or the complexity of procedures. - Highlights: • This simple protocol can achieve a reduction in dose–area product of 57%. • It does not interfere with the quality or complexity of the procedures. • Full advantage of “Last Fluoroscopy

  19. 1. Dose reduction of occupational exposure in cardiac catheterization and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Yoshimi [Kyushu Kosei Nenkin Hospital, Kitakyushu, Fukuoka (Japan); Matsumoto, Kunihiro; Fujihashi, Hiroshi; Umeda, Kazuhiro

    2000-08-01

    Occupational exposure to scattered radiation and protective equipment was assessed in 4 medical institutions in Kyushu, Japan. The areas where scattered radiation occurred, the scattered radiation dose in the operator's position, fluoroscopy time, the number of cinematography sessions, and annual number of patients were assessed, and the annual scattered radiation dose to the operator was estimated. Approximately 90% of scattered radiation was generated by the subject and the collimator. Measurement of scattered radiation during coronary arteriography yielded a dose of 255-1200 [{mu}Sv/hr.] during fluoroscopy and 3.8-26.7 [{mu}Sv/10 sec.] during radiography. The duration of fluoroscopy for ablation was much longer than during general examinations and PTCA, suggesting a possible contribution to occupational exposure. The data for the past 5 years show no marked change in total number of catheterizations, but the number of ablations has rapidly increased. Ablation requires specific skills, and thus it is frequently performed by only a few staff members, resulting in exposure being concentrated in a few specific persons. The estimated doses of scattered radiation to the eyes and thyroid gland, which are assumed to be the most highly exposed sites, were 116.2 [mSv/year] during fluoroscopy and 8.9 [mSv/year] during radiography, for a total of 125.1 [mSv/year]. This dose is very close to the maximum occupational exposure dose recommended by International Commission on Radiological Protection (ICRP), i.e., 150 [mSv/year]. A protective device that does not impose a burden on the operator or limit the functions of x-ray units was installed on top of the examining table as a measure to reduce the occupational dose. In an experiment using this device the scattered radiation dose during inguinal puncture decreased from 0.8 [mSv/hr.] to 0.02 [mSv/hr.], and the shielding rate was 2.5%. The dose was reduced 97.5%. The authors conclude that radiological personnel must make

  20. Central venous catheterization: comparison between interventional radiological procedure and blind surgical reocedure

    Energy Technology Data Exchange (ETDEWEB)

    Song, Won Gyu; Jin, Gong Yong; Han, Young Min; Yu, He Chul [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2002-11-01

    To determine the usefulness and safety of radiological placement of a central venous catheter by prospectively comparing the results of interventional radiology and blind surgery. For placement of a central venous catheter, the blind surgical method was used in 78 cases (77 patients), and the interventional radiological method in 56 cases (54 patients). The male to female ratio was 66:68, and the patients' mean age was 48 (range, 18-80) years. A tunneled central venous catheter was used in 74 cases, and a chemoport in 60. We evaluated the success and duration of the procedures, the number of punctures required, and ensuing complications, comparing the results of the two methods. The success rates of the interventional radiological and the blind surgical procedure were 100% and 94.8%, respectively. The duration of central catheterization was 3-395 (mean, 120) day, that of chemoport was 160.9 days, and that of tunneled central venous catheter was 95.1 days. The mean number of punctures of the subclavian vein was 1.2 of interventional radiology, and 2.1 for blind surgery. The mean duration of the interventional radiology and the blind surgical procedure was, respectively, 30 and 40 minutes. The postprocedure complication rate was 27.6% (37 cases). Early complications occurred in nine cases (6.7%): where interventional radiology was used, there was one case of hematoma, and blind surgery gave rise to hematoma (n=2), pneumothorax (n=2), and early deviation of the catheter (n=4). Late complications occurred in 32 cases (23.9%). Interventional radiology involved infection (n=4), venous thrombosis (n=1), catheter displacement (n=2) and catheter obstruction (n=5), while the blind surgical procedure gave rise to infection (n=5), venous thrombosis (n=3), catheter displacement (n=4) and catheter obstruction (n=8). The success rate of interventional radiological placement of a central venous catheter was high and the complication rate was low. In comparison with the blind

  1. Safety and efficacy of distal perfusion catheterization to prevent limb ischemia after common femoral artery cannulation for extracorporeal membrane oxygenation

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Chang Ho; Seong, Nak Jong; Yoon, Chang Jin [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2016-06-15

    The extracorporeal membrane oxygenation (ECMO) cannula has the potential for obstructing flow to the lower limb, thus causing severe ischemia and possible limb loss. We evaluated the safety and clinical efficacy of percutaneous distal perfusion catheterization in preventing limb ischemia. Between March 2013 and February 2015, 28 patients with distal perfusion catheterization after ECMO were included in this retrospective study. The technical success was evaluated by Doppler ultrasound at the popliteal level after saline injection via distal perfusion catheter. Clinical success was assessed when at least one of the following conditions was met: restoration of continuous peripheral limb oximetry value or presence of distal arterial pulse on Doppler ultrasound evaluation or resolution of early ischemic sign after connecting the catheter with ECMO. Twenty-six patients with early ischemia were successfully cannulated with a distal perfusion catheter (92.8%). Clinical success was achieved in 12/28 (42.8%) patients; 8/10 (80.0%) patients with survival duration exceeding 7 days and 4/18 (22.2%) patients with survival duration less than 7 days, respectively. A percutaneous distal perfusion catheter placement was a feasible tool with safety and efficacy in preventing lower limb ischemia for patients with prolonged common femoral arterial cannulation for ECMO.

  2. Thrombosis of the superior vena cava and auxiliary branches in patients with indwelling catheterization of the internal jugular vein

    Institute of Scientific and Technical Information of China (English)

    LI Han; WANG Shi-xiang; WANG Wei; XU Chen; SHEN Shen; YU Ling; ZHANG Gui-zhi

    2009-01-01

    central venous thrombosis. Logistic regressive analysis revealed that high level of homocysteic acid was the important risk factor for central venous thrombosis in HD patients with indwelling catheterization of the internal jugular vein.Conclusions The prevalence of central venous thrombosis in Chinese HD patients with indwelling catheterization of the internal jugular vein is quite high, especially in those patients with diabetes mellitus, malignant tumor, high levels of serum lipoprotein and homocysteic acid. Its clinical symptoms are insidious but dangerous. High level of homocysteic acid may be the important risk factor for central venous thrombosis in Chinese HD patients with indwelling catheterization of the internal jugular vein.

  3. Embolization of trauma-associated pelvic hemorrhage: Feasibility of super-selective catheterization in heavily injured patients as a damage control for life-threatening pelvic bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Park, Joon Young; Yim, Nam Yeol; Kim, Jae Kyu; Kim, Ook Hyoung; Kang, Yang Jun; Jung, Hye Doo; Kim, Seul Kee; Yoon, Woong [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2016-04-15

    To determine the efficacy of embolization with super-selective catheterization of the internal iliac arterial branches to treat heavily injured trauma patients with pelvic arterial bleeding. A retrospective analysis was performed using the medical records of 37 patients who underwent trans-arterial embolization for trauma-associated pelvic arterial hemorrhage in a regional trauma center between July 2010 and July 2013. In each patient, hemodynamic stability, embolization level, elapsed time for trans-arterial embolization, clinical outcome and embolization-related complications were evaluated. Comparison of elapsed time, and presence of complication was done according to embolization level. Transarterial embolization was conducted in 37 patients. Hemodynamic stability of each patient was classified into hemodynamic stable (n = 9), and unstable (n = 28). Twenty-nine of 37 patients underwent embolization after super-selective catheterization of more than 2nd order branch of internal iliac artery with a microcatheter, and 8 patients underwent proximal internal iliac artery embolization without super-selective catheterization. The mean elapsed procedure time for super-selective embolization (34.76 ± 20.0 minutes) was not significantly longer than proximal internal iliac artery embolization (33.87 ± 16.73 minutes, p = 0.215). Pelvic arterial embolization with super-selective catheterization is a safe and feasible treatment for heavily injured patients with trauma-associated pelvic arterial bleeding.

  4. Subclavian artery pseudoaneurysm complicating central venous catheterization: endovascular treatment with Amplatzer Vascular Plug 4 and covered stent.

    Science.gov (United States)

    Rossi, Umberto G; Petrocelli, Francesco; Ferro, Carlo

    2013-12-01

    Central venous catheterization is a routine vascular access procedure; however, it may be associated with life-threatening complications such as arterial puncture, leading to pseudoaneurysm formation. We report a case of a 41-year-old female that developed an iatrogenic left subclavian pseudoaneurysm complicating the attempt of left internal jugular vein cannulation for temporary hemodialysis therapy. The patient underwent urgent endovascular treatment with deployment of covered stent into the left subclavian artery (SCA) after embolization of the origin of the left internal mammary artery with Amplatzer Vascular Plug 4. The patient's recovery was unremarkable. Follow-up till 24 months reveals total exclusion of the pseudoaneurysm of the left SCA with patency of the distal branches.

  5. Central venous catheterization -- an anatomical review of a clinical skill -- Part 1: subclavian vein via the infraclavicular approach.

    Science.gov (United States)

    Boon, J M; van Schoor, A N; Abrahams, P H; Meiring, J H; Welch, T; Shanahan, D

    2007-08-01

    The safe and successful performance of a central venous catheterization (CVC) requires a specific knowledge of anatomy in addition to a working knowledge. Misunderstanding the anatomy may result in failure or complications. This review aims to aid understanding of the anatomical framework, pitfalls, and complications of CVC of the subclavian (SCV). CVC is common practice amongst surgeons, anesthesiologists, and emergency room physicians during the preparations for major surgical procedures such as open-heart surgery, as well as, for intensive care monitoring and rapid restoration of blood volume. Associated with this technique are certain anatomical pitfalls and complications that can be successfully avoided if one possesses a thorough knowledge of the contraindications, regional anatomy, and rationale of the technique.

  6. A New Technique for Superselective Catheterization of Arteries: Preshaping of a Micro-Guide Wire into a Shepherd's Hook Form

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Jee Hyun; Chung; Jin Wook; Jae, Hwan Jun; Lee, Whal; Park, Jae Hyung [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-06-15

    We wanted to introduce a new technique for superselective catheterization of arteries with preshaping of a micro-guide wire into a shepherd's hook form, and this is useful for superselection of small arteries branching at an acute angle from a large parent artery for the treatment of tumors and hemorrhages. We developed a superselective catheterization technique by using preshaping of a micro-guide wire into a shepherd's hook form. We encountered six patients in our practice for whom we failed to catheterize the small tumor-feeding arteries that branched at an acute angle from wide parent arteries during chemoembolization of hepatocellular carcinoma; the parent arteries were the right inferior phrenic artery (n = 4) and the left gastric artery (n = 1) from the celiac axis with celiac stenosis due to compression by the median arcuate ligament and the proper hepatic artery from the gastroduodenal artery (n = 1) in a patient who had celiac axis occlusion with collateral circulation via the pancreaticoduodenal arcade from the superior mesenteric artery. In these consecutive six patients, we tested the usefulness of this new technique with employing preshaping of a micro-guide wire into a shepherd's hook form for superselective catheterization of targeted vessels. The target arteries were successfully catheterized and satisfactory transcatheter arterial chemoembolization was performed in all six patients. There were no significant complications such as arterial dissection. We developed a technique that is effective for superselection of vessels with preshaping of micro-guide wire into a shepherd's hook hook form, and we successfully applied it during chemoembolization of hepatocellular carcinoma. This technique can be useful for superselection of small arteries that branch from a large parent artery at acute angles for the treatment of tumors and hemorrhages.

  7. In-line positioning of ultrasound images using wireless remote display system with tablet computer facilitates ultrasound-guided radial artery catheterization.

    Science.gov (United States)

    Tsuchiya, Masahiko; Mizutani, Koh; Funai, Yusuke; Nakamoto, Tatsuo

    2016-02-01

    Ultrasound-guided procedures may be easier to perform when the operator's eye axis, needle puncture site, and ultrasound image display form a straight line in the puncture direction. However, such methods have not been well tested in clinical settings because that arrangement is often impossible due to limited space in the operating room. We developed a wireless remote display system for ultrasound devices using a tablet computer (iPad Mini), which allows easy display of images at nearly any location chosen by the operator. We hypothesized that the in-line layout of ultrasound images provided by this system would allow for secure and quick catheterization of the radial artery. We enrolled first-year medical interns (n = 20) who had no prior experience with ultrasound-guided radial artery catheterization to perform that using a short-axis out-of-plane approach with two different methods. With the conventional method, only the ultrasound machine placed at the side of the head of the patient across the targeted forearm was utilized. With the tablet method, the ultrasound images were displayed on an iPad Mini positioned on the arm in alignment with the operator's eye axis and needle puncture direction. The success rate and time required for catheterization were compared between the two methods. Success rate was significantly higher (100 vs. 70 %, P = 0.02) and catheterization time significantly shorter (28.5 ± 7.5 vs. 68.2 ± 14.3 s, P method as compared to the conventional method. An ergonomic straight arrangement of the image display is crucial for successful and quick completion of ultrasound-guided arterial catheterization. The present remote display system is a practical method for providing such an arrangement.

  8. Relation Between Capillary Wedge Pressure Measured by Echocardiography Through Tissue Doppler Imaging (TDI Method and Catheterism in Patients with Mitral Valve Stenosis

    Directory of Open Access Journals (Sweden)

    Mashallah Dehghani

    2006-07-01

    Full Text Available Background: Considering suggested formula in the references and PCWP measured by catheterism, in the present study the relation between pulmonary capillary wedge pressure (PCWP measured the flow velocity of mitral valve and mitral annulus motion through tissue doppler imaging is evaluated Methods: 52 cases of severe MS were admitted for Balloon Mitral Valvolotomy (BMV are included in this study. Mean age was 35±5 years consisting of 40 females and 12 males. Valve area, Pulmonary artery systolic pressure (PAP, E (Maximum Velocity of mitral valve at the beginning of diastole & Em (Maximum rate of mitral annular motion at the beginning of diastole which is recorded through septal or lateral wall annulus site velocity and left atrial (LA size were also measured by echocardiography and PCWP & PAP through catheterism. All patients had normal ejection fraction (EF and coronary arteries; there was no other valvular diseases and shunts. Results: There was a significant correlation between PAP in echocardiography and catheterism. Mean PAP was 53±19 mmHg in echocardiography and 53.9±17.8mmHg in catheterism. There wasn't any correlation between PCWP in echocardiography and catheterism (P=0.33 and also no relation between PCWP and mitral valve area (MVA or LA size (P=0.2. E/Em ratio increased in severe MS cases.Conclusion: E/Em ratio and suggested formula would overestimate the wedge pressure so echocardiography is not a reliable method for measuring PCWP in severe MS. Em velocity and E/Em ratio may be used for estimating MS severity.

  9. Estimating the Incidence of Suspected Epidural Hematoma and the Hidden Imaging Cost of Epidural Catheterization: A Retrospective Review of 43,200 Cases

    Science.gov (United States)

    Henneman, Justin P.; Sandberg, Warren S.

    2013-01-01

    Introduction Hematoma associated with epidural catheterization is rare, but the diagnosis might be suspected relatively frequently. We sought to estimate the incidence of suspected epidural hematoma after epidural catheterization, and to determine the associated cost of excluding or diagnosing an epidural hematoma through radiologic imaging. Methods We conducted an electronic retrospective chart review of 43,200 patient charts using 4 distinct search strategies and cost analysis, all from a single academic institution from 2001 through 2009. Charts were reviewed for use of radiological imaging studies to identify patients with suspected and confirmed epidural hematomas. Costs for imaging to exclude or confirm the diagnosis were related to the entire cohort. Results In our analysis, over a 9-year period that included 43,200 epidural catheterizations, 102 patients (1:430) underwent further imaging studies to exclude or confirm the presence of an epidural hematoma—revealing 6 confirmed cases and an overall incidence (per 10,000 epidural blocks) of epidural hematoma of 1.38 (95% CI 0, 0.002). Among our patients, 207 imaging studies, primarily lumbar spine MRI, were performed. Integrating Medicare cost expenditure data, the estimated additional cost over a 9-year period for imaging and hospital charges related to identifying epidural hematomas nets to approximately $232,000 or an additional $5.37 per epidural. Discussion About 1 in 430 epidural catheterization patients will be suspected to have an epidural hematoma. The cost of excluding the diagnosis, when suspected, is relatively low when allocated across all epidural catheterization patients. PMID:23924685

  10. Influence of repeated PICC catheterized on catheter tip location%多次 PICC 置管对导管尖端位置的影响

    Institute of Scientific and Technical Information of China (English)

    郝敏; 马燕兰; 郭艳艳; 叶明; 宋林萍

    2015-01-01

    Objective To explore the influence of repeatedly PICC catheterized on catheter tip position. Methods We analyzed the catheter tip position of patients who located PICC in one level three class-A hospital in Beijing from May to October in 2014. A total of 381 effective medical records were collected and divided into having the history of catheterization group and having no history of catheterization group depending on patients whether catheterized before. The patients having the history catheterization were divided into ipsilateral catheter group(B1 group)and no ipsilateral catheter group(B0 group),the catheter tip position was compared. Results The best catheter tip position for patients having the history of catheterization was 30. 79% , which was lower than patients having no history group of 52. 66%(χ2 = 17. 565,P < 0. 01),and the patients of having catheterization history group had the incidence rate of shallow catheterization(47. 74% )higher than 35. 40% in the no catheterization history group(χ2 = 5. 817,P < 0. 05). The patients of having catheterization history group happened the incidence of catheter tip position acquired dystopia of venae subclavia higher than patients having no catheterization history group(P < 0. 05). The best catheter tip position had lower rate in the B1 group comparing with B0 group,but the patients acquired dystopia of venae subclavia in the B1 group was lower than the patients in the B0 group(P < 0. 05). Conclusions Multiple PICC catheterization reduces the accuracy of catheter tip position,and impacts the safety and reservation of PICC. We should minimize the non-planned extubation incidences. If patients require re-catheterizaiton,we should select the opposite limbs to catheterize without catheterizaiton contraindication to ensure the safe of PICC catheterization.%目的:探讨多次 PICC 置管对导管尖端位置的影响。方法对2014年5—10月北京市某三级甲等医院肿瘤科 PICC 置管患者的导管尖端

  11. INVESTIGATION OF CENTRAL HEMODYNAMICS VIA RIGHT HEART AND PULMONARY ARTERY CATHETERIZATION IN PATIENTS WITH SYSTEMIC CONNECTIVE TISSUE DISEASES

    Directory of Open Access Journals (Sweden)

    E. V. Nikolaeva

    2015-01-01

    Full Text Available Pulmonary arterial hypertension (PAH associated with systemic connective tissue diseases (SCTD is a poor prognostic manifestation of the latter that result in death if untreated. The invasive determination of hemodynamic parameters is prominent in diagnosing the disease and determining its treatment policy and prognosis.Objective: to analyze the results of catheterization in PAH-SCTD patients admitted to the V.A. Nasonova Research Institute of Rheumatology.Subjects and methods. The investigation included 59 patients admitted to the V.A. Nasonova Research Institute of Rheumatology from September 2009 to September 2014. PAH was diagnosed in accordance with the conventional guidelines. All the patients underwent right heart and pulmonary artery (PA catheterization at the diagnosis and over time during treatment.Results and discussion. All the patients included in the trial met the pre-capillary pulmonary hypertension (PH criteria: mean pulmonary artery pressure (MPAP ≥25 mm Hg; and PA wedge pressure (PAWP <15 mm Hg. The exclusion of other causes of PH (pulmonary fibrosis, left heart disease, and thromboembolism, as well as a high transpulmonary pressure gradient >15 mm Hg and pulmonary vascular resistance (PVR >3 Wood units could diagnose PAH in all our patients. There was a statistically highly significant association between pathological hemodynamic changes and functional class (FC. FC was found to be most closely correlated with right atrial pressure (RAP, cardiac output (CO, PVR, and cardiac index (CI. Among the most common manifestations of heart failure, only the presence of peripheral edemas was associated with worse hemodynamic parameters in PAH. It should be noted that out of two biomarkers (N-terminal pro-brain natriuretic peptide and uric acid, the former is largely related to the magnitude of changes in hemodynamic factors. The critical values of hemodynamic parameters were due to extreme edema – anasarca (RAP >17 mm Hg

  12. A Hidden Markov Model for 3D Catheter Tip Tracking with 2D X-ray Catheterization Sequence and 3D Rotational Angiography.

    Science.gov (United States)

    Ambrosini, Pierre; Smal, Ihor; Ruijters, Daniel; Niessen, Wiro; Moelker, Adriaan; van Walsum, Theo

    2016-11-07

    In minimal invasive image guided catheterization procedures, physicians require information of the catheter position with respect to the patient's vasculature. However, in fluoroscopic images, visualization of the vasculature requires toxic contrast agent. Static vasculature roadmapping, which can reduce the usage of iodine contrast, is hampered by the breathing motion in abdominal catheterization. In this paper, we propose a method to track the catheter tip inside the patient's 3D vessel tree using intra-operative single-plane 2D X-ray image sequences and a peri-operative 3D rotational angiography (3DRA). The method is based on a hidden Markov model (HMM) where states of the model are the possible positions of the catheter tip inside the 3D vessel tree. The transitions from state to state model the probabilities for the catheter tip to move from one position to another. The HMM is updated following the observation scores, based on the registration between the 2D catheter centerline extracted from the 2D X-ray image, and the 2D projection of 3D vessel tree centerline extracted from the 3DRA. The method is extensively evaluated on simulated and clinical datasets acquired during liver abdominal catheterization. The evaluations show a median 3D tip tracking error of 2.3 mm with optimal settings in simulated data. The registered vessels close to the tip have a median distance error of 4.7 mm with angiographic data and optimal settings. Such accuracy is sufficient to help the physicians with an up-to-date roadmapping. The method tracks in real-time the catheter tip and enables roadmapping during catheterization procedures.

  13. Experience in clinical nursing of patients undergoing deep venous catheterization%心血管疾病护理中不安全因素分析

    Institute of Scientific and Technical Information of China (English)

    刘传芬; 吴漫

    2013-01-01

    Objective To investigate the role of careful clinical nursing in preventing the complications of deep venous catheterization. Methods Fifty patients who underwent deep venous catheterization in the Internal Medicine Department of our hospital from February 2010 to March 2013 were selected for nursing evaluation. Results Standard aseptic operation, nursing for the site of puncture, close observation, good psychological nursing, and effective maintenance of central venous catheter like keeping the catheter unobstructed could reduce the rates of various complications and achieve good nursing effect. ConclusionEnhancing the nursing of patients undergoing deep venous catheterization can ensure the life and safety of patients, bring convenience to the treatment and nursing of severe cases, and effectively promote the recovery of patients, and careful nursing can effectively prevent the complications of deep venous catheterization.%本文将2010年6月-2012年6月来我院进行治疗的心血管患者198例作为研究对象,分析护理过程中存在的不安全因素,进而提出相关的改进措施。采取问卷调查的方式,本文对其中的不安全因素进行了归纳总结,得出心血管科的护理人员应该对护理过程中所存在的这些不安全因素给予足够的重视,通过自身护理水平的不断提高来减少医患之间的纠纷,进而提高医院的整体服务质量。

  14. Application of modified seldinger technique on-ultrasound-guided PICC catheterization of cancer patients.%非超声引导下改良塞丁格技术在肿瘤病人PICC置管时的应用

    Institute of Scientific and Technical Information of China (English)

    张玉珍; 苏迅; 张芳; 刘菊琴; 张娜

    2012-01-01

    Objective:To investigate the special method of non - ultrasound - guided PICC catheterization. Methods: A retrospective analysis of 122 cases of the successful PICC catheterization, among them, non - ultrasound - guided PICC catheterization for 32 patients were implemented by using modified Seldinger technique, which could not be implemented in conventional methods due to poor blood vessels. Results Successful catheterization for 31 patients, and unsuccessful catheterization for 1 patient, a catheter was inserted into the inferior vena cava through the femoral vein. Conclusion: Catheterization can be effectively implemented by using modified Seldinger technique , which can not be implemented in conventional methods. Modified Seldinger technique improve the success rate of PICC catheterization. This technique is simple, convenient, and is recommended as a back - up of regular catheterization method.%目的:探讨非超声引导下无法采用常规穿刺成功置入PICC导管的方法.方法:总结分析122例同期实施PICC置管肿瘤病人因血管条件差,无法实施常规穿刺置管的32例病人,在非超声引导下应用改良赛丁格技术穿刺置管的资料.结果:31例病人置管成功,1例穿刺成功后,因置入导管失败而改为股静脉穿刺,置入到下腔静脉.结论:在非超声引导下采用改良塞丁格技术,可有效解决常规方法不能实现的穿刺,提高了PICC置管成功率,操作简单、方便,作为常规置管的后备方法值得推荐.

  15. Reducing bed rest time from five to three hours does not increase complications after cardiac catheterization: the THREE CATH Trial 1

    Science.gov (United States)

    Matte, Roselene; Hilário, Thamires de Souza; Reich, Rejane; Aliti, Graziella Badin; Rabelo-Silva, Eneida Rejane

    2016-01-01

    Abstract Objective: to compare the incidence of vascular complications in patients undergoing transfemoral cardiac catheterization with a 6F introducer sheath followed by 3-hour versus 5-hour rest. Methods: randomized clinical trial. Subjects in the intervention group (IG) ambulated 3 hours after sheath removal, versus 5 hours in the control group (CG). All patients remained in the catheterization laboratory for 5 hours and were assessed hourly, and were contacted 24, 48, and 72 h after hospital discharge. Results: the sample comprised 367 patients in the IG and 363 in the GC. During cath lab stay, hematoma was the most common complication in both groups, occurring in 12 (3%) IG and 13 (4%) CG subjects (P=0.87). Bleeding occurred in 4 (1%) IG and 6 (2%) CG subjects (P=0.51), and vasovagal reaction in 5 (1.4%) IG and 4 (1.1%) CG subjects (P=0.75). At 24-h, 48-h, and 72-h bruising was the most commonly reported complication in both groups. None of the comparisons revealed any significant between-group differences. Conclusion: the results of this trial show that reducing bed rest time to 3 hours after elective cardiac catheterization is safe and does not increase complications as compared with a 5-hour rest. ClinicalTrials.gov Identifier: NCT-01740856 PMID:27463113

  16. Image Fusion of Preprocedural CTA with Real-time Fluoroscopy to Guide Proper Hepatic Artery Catheterization During Transarterial Chemoembolization of Hepatocellular Carcinoma: A Feasibility Study

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    Bargellini, Irene, E-mail: irenebargellini@hotmail.com; Turini, Francesca; Bozzi, Elena; Lauretti, Dario; Cicorelli, Antonio; Lunardi, Alessandro; Cioni, Roberto; Bartolozzi, Carlo [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy)

    2013-04-15

    To assess feasibility of proper hepatic artery catheterization using a 3D model obtained from preprocedural computed tomographic angiography (CTA), fused with real-time fluoroscopy, during transarterial chemoembolization of hepatocellular carcinoma. Twenty consecutive cirrhotic patients with hepatocellular carcinoma undergoing transarterial chemoembolization were prospectively enrolled onto the study. The early arterial phase axial images of the preprocedural CTA were postprocessed on an independent workstation connected to the angiographic system (Innova 4100; GE Healthcare, Milwaukee, WI), obtaining a 3D volume rendering image (VR) that included abdominal aorta, splanchnic arteries, and first and second lumbar vertebrae. The VR image was manually registered to the real-time X-ray fluoroscopy, with the lumbar spine used as the reference. The VR image was then used as guidance to selectively catheterize the proper hepatic artery. The procedure was considered successful when performed with no need for intraarterial contrast injections or angiographic acquisitions. The procedure was successful in 19 (95 %) of 20 patients. In one patient, celiac trunk angiography was required for the presence of a significant ostial stenosis that was underestimated at computed tomography. Time for image reconstruction and registration was <10 min in all cases. The use of preprocedural CTA model with fluoroscopy enables confident and direct catheterization of the proper hepatic artery with no need for preliminary celiac trunk angiography, thus reducing radiation exposure and contrast media administration.

  17. Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure

    Directory of Open Access Journals (Sweden)

    Luís E. Rohde

    2002-03-01

    Full Text Available OBJECTIVE: To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure. METHODS: Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements. RESULTS: We assessed 19 patients (age = 48±12 years and ejection fraction = 21±5% with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43% pulmonary artery occlusion pressure (P<0.001, with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, P<0.001. We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001 and central venous pressure (r=0.63; P<0.001. After clinical optimization, improvement in functional class occurred (P< 0.001, with a tendency towards improvement in ejection fraction and no impairment to renal function. CONCLUSION: Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in imme-diate benefits for patients with severe heart failure.

  18. A COMPARATIVE STUDY OF PEDIATRIC CARDIAC CATHETERIZATION PROCEDURE UNDER GENERAL ANESTHESIA WITH OR WITHOUT FEMORAL NERVE BLOCK

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    Jigisha

    2016-02-01

    Full Text Available OBJECTIVE Anesthetic management for interventional cardiac procedures/cardiac catheterization in pediatric patients is challenging. Cardiac anomalies vary from simple to complex congenital cardiac anomalies, shunts may be present at multiple levels and patients may be profoundly cyanotic, may be with ventricular dysfunction. They usually require sedation and analgesia to maintain steady stable state. In adults, such type of procedures can be well managed with local anesthesia. METHODS Fifty patients were included in the study. They were randomly divided into two groups- Group A (n=25 patients received femoral N. block along with IV sedation and analgesia while group B (n=25 patients received only IV sedation and analgesia. Both groups were compared for hemodynamics, pain score and requirement of IV anesthetic agents and any complications if come up. RESULTS Group A patients required IV ketamine 3.24mg/kg (±0.31SD as compared to 5.58mg/kg (±1.6SD in group B, which suggests significantly reduced requirement of IV anesthetic agents in group where femoral nerve block has been given. Hemodynamic parameters remained stable and comparable (no statistically significant variation Pain score was less in group A patients than group B. CONCLUSION It has been observed that Group A patients required less dosages of IV anesthetic agents, with stable hemodynamics and less pain score and sedation score as compared to group B patients.

  19. Hemodynamic parameters obtained by transthoracic echocardiography and right heart catheterization: a comparative study in patients with pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    TIAN Zhuang; ZENG Xiao-feng; LIU Yong-tai; FANG Quan; NI Chao; CHEN Tai-bo; FANG Li-gang; GAO Peng; JIANG Xiu-chun; LI Meng-tao

    2011-01-01

    Background Hemodynamic evaluation is crucial for the management of patients with pulmonary hypertention. Clinicians often prefer a rapid and non-invasive method. This study aimed to examine the feasibility of transthoracic echocardiography for the measurements of hemodynamic parameters in patients with pulmonary hypertension.Methods A prospective single-center study was conducted among 42 patients with pulmonary hypertension caused by different diseases. Transthoracic echocardiography and right-heart catheterization were performed within 24 hours. Pulmonary artery systolic, diastolic and mean pressure (PASP, PADP and PAMP), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP) were measured by both methods. A linear correlation and a Bland-Altman analysis were performed to compare the two groups of hemodynamic parameters.Results A good correlation was found between invasive and non-invasive measurements for PASP (r=0.96), PADP (r=0.85), PAMP (r=0.88), CO (r=0.82), and PCWP (r=0.81). Further agreement analysis done by the Bland-Altman method showed that bias and a 95% confidence interval for PASP, PADP, and CO were clinically acceptable while great discrepancies existed for PAMP and PCWP.Conclusions The non-invasive measurements by PASP, PADP, and CO in patients with pulmonary hypertension correlate well with the invasive determinations. Transthoracic echocardiography (TTE) was inappropriate for estimating PCWP and PAMP.

  20. Hybrid echo and x-ray image guidance for cardiac catheterization procedures by using a robotic arm: a feasibility study

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    Ma Yingliang; Penney, Graeme P; Razavi, Reza; Rhode, Kawal S [Division of Imaging Sciences, King' s College, London SE1 7EH (United Kingdom); Bos, Dennis; Frissen, Peter [Philips Applied Technologies, High Tech. Campus 7, 5656 AE Eindhoven (Netherlands); Rinaldi, C Aldo, E-mail: y.ma@kcl.ac.u [Department of Cardiology, Guy' s and St Thomas' NHS Foundation Trust, London SE1 7EH (United Kingdom)

    2010-07-07

    We present a feasibility study on hybrid echocardiography (echo) and x-ray image guidance for cardiac catheterization procedures. A self-tracked, remotely operated robotic arm with haptic feedback was developed that attached to a standard x-ray table. This was used to safely manipulate a three-dimensional (3D) trans-thoracic echo probe during simultaneous x-ray fluoroscopy and echo acquisitions. By a combination of calibration and tracking of the echo and x-ray systems, it was possible to register the 3D echo images with the 2D x-ray images. Visualization of the combined data was achieved by either overlaying triangulated surfaces extracted from segmented echo data onto the x-ray images or by overlaying volume rendered 3D echo data. Furthermore, in order to overcome the limited field of view of the echo probe, it was possible to create extended field of view (EFOV) 3D echo images by co-registering multiple tracked echo data to generate larger roadmaps for procedure guidance. The registration method was validated using a cross-wire phantom and showed a 2D target registration error of 3.5 mm. The clinical feasibility of the method was demonstrated during two clinical cases for patients undergoing cardiac pacing studies. The EFOV technique was demonstrated using two healthy volunteers. (note)

  1. 36. Anesthesia for high risk patients undergoing percutaneous mitral valve repair with the mitraclip system in the catheterization laboratory

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    R. Soliman

    2016-07-01

    Full Text Available MitraClip system implantation is used inhigh-risk patients with severe mitral regurgitation.anesthetic management for mitral clip implantation. The study included 34patients scheduled for MitraClip implantations in the catheterization laboratory. An arterial line and central venous line were inserted under local anesthesia before induction. Epinephrine was started before induction and milrinone infusion was started after induction. The anesthetic technique for induction and maintenance was the same for all patients. All patients were hemodynamically stable intra- and postoperatively. The intervention was successful in 33 cases and aborted in one case because of severe posteromedial leaflet tethering. The epinephrine and milrinone were weaned and all patients were extubated, except, one case mortality happened within the first 8 hours postoperatively. Percutaneous mitral valve repair with MitraClip implantation is a successful alternative in high-risk patients with symptomatic severe mitral regurgitation. Starting epinephrine before anesthetic induction and milrinone infusion induction resulted in decreased pulmonary artery pressure, increased ejection fraction and maintained arterial blood pressure during procedure inspite of worse preoperative conditions.

  2. A COMPARATIVE STUDY BETWEEN ULTRASOUND GUIDED CATHETERIZATION OF THE INTERNAL JUGULAR VEIN AND CLASSICAL LAND MARK TECHNIQUE

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    Henjarappa K S

    2014-12-01

    Full Text Available Background: Catheterization of Internal Jugular Vein (IJV is commonly attempted to obtain central venous access for hemodynamic monitoring, long term administration of fluids, total parenteral nutrition and hemodialysis in critical care patients. The safe puncture of the IJV is achieved by using anatomical land marks on skin surface. Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, decreasing access time and decreasing complications. Material and Methods: Sixty critical care patients were selected for IJV cannulation either by land mark technique or by ultrasound guided technique in two groups of thirty each. Results: In our study there was 100% success rate for first attempt cannulation in USG technique and where as it was 83.3% in LMG technique. The mean access time in USG technique was 152.50 ± 63.90 sec as against 323.23 ± 146.19 sec in LMG group. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure.

  3. Suspension model for blood flow through a catheterized arterial stenosis with peripheral layer of plasma free from cells

    Science.gov (United States)

    Ponalagusamy, R.

    2016-06-01

    The present article describes the blood flow in a catheterized artery with radially symmetric and axially asymmetric stenosis. To understand the effects of red cell concentration, plasma layer thickness and catheter size simultaneously, blood is considered by a two-layered model comprising a core region of suspension of all the erythrocytes (particles) supposed to be a particle-fluid mixture and a peripheral zone of cell-free plasma. The analytical expressions for flow features, such as fluid phase and particle phase velocities, flow rate, wall shear stress and resistive force are obtained. It is witnessed that the presence of the catheter causes a substantial increase in the frictional forces on the walls of arterial stenosis and catheter, shear stress and flow resistance, in addition to that, have occurred due to the presence of red cells concentration (volume fraction density of the particles) and the absence of peripheral plasma layer near the wall of the stenosed artery. The introduction of an axially asymmetric nature of stenosis and plasma layer thickness causes significant reduction in flow resistance. One can notice that the two-phase fluid (suspension model) is more profound to the thickness of peripheral plasma layer and catheter than the single-phase fluid.

  4. 脐静脉置管137例临床分析%ClinicalAnalysison137casesofUmbilicalVenousCatheterization

    Institute of Scientific and Technical Information of China (English)

    杨祖铭; 周景; 王三南; 马月兰; 杨晓路; 朱梅英

    2013-01-01

    Objective To investigate the state of umbilical venous catheterization in neonatal intensive care unit of Suzhou Municipal Hospital. Methods Analyze retrospectively of umbilical venous catheterization in neonatal intensive care unit from July 2011 to December 2012. Results 137 infants had umbilical venous catheterization. 134 (97.8%) cases were extremely low birth weight infants and very low birth weight infants, and other 3 cases were Rh blood group incompatibility, persistent hypoglycemia and severe asphyxia. Umbilical venous catheter tip position reached the adjunction of right atrium and inferior vena cava in 106 (77.4%) cases and the duration of catheterization were 7 to 14 days, 27 (19.7%) cases were not in good position and catheters kept in depth of 4 to 5cm for a short period use of 3 to 5 days, 4 (2.9%) cases of umbilical venous catheterization were failed. All catheter tips were sent for organism culture, 5 (3.8%) cases were positive and there were 3(2.3%) cases got the same bacteria growing in blood culture at same time. The average duration of catheterization in the 5 cases was 10.8 days which was little longer than the average duration. Conclusions Umbilical venous catheterization is an important technic in neonatal intensive care, which is routinely used in various conditions, especially in extremely low birth weight infants and very low birth weight infants as central venous for 7 to 10 days.%  目的探讨脐静脉置管在新生儿重症监护室的临床应用。方法对我科新生儿重症监护病房2011年7月至2012年12月脐静脉置管情况进行回顾性分析。结果137例新生儿进行了脐静脉置管,134例(97.8%)为极低或超低出生体质量儿,另外3例为Rh血型不合溶血病换血1例、难治性低血糖1例和重度窒息复苏1例。106例(77.4%)导管位置在右心房和下腔静脉连接处,正常使用7~14d,27例(19.7%)置管不顺利,留置深度在4~5cm,短期使用3~5d,4例(2

  5. Punciones repetidas de la arteria radial para cateterismo cardíaco Repeated radial artery puncture for cardiac catheterization

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    Eduardo Magariños

    2007-06-01

    Full Text Available La punción percutánea de la arteria radial para la realización de procedimientos por cateterismo ha ganado aceptación debido a una eficacia similar a la obtenida con el acceso femoral. En el presente trabajo evaluamos los resultados obtenidos con la punción repetida de esta arteria. En un total de 182 accesos radiales se realizaron 17 punciones repetidas, y mediante ellas, 20 procedimientos (9 coronariografías y 11 angioplastias. Se obtuvo éxito del acceso en 15 punciones repetidas (88.2% y éxito del procedimiento en todos los casos cuando logramos éxito del acceso. Si bien el grupo es pequeño es suficiente para mostrar que la punción repetida de la arteria radial es factible y permite una alta tasa de éxito de los procedimientos con una disminución ostensible de las complicaciones locales.The radial artery approach for percutaneous cardiac interventions has gained worldwide acceptance due to the similar results obtained by the femoral artery access. In this paper, we report our experience with repeated puncture of the radial artery. One hundred and eighty two radial artery access procedures were performed, in 17 interventions the puncture was repeated once or twice, with a total of 20 therapeutic catheterizations (9 coronary angiographies, 11 angioplasties. There was no therapeutic failure through the radial approach but, we successfully gained access in 88.2% (15/17 of the re-interventions cases. Although an experience with a low number of cases, we had a very high successful therapeutic rate, and also a remarkable lowering of local complications, this shows the feasibility and potential of this technique.

  6. Fast catheter segmentation from echocardiographic sequences based on segmentation from corresponding X-ray fluoroscopy for cardiac catheterization interventions.

    Science.gov (United States)

    Wu, Xianliang; Housden, James; Ma, YingLiang; Razavi, Benjamin; Rhode, Kawal; Rueckert, Daniel

    2015-04-01

    Echocardiography is a potential alternative to X-ray fluoroscopy in cardiac catheterization given its richness in soft tissue information and its lack of ionizing radiation. However, its small field of view and acoustic artifacts make direct automatic segmentation of the catheters very challenging. In this study, a fast catheter segmentation framework for echocardiographic imaging guided by the segmentation of corresponding X-ray fluoroscopic imaging is proposed. The complete framework consists of: 1) catheter initialization in the first X-ray frame; 2) catheter tracking in the rest of the X-ray sequence; 3) fast registration of corresponding X-ray and ultrasound frames; and 4) catheter segmentation in ultrasound images guided by the results of both X-ray tracking and fast registration. The main contributions include: 1) a Kalman filter-based growing strategy with more clinical data evalution; 2) a SURF detector applied in a constrained search space for catheter segmentation in ultrasound images; 3) a two layer hierarchical graph model to integrate and smooth catheter fragments into a complete catheter; and 4) the integration of these components into a system for clinical applications. This framework is evaluated on five sequences of porcine data and four sequences of patient data comprising more than 3000 X-ray frames and more than 1000 ultrasound frames. The results show that our algorithm is able to track the catheter in ultrasound images at 1.3 s per frame, with an error of less than 2 mm. However, although this may satisfy the accuracy for visualization purposes and is also fast, the algorithm still needs to be further accelerated for real-time clinical applications.

  7. A retrospective clinical audit of 696 central venous catheterizations at a tertiary care teaching hospital in India

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    Sanjay Agrawal

    2012-01-01

    Full Text Available Background: Malpositions after central venous cannulation are frequently encountered and may need a change in catheter. The incidence of malpositions are varied according to various studies and depend on the experience of the operator performing the cannulation. Aim: To access the incidence of malpositions and related complications associated with landmark-guided central venous cannulation in a 15-bedded medical surgical ICU over a period of three years. Settings and Design: Retrospective analysis of records of all the central venous cannulation done in a 15- bedded medical- surgical ICU over the period of three years (April 2008 to June 2011 were evaluated for the site and side of insertion, number of attempts of puncture, arterial puncture as well as the malpositions on post procedural chest X-ray. The records were also evaluated for the experience of the operator performing cannulation and relationship between experience of operator to malpositions of catheter. Statistical Analysis: Analysis was done using SPSS v 17.0 for Windows. Chi-square test was applied to evaluate the statistical significance. P > 0.05 was significant. Results: Records of 696 cannulations were evaluated. Malpositions occurred in 40 patients. Subclavian vein cannulation resulted in increased malpositions in relation to internal jugular vein cannulation. More common with left sided cannulation. Experience of operator had positive correlation with malpositions and arterial puncture. Arterial puncture was common in 6%, while more than one attempt for cannulation was taken in 100 patients. Conclusion: Incidence of malpositions was low. We conclude that experience of operator improves successful catheterization with lesser number of complications.

  8. Determining the variables associated to clean intermittent self-catheterization adherence rate: one-year follow-up study

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    Marcia Eli Girotti

    2011-12-01

    Full Text Available PURPOSE: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC. MATERIALS AND METHODS: Patients refereed to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD and WHOQoL-bref questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80% of the initial recommendation. RESULTS: Sixty patients (50.4 ± 19.9 years old were trained to perform CISC (21 female and 39 male. Out of them, 30 (50% had neurogenic and 30 (50% had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7%, 58%, respectively. Patients < 40 years old had adherence rate of 86%. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively. In the WHOQoL-bref, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-bref scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. CONCLUSION: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-bref.

  9. Design and Application of Assessment Flowchart for PlCC Catheterization%PICC置管前评估流程图的设计与应用

    Institute of Scientific and Technical Information of China (English)

    言克莉; 钱薇; 陶彤; 李金花

    2014-01-01

    Objective To conduct comprehensive assessment before PICC catheterization for the safety of catheterization and reducing complications. Methods An assessment flowchart for PICC catheterization including three phases and six steps was developed based on recent evidence -based researches on assessment before PICC catheterization, then it was applied in the assessment of 82 patients clinically. Results After assessment, PICC was placed based on patients’ individual condition and no complications were found induced by incomplete assessment in and after the catheterization. Conclusion Assessment flowchart for PICC catheterization benefits nurses’ overall evaluation of patients’ condition and the indication, contraindication and risk factors of PICC.%目的:实施 PICC 置管前全面评估,确保置管安全,减少并发症。方法基于近年来 PICC 置管前评估大量循证研究,设计置管前评估流程图,该流程图分为3个阶段,按照“患者是否适合使用 PICC、哪侧上肢适合留置 PICC、上肢的哪条静脉适合穿刺 PICC 以及穿刺时的注意事项”的顺序分6个步骤,在临床应用于82例患者的 PICC 置管前评估。结果经评估,82例患者中不适合置入 PICC 的患者有10例;在适合置入 PICC 的72例患者中,双侧上肢风险评估未见异常者有55例,均选择非主利手上肢置入 PICC;高风险者17例,选择健侧上肢置入 PICC 14例,选择患侧上肢置入 PICC 2例,改选输液港置入1例。穿刺中、置管后未出现因评估不全导致的相关并发症。结论 PICC 置管前评估流程图可以指引 PICC 护士实施全面、正确评估,具有内容全面、条理清晰、逻辑性强、及时给出指导、缩短评估时间等优点,有利于客观评价 PICC 适应证、禁忌证及风险因素,便于确认 PICC穿刺侧肢体及静脉。

  10. 股静脉置管两种缝合固定方法的比较%Comparison of 2 methods for suture in femoral venous catheterization

    Institute of Scientific and Technical Information of China (English)

    胡丽娟

    2011-01-01

    Objective: To compare the effects of two different butterfly suture and fixation methods for the femoral vein catheterization.Methods: A total of 300 patients with femoral vein catheterization were randomized into experimental group and control group. Unilateral suture was used to fix the catheter in the experimental group and bilateral suture used in (he control group.Results: For catheterization duration time and accidental removal rate, there was no significant difference (p>0.5) between two groups.Conclusion: Both methods can guarantee the safe therapy very well. Unilateral suture can provide a thorough sterilizing and decrease the pain in placement and removal of catheter, improve patients' quality of life and reduce the work of medical care personnel.%目的:对股静脉置管后采用两种不同缝合固定方法的效果比较.方法:将300例股静脉置管患者随机分为对照组和实验组,对照组采用两侧蝶翼缝合固定方法,实验组采用一侧蝶翼缝合固定方法.结果:两组患者导管留置时间和意外拔管率比较,差异均无统计学意义(均P>0.05).讨论:两种固定方法均可保证患者的治疗顺利进行.一侧蝶翼缝合固定方法较两侧蝶翼缝合固定方法消毒时更彻底,且置管和拔管中均可减少患者的痛苦,提高患者的生活质量,同时减少医护人员的工作量.

  11. Comparison of Estimations Versus Measured Oxygen Consumption at Rest in Patients With Heart Failure and Reduced Ejection Fraction Who Underwent Right-Sided Heart Catheterization.

    Science.gov (United States)

    Chase, Paul J; Davis, Paul G; Wideman, Laurie; Starnes, Joseph W; Schulz, Mark R; Bensimhon, Daniel R

    2015-12-01

    Cardiac output during right-sided heart catheterization is an important variable for patient selection of advanced therapies (cardiac transplantation and left ventricular assist device implantation). The Fick method to determine cardiac output is commonly used and typically uses estimated oxygen consumption (VO2) from 1 of 3 published empirical formulas. However, these estimation equations have not been validated in patients with heart failure and reduced ejection fraction (HFrEF). The objectives of the present study were to determine the accuracy of 3 equations for estimating VO2 compared with direct measurement of VO2 and determine the extent clinically significant error occurred in calculating cardiac output of patients with HFrEF. Breath-by-breath measurements of VO2 from 44 patients who underwent cardiac catheterization (66% men; age, 65 ± 11 years, left ventricular ejection fraction, 22 ± 6%) were compared with the derived estimations of LaFarge and Miettinen, Dehmer et al, and Bergstra et al. Single-sample t tests found only the mean difference between the estimation of LaFarge and Miettinen and the measured VO2 to be nonsignificant (-10.3 ml/min ± 6.2 SE, p = 0.053). Bland-Altman plots demonstrated unacceptably large limits of agreement for all equations. The rate of ≥25% error in the equations by LaFarge and Miettinen, Dehmer et al, and Bergstra et al occurred in 11%, 23%, and 45% of patients, respectively. Misclassification of cardiac index derived from each equation for 2 clinically important classifications: cardiogenic shock-21%, 23%, and 32% and hypoperfusion-16%, 16%, and 25%; respectively. In conclusion, these findings do not support the use of these empiric formulas to estimate the VO2 at rest in patients with HFrEF who underwent right-sided heart catheterization.

  12. Correlation of 64 row MDCT, echocardiography and cardiac catheterization angiography in assessment of pulmonary arterial anatomy in children with cyanotic congenital heart disease

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    Chandrashekhar, Guruprasadh, E-mail: cguruprasadh@gmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Sodhi, Kushaljit Singh, E-mail: sodhiks@gmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Saxena, Akshay Kumar, E-mail: fatakshay@yahoo.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Rohit, Manoj Kumar, E-mail: rohitmanoj@gmail.com [Department of Pediatric Cardiology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India)

    2012-12-15

    Objective: To study the correlation of low-dose 64-row multi-detector computed tomography (MDCT) with echocardiography and cardiac catheterization angiography (CCA) in the assessment of pulmonary arterial anatomy in children with cyanotic congenital heart disease (CCHD). Materials and methods: This prospective study included 105 children (74 males, 31 females) with CCHD, in the age group of 2 months to 20 years, who underwent 64-row MDCT examination (low-dose CT protocol), echocardiography and CCA for the assessment of pulmonary arteries, including visualization, presence of confluence, stenosis and collaterals. Statistical analysis was performed using the non-parametric statistical analysis test to evaluate the concordance or discordance between echocardiography, MDCT and CCA. Results: 64-row MDCT detected significantly more main and branch pulmonary arteries, patent pulmonary confluences, and more cases of pulmonary artery stenosis. CCA detected more major aorto-pulmonary collaterals than MDCT, whereas echocardiography failed to identify these major aorto-pulmonary collaterals. The effective CT radiation dose to patients less than 2 years of age was in the range of 0.7–2.5 mSv, where as the dose in patients more than 2 years of age ranged from that of 2.1 to 4.2 mSv, which is much less than the radiation dose reported in cardiac catheterization angiography. Conclusion: In cases where cardiac MRI cannot be performed, or is not sufficiently informative, low-dose 64-row MDCT correlates well with CCA and can provide adequate information about pulmonary arterial anatomy in children with cyanotic congenital heart disease, and can replace invasive cardiac catheterization angiography with markedly reduced radiation dosage to the patient.

  13. The use of web-based learning for simulation-based education and training of central venous catheterization in novice learners.

    Science.gov (United States)

    Cheung, Jeffrey J H; Koh, Jansen; Mackinnon, Kim; Brett, Clare; Bägli, Darius; Kapralos, Bill; Dubrowski, Adam

    2013-01-01

    Both simulation-based education and training (SBET) and Web-based Learning (WBL) are increasingly used in medical education. We developed a Web-based learning course on "Observational Practice and Educational Networking" (OPEN), to augment SBET for central venous catheterization (CVC), a complex clinical skill, for novice learners. This pilot study aimed to firstly, understand the perspectives of novice learners on using WBL in preparation for SBET for a psychomotor skill and secondly, to observe how learners use the OPEN courseware to learn more about how to perform this skill.

  14. Relationships between left heart chamber dilatation on echocardiography and left-to-right ventricle shunting quantified by cardiac catheterization in children with ventricular septal defects.

    Science.gov (United States)

    Gokalp, Selman; Guler Eroglu, Ayse; Saltik, Levent; Koca, Bulent

    2014-04-01

    Left atrium and/or left ventricle dilatation on echocardiography is considered to be an indication for closure of ventricular septal defects (VSD). No study has addressed the accuracy of using dilated left heart chambers when defining significant left-to-right shunting quantified by cardiac catheterization in isolated small or moderate VSDs. In this study, the relation between dilated left heart chambers, measured by echocardiography, and left-to-right ventricle shunting, quantified by cardiac catheterization, was evaluated in patients with isolated VSD. The medical records of all patients with isolated VSD who had undergone catheterization from 1996 to 2010 were examined retrospectively. Normative data for left heart chambers adjusted for body weight (BW) and body surface area (BSA) were used. The pulmonary-to-systemic flow ratio (Qp:Qs) was calculated by an oximetry technique. A total of 115 patients (mean age 7.3 ± 5 years) fulfilled the inclusion criteria. There was a statistically significant difference in terms of Qp:Qs between the patient groups with normal and dilated left heart chambers, when adjusted for BW and BSA (p = 0.001 and p = 0.002, respectively). But the relationships between Qp:Qs and left heart chamber sizes on echocardiography were not strong enough to be useful for making surgical decisions, as left heart chamber dilatation was not significantly associated with Qp:Qs ≥ 2 (p = 0.349 when adjusted for BW, p = 0.107 when adjusted for BSA). Left heart chamber dilatation was significantly associated with Qp:Qs ≥ 1.5 only when it was adjusted for BSA (for BW p = 0.022, for BSA p = 0.006). As a result, left heart chamber dilatation measured by echocardiography does not show significant left-to-right ventricle shunting, as quantified by catheterization. We still advocate that catheter angiography should be undertaken when left heart chambers are dilated in echocardiography in order to make decisions about closing small- to moderate-sized VSD.

  15. Concentrated Arabinoxylan but Not Concentrated Beta-Glucan in Wheat Bread Has Similar Effects on Postprandial Insulin as Whole-Grain Rye in Porto-arterial Catheterized Pigs

    DEFF Research Database (Denmark)

    Christensen, Kirstine Lykke; Hedemann, Mette Skou; Lærke, Helle Nygaard;

    2013-01-01

    The acute glycemic effects of concentrated dietary fibers (DF) versus whole-grain rye were studied in portoarterial catheterized pigs. Two white wheat breads with wheat arabinoxylan (AX) or oat beta-glucan (BG), two rye breads with intact rye kernels (RK) or milled rye (GR), and a low DF white...... min postprandial for AX and GR (74.4 and 129 pmol/min for AX and GR, respectively, compared to 738 pmol/min for WF, P effective in improving insulin economy, suggesting that arabinoxylan from wheat and rye induces similar outcomes in the metabolic...

  16. Catheterized guinea pigs infected with Ebola Zaire virus allows safer sequential sampling to determine the pharmacokinetic profile of a phosphatidylserine-targeting monoclonal antibody.

    Science.gov (United States)

    Dowall, Stuart; Taylor, Irene; Yeates, Paul; Smith, Leonie; Rule, Antony; Easterbrook, Linda; Bruce, Christine; Cook, Nicola; Corbin-Lickfett, Kara; Empig, Cyril; Schlunegger, Kyle; Graham, Victoria; Dennis, Mike; Hewson, Roger

    2013-02-01

    Sequential sampling from animals challenged with highly pathogenic organisms, such as haemorrhagic fever viruses, is required for many pharmaceutical studies. Using the guinea pig model of Ebola virus infection, a catheterized system was used which had the benefits of allowing repeated sampling of the same cohort of animals, and also a reduction in the use of sharps at high biological containment. Levels of a PS-targeting antibody (Bavituximab) were measured in Ebola-infected animals and uninfected controls. Data showed that the pharmacokinetics were similar in both groups, therefore Ebola virus infection did not have an observable effect on the half-life of the antibody.

  17. 深静脉置管临床护理体会%Experience in clinical nursing of patients undergoing deep venous catheterization

    Institute of Scientific and Technical Information of China (English)

    廖道荣

    2013-01-01

    Objective To investigate the role of careful clinical nursing in preventing the complications of deep venous catheterization. Methods Fifty patients who underwent deep venous catheterization in the Internal Medicine Department of our hospital from February 2010 to March 2013 were selected for nursing evaluation. Results Standard aseptic operation, nursing for the site of puncture, close observation, good psychological nursing, and effective maintenance of central venous catheter like keeping the catheter unobstructed could reduce the rates of various complications and achieve good nursing effect. Conclusion Enhancing the nursing of patients undergoing deep venous catheterization can ensure the life and safety of patients, bring convenience to the treatment and nursing of severe cases, and effectively promote the recovery of patients, and careful nursing can effectively prevent the complications of deep venous catheterization.%目的探讨在临床中精心护理有效预防深静脉置管的并发症。方法选取我院内科2010年2月~2013年3月进行深静脉置管治疗的50例患者进行护理观察。结果严格无菌操作,穿刺部位的护理,密切观察,良好的心理护理,保持导管通畅等对中心静脉导管进行有效维护,可以降低各种并发症的发生率,取得了良好的护理效果。结论加强对患者深静脉置管的护理,可以确保患者的生命安全,为重病患者的治疗和护理带来方便,有效提高患者的身体恢复水平,精心护理有效预防深静脉置管并发症发生。

  18. 糖尿病合并冠心病的临床护理分析%Experience in clinical nursing of patients undergoing deep venous catheterization

    Institute of Scientific and Technical Information of China (English)

    施文清

    2013-01-01

    Objective To investigate the role of careful clinical nursing in preventing the complications of deep venous catheterization. Methods Fifty patients who underwent deep venous catheterization in the Internal Medicine Department of our hospital from February 2010 to March 2013 were selected for nursing evaluation. Results Standard aseptic operation, nursing for the site of puncture, close observation, good psychological nursing, and effective maintenance of central venous catheter like keeping the catheter unobstructed could reduce the rates of various complications and achieve good nursing effect. ConclusionEnhancing the nursing of patients undergoing deep venous catheterization can ensure the life and safety of patients, bring convenience to the treatment and nursing of severe cases, and effectively promote the recovery of patients, and careful nursing can effectively prevent the complications of deep venous catheterization.%目的:探讨糖尿病合并冠心病患者的临床护理措施。方法将我院收治的84例糖尿病合并冠心病患者随机分为两组,各42例,对照组采取常规护理干预,实验组给予全面护理。观察分析两组并发症发生情况与患者护理满意率。结果实验组并发症发生率明显低于对照组(P约0.05),实验组患者护理满意率明显高于对照组患者(P约0.05)。结论对糖尿病合并冠心病患者采取全面护理干预,能够有效降低并发症发生率,提高患者护理满意率,值得临床推广使用。

  19. Elevation of urinary liver-type fatty acid binding protein after cardiac catheterization related to cardiovascular events

    Directory of Open Access Journals (Sweden)

    Kamijo-Ikemori A

    2015-08-01

    Full Text Available Atsuko Kamijo-Ikemori,1,3 Nobuyuki Hashimoto,2 Takeshi Sugaya,1 Katsuomi Matsui,1 Mikako Hisamichi,1 Yugo Shibagaki,1 Fumihiko Miyake,2 Kenjiro Kimura1 1Department of Nephrology and Hypertension, 2Department of Cardiology, 3Department of Anatomy, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan Purpose: Contrast medium (CM induces tubular hypoxia via endothelial damage due to direct cytotoxicity or viscosity. Urinary liver-type fatty acid binding protein (L-FABP increases along with tubular hypoxia and may be a detector of systemic circulation injury. The aim of this study was to evaluate the clinical usefulness of detecting increases in urinary L-FABP levels due to administration of CM, as a prognostic biomarker for cardiovascular disease in patients without occurrence of CM-induced nephropathy undergoing cardiac catheterization procedure (CCP. Methods: Retrospective longitudinal analyses of the relationship between urinary L-FABP levels and occurrence of cardiovascular events were performed (n=29. Urinary L-FABP was measured by ELISA before CCP, and at 6, 12, 24, and 48 hours after CCP. Results: Urinary L-FABP levels were significantly higher at 12 hours (P<0.05 and 24 hours (P<0.005 after CCP compared with before CCP, only in the patients with occurrence of cardiovascular events (n=17, but not in those without cardiovascular events (n=12. The parameter with the largest area under the curve (0.816 for predicting the occurrence of cardiovascular events was the change in urinary L-FABP at 24 hours after CCP. The difference in urinary L-FABP levels (ΔL-FABP ≥11.0 µg/g creatinine between before CCP and at 24 hours after CCP was a risk factor for the occurrence of cardiovascular events (hazard ratio, 4.93; 95% confidence interval, 1.27–19.13; P=0.021. Conclusion: Measurement of urinary L-FABP before CCP and at 24 hours after CCP in patients with mild to moderate renal dysfunction may be an important indicator for risk

  20. Infections following epidural catheterization

    DEFF Research Database (Denmark)

    Holt, MS; Andersen, SS; Andersen, Ove

    1995-01-01

    Seventy-eight patients with culture-positive epidural catheters, were studied. Fifty-nine had symptoms of exit site infection and 11 patients had clinical meningitis, two of whom also had an epidural abscess. This corresponds to a local infection incidence of at least 4.3% and an incidence of cen...... frequently than the others. We discuss the symptoms and diagnosis of spinal epidural abscess and suggest a proposal for prophylactic and diagnostic guidelines for epidural catheter-related infections. Comment in: J Hosp Infect. 1997 Mar;35(3):245....

  1. Cardiac Catheterization (For Teens)

    Science.gov (United States)

    ... heart's electrical activity. Doctors also might do an echocardiogram (ECHO), a test that uses sound waves to ... stomach can increase the risk of complications from anesthesia. You'll be able to eat and drink ...

  2. Cardiac Catheterization (For Parents)

    Science.gov (United States)

    ... perform a number of diagnostic tests, including an echocardiogram (ECHO), which uses sound waves to create a ... stomach can increase the risk of complications from anesthesia. After the procedure, your child will be able ...

  3. Radial Artery Catheterization

    Science.gov (United States)

    ... Search Donate Circulation My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Doodle → Blip the Doodle Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  4. 间歇导尿术对糖尿病神经原性膀胱治疗效果的评价%Observation on effect of intermittent urethral catheterization of neurogenic bladder in diabetes patients

    Institute of Scientific and Technical Information of China (English)

    谢英才; 徐明利; 陈文璞; 陈晓铭; 武革

    2002-01-01

    Objective To evaluate efficacy of intermittent urethral catheterization in the treatment of intractable diabetic neurogenic bladder.Method 41 patients with intractable diabetetic neurogenic bladder were randomly divided into study group(n=21) and control group(n=20).Study group received intermittent urethral catheterization and control group received routine therapy.Therapeutic effect of two groups was compared.Result Total effective rate was 90.5% and 40.0% for study group and control group respectively(P< 0.01). In study group,area opaca of residual urine shown by ultrasound examination and number of urination decreased,urine volume increased(P<0.05)which were both better than those of control group after treatment.Conclusion Intermittent urethral catheterization can effectively manage intractable diabetic neurogenic bladder,improve urinary incontinence,urinary retention,resume reflection bladder.

  5. Carotid Catheterization and Automated Blood Sampling Induce Systemic IL-6 Secretion and Local Tissue Damage and Inflammation in the Heart, Kidneys, Liver and Salivary Glands in NMRI Mice

    DEFF Research Database (Denmark)

    Teilmann, Anne Charlotte; Rozell, Björn; Kalliokoski, Otto

    2016-01-01

    Automated blood sampling through a vascular catheter is a frequently utilized technique in laboratory mice. The potential immunological and physiological implications associated with this technique have, however, not been investigated in detail. The present study compared plasma levels of the cyt......Automated blood sampling through a vascular catheter is a frequently utilized technique in laboratory mice. The potential immunological and physiological implications associated with this technique have, however, not been investigated in detail. The present study compared plasma levels...... of the cytokines IL-1β, IL-2, IL-6, IL-10, IL-17A, GM-CSF, IFN-γ and TNF-α in male NMRI mice that had been subjected to carotid artery catheterization and subsequent automated blood sampling with age-matched control mice. Body weight and histopathological changes in the surgical area, including the salivary glands......, the heart, brain, spleen, liver, kidneys and lungs were compared. Catheterized mice had higher levels of IL-6 than did control mice, but other cytokine levels did not differ between the groups. No significant difference in body weight was found. The histology revealed inflammatory and regenerative (healing...

  6. 留置导尿在无痛分娩中的必要性研究%The necessity study of urinary catheterization during painless labor

    Institute of Scientific and Technical Information of China (English)

    陈意坚; 龚桂芳; 符芳

    2012-01-01

    目的 探讨留置导尿在无痛分娩中的必要性.方法 采用随机分组的方法对60例接受腰硬麻醉无痛分娩的产妇进行病例对照研究,对照组(30例)在腰硬麻醉后常规给予立即插尿管留置导尿;观察组(30例)腰硬麻醉后来插尿管,而是通过专责助产士在产程进展中积极鼓励和协助患者排尿,产后通过B超观察膀胱残余尿量和尿液培养评估产后尿潴留和尿道感染情况,观察两组的区别.结果 观察组在分娩过程中有19例(63.33%)能够成功自行排尿,发生产后尿潴留3例,尿道感染1例;对照组发生产后尿潴留14例,尿道感染6例.结论 无痛分娩过程中无需常规持续留置导尿,积极鼓励、指导和协助患者排尿,可以减少尿道感染和产后尿潴留的发生.%OBJECTIVE To investigate the necessity of urinary catheteruation during women who received epidural anesthesia for painless labor. METHODS 60 pucrperas who received epidural anesthesia procedure were randomized divided into object group (n = 30) and control group ( n= 30). Urinary catheterization operation was provided for the control women after epidural anesthesia immediately. All cases in the object group received a bed pan repeatedly and actively mental encourage to void throughout labor by midwives instead of urinary catheterization. Then observed the difference of residual urine volume and urinary tract infection between two groups. RESULTS 19 cases (63.33%) could void successfully by themselves, leaving 3 patients with postpartum urinary retention and 1 with urinary tract infection. However, there were 14 women suffered from postpar-lum urinary retention and 6 women had urinary tract infection in control group. CONCLUSION There is a unnecessary lor routinely operating urinary catheterization during painless labor. Midwives can actively guide and help puerperas to void to prevent the postpartum urinary retention and urinary tract infection.

  7. 中心静脉穿刺置管180例临床分析%Clinical effect of central venous catheterization:an analysis of 180 patients

    Institute of Scientific and Technical Information of China (English)

    郭雪叶

    2016-01-01

    目的:分析研究中心静脉穿刺置管术对患者产生的临床疗效。方法抽取2013年6月~2015年12月我院收治的180例接受中心静脉穿刺置管术的患者作为研究对象,采取回顾性分析方法对这些患者的临床治疗资料进行分析。结果经过治疗后,180例患者一针穿刺成功率为93.9%,再穿刺成功率为5.5%,总穿刺成功率达到99.4%;总共有5例患者产生并发症,其中没有严重并发症,并发症出现率为2.8%。结论临床治疗中,中心静脉穿刺置管得到了广泛应用,整个穿刺过程中往往会碰到很多问题,相关手术人员应该熟悉静脉解剖,并且技术娴熟,进行认真观察以及仔细分析,这样才可以保证穿刺成功。%Objective To investigate the clinical effect of central venous catheterization in patients. Methods A total of 180 patients who were admitted to our hospital from June 2013 to December 2015 and underwent central venous catheterization were enrolled as study subjects, and their clinical treatment data were analyzed retrospectively. Results After treatment, the one-time success rate of puncture was 93.9%, and the success rate of re- puncture was 5.5%, resulting in an overall success rate of puncture of 99.4%. Five patients experienced complications, and there were no serious complications. The incidence rate of complications was 2.8%. Conclusion Central venous catheterization is widely used in clinical treatment, and various problems may occur during the whole process of puncture. The persons involved should be familiar with venous anatomy, have technical skills, and perform careful observation and analysis. This will ensure the success of puncture.

  8. Optimize Cardiac Catheterization Startup Process Gradually by Modern Information Means%利用现代化信息手段逐步优化导管室启动流程

    Institute of Scientific and Technical Information of China (English)

    艳飞; 龚志华; 向定成

    2015-01-01

    Cardiac catheterization can timely launch of D - to - B time one of the important factors. Our chest pain center (CPC) was set up before and after has experienced three different forms of cardiac catheterization startup mode, respectively, including traditional cardiac catheterization startup mode, remote real-time transmission Based on ecg one-click launch international models and core believe in chest pain group, three models in different degree, effectively promote shortening the time of D - to - B, including WeChat group of model is more advantageous to reducing cardiac catheterization activation time.%导管室能否及时启动是影响D-to-B时间的重要因素之一。广州军区总医院胸痛中心(CPC)成立前后共经历了三种不同形式的导管室启动模式,分别包括传统导管室启动模式、远程实时传输心电图基础上的一键式启动导管室模式和胸痛中心微信群模式,三种模式在不同程度上有效促进缩短D-to-B时间,其中微信群模式更有利于缩短导管室激活时间。

  9. [Fractional flow reserve and instantaneous wave-free ratio for the physiological assessment of coronary artery stenosis in the catheterization laboratory: Practical tips].

    Science.gov (United States)

    Picard, F; Tadros, V X; Pighi, M; Spagnoli, V; De Hemptinne, Q; Ly, H Q

    2017-02-01

    In recent years, a large body of evidence has revealed the limitations of angiographic evaluation in determining the physiological significance of coronary stenosis, particularly when these are intermediate lesions. Percutaneous coronary interventions (PCI) guided by physiological assessment using fractional flow reserve (FFR) have been shown to reduce cardiovascular events when compared to angiography alone. Recently, another coronary physiologic parameter has been introduced: the "instantaneous wave-free ratio" (iFR). In this review, we will discuss the FFR, the iFR, and their use in the functional assessment of coronary stenosis in the cardiac catheterization laboratory. This review will cover theoretical aspects for non-interventional cardiologists, as well as practice points and common pitfalls related to coronary physiological assessment for interventional cardiologists.

  10. Estimation of radiation dose and risk to children undergoing cardiac catheterization for the treatment of a congenital heart disease using Monte Carlo simulations

    Energy Technology Data Exchange (ETDEWEB)

    Yakoumakis, Emmanuel; Kostopoulou, Helen; Dimitriadis, Anastastios; Georgiou, Evaggelos [University of Athens, Medical Physics Department, Medical School, Athens (Greece); Makri, Triantafilia [' Agia Sofia' Hospital, Medical Physics Unit, Athens (Greece); Tsalafoutas, Ioannis [Anticancer-Oncology Hospital of Athens ' Agios Savvas' , Medical Physics Department, Athens (Greece)

    2013-03-15

    Children diagnosed with congenital heart disease often undergo cardiac catheterization for their treatment, which involves the use of ionizing radiation and therefore a risk of radiation-induced cancer. The purpose of this study was to calculate the effective and equivalent organ doses (H{sub T}) in those children and estimate the risk of exposure-induced death. Fifty-three children were divided into three groups: atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). In all procedures, the exposure conditions and the dose-area product meters readings were recorded for each individual acquisition. Monte Carlo simulations were run using the PCXMC 2.0 code and mathematical phantoms simulating a child's anatomy. The H{sub T} values to all irradiated organs and the resulting E and risk of exposure-induced death values were calculated. The average dose-area product values were, respectively, 40 {+-} 12 Gy.cm{sup 2} for the ASD, 17.5 {+-} 0.7 Gy.cm{sup 2} for the VSD and 9.5 {+-} 1 Gy.cm{sup 2} for the PDA group. The average E values were 40 {+-} 12, 22 {+-} 2.5 and 17 {+-} 3.6 mSv for ASD, VSD and PDA groups, respectively. The respective estimated risk of exposure-induced death values per procedure were 0.109, 0.106 and 0.067%. Cardiac catheterizations in children involve a considerable risk for radiation-induced cancer that has to be further reduced. (orig.)

  11. Assessment of the efficacy of phentolamine to prevent radial artery spasm during cardiac catheterization procedures: a randomized study comparing phentolamine vs. verapamil.

    Science.gov (United States)

    Ruiz-Salmerón, Rafael J; Mora, Ramón; Masotti, Mónica; Betriu, Amadeo

    2005-10-01

    The objective of this study was to evaluate phentolamine as radial artery spasmolytic in transradial catheterization procedures. Radial artery spasm is a relatively frequent complication during transradial approach, causing patient discomfort or even making it impossible to continue the procedure. As radial artery spasm is mediated by the stimulation of alpha-adrenoreceptors, the use of the alpha-blocker phentolamine could make sense as spasmolytic. We designed a randomized double-blind study to compare phentolamine vs. verapamil, the standard spasmolytic agent. Five hundred patients (250 in each arm) submitted to a transradial cardiac catheterization were consecutively included and randomly assigned to receive 2.5 mg of verapamil or 2.5 mg of phentolamine after sheath insertion. Both vasodilator agents induced a significant radial artery diameter increase (from 2.22 +/- 0.53 to 2.48 +/- 0.57 mm, P phentolamine). However, verapamil was more efficacious to prevent radial artery spasm (13.2% compared with 23.2% in phentolamine-treated patients; P = 0.004). Follow-up (20 +/- 18 days) evaluation of the radial artery patency by plestismography and pulse oximetry showed no differences between the two groups in the rate of radial occlusion (3.0% vs. 3.2% in verapamil and phentolamine treated patients, respectively). Phentolamine was an effective radial vasodilator agent, although it showed less ability to prevent radial artery spasm than verapamil. Radial artery occlusion rate was almost identical for both vasodilators. Thus, phentolamine could be a valid alternative to verapamil as a radial artery spasmolytic agent.

  12. Clinical Application of Umbilical Vein Catheterization in Neonatal Transfusion%脐静脉置管术在新生儿输液中的临床应用

    Institute of Scientific and Technical Information of China (English)

    夏晓芹; 卢庆晖; 阳红华; 张志刚; 唐上可; 赖宝添; 陈均龙

    2014-01-01

    目的:探讨脐静脉置管技术在新生儿静脉营养支持中的临床应用价值。方法选择2011年6月至2014年1月入院至东华医院新生儿科,因不同疾病需要救治且需要静脉营养支持治疗的新生儿(早产儿54例,足月小样儿8例,足月儿合并重症不能进食者18例)80例,在出生<24 h内行脐静脉置管术,建立静脉输液通道,并对其临床应用效果进行分析。结果80例患儿中77例置管成功,3例失败,置管成功率为96.3%。导管留置时间为7~21(7.5±2.2)d。其中4例使用1~3 d后导管堵塞,1例拆管剪线时误剪断导管,且回缩,后采取手术取出;3例发生导管相关感染,行血培养检查均为阴性,感染率为3.75%。留置导管过程中未发生腹腔感染、心律失常、新生儿坏死性肠炎、肝实质损伤、肝坏死、血栓、空气栓塞及脐出血等并发症。结论脐静脉置管术是重症新生儿静脉营养支持的一项重要技术,操作相对容易掌握,不良反应少,较经外周中心静脉置管术(PICC)时间早、成功率较高,出生后早期即可以安全使用,尤其是在低体质量、极低体质量患儿的应用中有广泛的前景。%Objective To explore the clinical value of umbilical venous catheterization tech-nique in intravenous nutritional support in neonates.Methods Umbilical vein catheterization was performed within 24 hours after birth to establish intravenous access in 80 neonates who were ad-mitted to the Department of Neonatology of the Affiliated Dungwah Hospital of Sun Yat-sen Uni-versity from June 2011 to January 2014 for treatment and intravenous nutritional support (54 pre-mature infants,8 small for gestational age infants and 1 8 full-term infants with severe aphago-sis).The clinical efficacy was analyzed in all neonates.Results Among the 80 neonates,umbilical venous catheterization was successful in 77 (96.3%)and failed in 3.The

  13. Quantification of aortic valve area at 256-slice computed tomography: Comparison with transesophageal echocardiography and cardiac catheterization in subjects with high-grade aortic valve stenosis prior to percutaneous valve replacement

    Energy Technology Data Exchange (ETDEWEB)

    Klass, Oliver, E-mail: oliver.klass@uniklinik-ulm.de [University Hospital of Ulm, Department of Diagnostic and Interventional Radiology, Steinhoevelstr. 9, 89075 Ulm (Germany); Walker, Matthew J.; Olszewski, Mark E. [Philips Healthcare, CT Clinical Science, Cleveland, OH (United States); Bahner, Johannes; Feuerlein, Sebastian; Hoffmann, Martin H.K.; Lang, Alexandra [University Hospital of Ulm, Department of Diagnostic and Interventional Radiology, Steinhoevelstr. 9, 89075 Ulm (Germany)

    2011-10-15

    Purpose: The purpose of this study was to compare planimetric aortic valve area (AVA) measurements from 256-slice CT to those derived from transesophageal echocardiography (TEE) and cardiac catheterization in high-risk subjects with known high-grade calcified aortic stenosis. Methods and materials: The study included 26 subjects (10 males, mean age: 79 {+-} 6; range, 61-88 years). All subjects were clinically referred for aortic valve imaging prior to percutaneous aortic valve replacement from April 2008 to March 2009. Two radiologists, blinded to the results of TEE and cardiac catheterization, independently selected the systolic cardiac phase of maximum aortic valve area and independently performed manual CT AVA planimetry for all subjects. Repeated AVA measurements were made to establish CT intra- and interobserver repeatability. In addition, the image quality of the aortic valve was rated by both observers. Aortic valve calcification was also quantified. Results: All 26 subjects had a high-grade aortic valve stenosis (systolic opening area <1.0 cm{sup 2}) via CT-based planimetry, with a mean AVA of 0.62 {+-} 0.18. In four subjects, TEE planimetry was precluded due to severe aortic valve calcification, but CT-planimetry was successfully performed with a mean AVA of 0.46 {+-} 0.23 cm{sup 2}. Mean aortic valve calcium mass score was 563.8 {+-} 526.2 mg. Aortic valve area by CT was not correlated with aortic valve calcium mass score. A bias and limits of agreement among CT and TEE, CT and cardiac catheterization, and TEE and cardiac catheterization were -0.07 [-0.37 to 0.24], 0.03 [-0.49 to 0.55], 0.12 [-0.39 to 0.63] cm{sup 2}, respectively. Differences in AVA among CT and TEE or cardiac catheterization did not differ systematically over the range of measurements and were not correlated with aortic valve calcium mass score. Conclusion: Planimetric aortic valve area measurements from 256-slice CT agree well with those derived from TEE and cardiac catheterization in

  14. Clinical observation of two deep vein catheterizations in ICU%两种深静脉置管术在 ICU 临床应用观察

    Institute of Scientific and Technical Information of China (English)

    郝建; 郝华; 何先弟

    2015-01-01

    Objective To observe the difficulties and main complications in clinical application of subclavian venous cath-eterization and femoral venous catheterization.Methods 300 ICU patients who needed to be treated with domestic deep ve-nous catheter,were randomly divided into a subclavian vein group ( group A,150 cases) ,and a femoral vein group( group B, 150 cases) ,and the success rate,major complications and other indicators were compared so as to evaluate the advantages and disadvantages of the two punctures.Results The success rate of femoral vein puncture was higher.The difference was signifi-cant(P0.05).Conclusion Both methods have their advantages and disadvantages.The operator can choose the better method according to the purpose of the tube,the patient's condition and personal proficiency to reduce possible catheter complications.It is necessary to be familiar with the a-natomy of the catheter tube and summarize accumulated lessons to ensure the success of catheterization.%目的:观察锁骨下和股静脉较两种深静脉置管术的难易程度及其主要的并发症。方法选择ICU内需做深静脉置管的患者300例,随机分为锁骨下静脉(A组)150例,股静脉(B组)150例,通过比较2组的穿刺的成功率及其主要并发症等指标,从而明确两个部位穿刺的优缺点。结果股静脉穿刺组成功率高,与锁骨下静脉组比较差异有显著性(P<0.05)。锁骨下置管并发导管移位、气胸最高(P<0.05),而股静脉置管并发误入动脉,感染,及堵管较高(P<0.05)。导管脱出并发症两者无显著性差异(P>0.05)。结论2种置管方法各有其优缺点,操作者可以根据置管的目的,患者情况以及个人对两种置管术操作的熟练程度,合理选择置管方法,减少置管出现的并发症的可能。

  15. Evaluation of a simple radionuclide procedure for left-to-right cardiac shunt measurement - correlation with earpiece densitometry and cardiac catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Ziada, G.; Hayat, N.; Jarrad, I.; Uthaman, B.; Abdel-Dayem, H.M.

    1986-08-01

    Measurement of shunts from systemic to pulmonary circulation using a simple radionuclide technique has been introduced at our department. A good bolus of the Technetium-99m sodium pertechnetate at a dose of 200 ..mu..Ci/kg body weight (minimal dose 2 mCi) was injected by way of a scalp vein needle connected to a three-way stopcock, thus permitting immediate flushing of the radioactive bolus dose with physiologic saline solution. An IGE-400A gamma camera with a low-energy, high-sensitivity parallel hole collimator was used. The data were stored for analysis on a Star computer at a rate of 4 frames/second for a 40-second period. Twenty-three patients (aged 3-33 years) underwent first pass radionuclide angiography and cardiac catheterization to estimate the degree of systemic-to-pulmonary shunting (QP/QS) ratio). In 15 of these patients, another non-invasive method, earpiece densitometry (EPD), was done to determine the size of the shunt qualitatively. Fifteen healthy volunteers submitted to first pass studies comprised our control group. Out of the 23 patients with shunts, 15 had simple intra-cardiac septal defects (atrial or ventricular) or patent ductus arteriosus, and 8 had valvular lesions plus shunts. Compared with the oximetry data, EPD resulted in misclassification of 5 out of 15 patients in that left-to-right shunts were interpreted as moderate in 4, i.e. QP/QS 2:1, when in fact they were smaller. The correlation coefficient value of the first pass method for simple defect is r=0.89 (A=0.41 and B=0.85), for combined lesions it is r=0.94 (A=0.1 and B=1.1). The mean value for QP:QS in 15 normal subjects is 1.06:1 (SD=+- 0.05). We conclude that first pass radionuclide angiography is a non-invasive and reliable method for determining QP/QS ratios. Unlike cardiac catheterization, it can be performed rapidly on an out-patient basis. (orig./TRV).

  16. Association of Roadway Proximity with Fasting Plasma Glucose and Metabolic Risk Factors for Cardiovascular Disease in a Cross-Sectional Study of Cardiac Catheterization Patients

    Science.gov (United States)

    Kraus, William E.; Blach, Colette; Haynes, Carol S.; Dowdy, Elaine; Miranda, Marie Lynn; Devlin, Robert B.; Diaz-Sanchez, David; Cascio, Wayne E.; Mukerjee, Shaibal; Stallings, Casson; Smith, Luther A.; Gregory, Simon G.; Shah, Svati H.; Hauser, Elizabeth R.; Neas, Lucas M.

    2015-01-01

    Background The relationship between traffic-related air pollution (TRAP) and risk factors for cardiovascular disease needs to be better understood in order to address the adverse impact of air pollution on human health. Objective We examined associations between roadway proximity and traffic exposure zones, as markers of TRAP exposure, and metabolic biomarkers for cardiovascular disease risk in a cohort of patients undergoing cardiac catheterization. Methods We performed a cross-sectional study of 2,124 individuals residing in North Carolina (USA). Roadway proximity was assessed via distance to primary and secondary roadways, and we used residence in traffic exposure zones (TEZs) as a proxy for TRAP. Two categories of metabolic outcomes were studied: measures associated with glucose control, and measures associated with lipid metabolism. Statistical models were adjusted for race, sex, smoking, body mass index, and socioeconomic status (SES). Results An interquartile-range (990 m) decrease in distance to roadways was associated with higher fasting plasma glucose (β = 2.17 mg/dL; 95% CI: –0.24, 4.59), and the association appeared to be limited to women (β = 5.16 mg/dL; 95% CI: 1.48, 8.84 compared with β = 0.14 mg/dL; 95% CI: –3.04, 3.33 in men). Residence in TEZ 5 (high-speed traffic) and TEZ 6 (stop-and-go traffic), the two traffic zones assumed to have the highest levels of TRAP, was positively associated with high-density lipoprotein cholesterol (HDL-C; β = 8.36; 95% CI: –0.15, 16.9 and β = 5.98; 95% CI: –3.96, 15.9, for TEZ 5 and 6, respectively). Conclusion Proxy measures of TRAP exposure were associated with intermediate metabolic traits associated with cardiovascular disease, including fasting plasma glucose and possibly HDL-C. Citation Ward-Caviness CK, Kraus WE, Blach C, Haynes CS, Dowdy E, Miranda ML, Devlin RB, Diaz-Sanchez D, Cascio WE, Mukerjee S, Stallings C, Smith LA, Gregory SG, Shah SH, Hauser ER, Neas LM. 2015. Association of roadway

  17. 明视深静脉穿刺置管术犬实验研究%Research on visual deep vein puncture and catheterization

    Institute of Scientific and Technical Information of China (English)

    冯继泽

    2011-01-01

    Objective To investigate the effect and adverse reaction of the self - made visual deep vein puncture needle. Methods Sixty adult dogs were randomly divided into jugular vein puncture group ( 30 dogs ) and femoral vein puncture group ( 30 dogs ). Vein display, success catheterization, and edema after pressure injection of saline were ohserved and compared between two groups. Results The vein puncture was clearly showed and the catheterization was successful in both groups. The definition in femoral vein group was slightly higher than that in jugular vein. Edema occurred in puncture site after local pressure injection in both groups; but the edema was more ohvious in femoral vein group compared with that in jugular vein group ( P <0. 05 ). Conclusion Visual puncture technique can effectively improve the precision and security of puncture , facilitate the operation of difficult puncture, and reduce the incidence of puncture complications.%目的 探讨自制可视深静脉穿刺针的穿刺效果及不良反应.方法 将60只成年犬随机分为两组,各30只,颈内静脉组采用颈内静脉穿刺,股静脉组采用股静脉穿刺,分别观察能否清晰显示静脉、穿刺置管是否成功,对加压注入0.9%氯化钠溶液后水肿情况及恢复情况进行对比分析.结果 两组不同路径穿刺均能较清晰显示静脉、穿刺置管是否成功,在清晰程度上股静脉组清晰度略高于颈内静脉组,加压注水后穿刺局部都有水肿,但颈内静脉组水肿程度轻,且差异具有统计学意义(P<0.05).结论 应用明视穿刺技术可有效提高穿刺精确度,解决困难穿刺的问题,并可减少穿刺并发症的发生,提高穿刺的安全性.

  18. SCAI Expert consensus statement: Evaluation, management, and special considerations of cardio-oncology patients in the cardiac catheterization laboratory (endorsed by the cardiological society of india, and sociedad Latino Americana de Cardiologıa intervencionista).

    Science.gov (United States)

    Iliescu, Cezar A; Grines, Cindy L; Herrmann, Joerg; Yang, Eric H; Cilingiroglu, Mehmet; Charitakis, Konstantinos; Hakeem, Abdul; Toutouzas, Konstantinos P; Leesar, Massoud A; Marmagkiolis, Konstantinos

    2016-04-01

    In the United States alone, there are currently approximately 14.5 million cancer survivors, and this number is expected to increase to 20 million by 2020. Cancer therapies can cause significant injury to the vasculature, resulting in angina, acute coronary syndromes (ACS), stroke, critical limb ischemia, arrhythmias, and heart failure, independently from the direct myocardial or pericardial damage from the malignancy itself. Consequently, the need for invasive evaluation and management in the cardiac catheterization laboratory (CCL) for such patients has been increasing. In recognition of the need for a document on special considerations for cancer patients in the CCL, the Society for Cardiovascular Angiography and Interventions (SCAI) commissioned a consensus group to provide recommendations based on the published medical literature and on the expertise of operators with accumulated experience in the cardiac catheterization of cancer patients.

  19. SCAI expert consensus statement: Evaluation, management, and special considerations of cardio-oncology patients in the cardiac catheterization laboratory (Endorsed by the Cardiological Society of India, and Sociedad Latino Americana de Cardiologıa Intervencionista).

    Science.gov (United States)

    Iliescu, Cezar; Grines, Cindy L; Herrmann, Joerg; Yang, Eric H; Cilingiroglu, Mehmet; Charitakis, Konstantinos; Hakeem, Abdul; Toutouzas, Konstantinos; Leesar, Massoud A; Marmagkiolis, Konstantinos

    2016-04-01

    In the United States alone, there are currently approximately 14.5 million cancer survivors, and this number is expected to increase to 20 million by 2020. Cancer therapies can cause significant injury to the vasculature, resulting in angina, acute coronary syndromes (ACS), stroke, critical limb ischemia, arrhythmias, and heart failure, independently from the direct myocardial or pericardial damage from the malignancy itself. Consequently, the need for invasive evaluation and management in the cardiac catheterization laboratory (CCL) for such patients has been increasing. In recognition of the need for a document on special considerations for cancer patients in the CCL, the Society for Cardiovascular Angiography and Interventions (SCAI) commissioned a consensus group to provide recommendations based on the published medical literature and on the expertise of operators with accumulated experience in the cardiac catheterization of cancer patients.

  20. 双氯芬酸二乙胺凝胶预防PICC机械性静脉炎的临床观察%The clinical observation of Diclofenac Diethylamine Emulgel on preventing mechanical phlebitis after PICC catheterization

    Institute of Scientific and Technical Information of China (English)

    李秀丽; 姚小春; 赵丽平; 雷小华

    2012-01-01

    目的 观察双氯芬酸二乙胺凝胶对预防PICC致机械性静脉炎的临床效果.方法 将136例PICC置管者按穿刺次序单双号随机分为对照组和实验组.实验组在穿刺前30 min给予涂擦双氯芬酸二乙胺凝胶.5d后观察两组机械性静脉炎发生的例数.结果 实验组机械性静脉炎发生率明显低于对照组,差异具有显著性(P<0.05).结论 双氯芬酸二乙胺凝胶能有效预防PICC置管所致机械性静脉炎.%Objective To explore the clinical effect of Diclofenac Diethylamine Emulgel on preventing mechanical phlebitis after PICC catheterization.Methods A total of 136 patients before PICC catheterization were divided into two groups according to priority.The observation group was used Diclofenac Diethylamine EmulgelInunction 30 minutes before PICC catheterization.Incidence rate of phlebitis was compared after 5 days between two groups.Results Compared with the control group,the incidence rate of mechanical phlebitis was lower significantly in the observation group.Conclusions The Diclofenac Diethylamine Emulgel can effectively prevent the mechanical phlebitis after PICC catheterization.

  1. SCAI/CCAS/SPA expert consensus statement for anesthesia and sedation practice: Recommendations for patients undergoing diagnostic and therapeutic procedures in the pediatric and congenital cardiac catheterization laboratory.

    Science.gov (United States)

    Odegard, Kirsten C; Vincent, Robert; Baijal, Rahul; Daves, SuAnne; Gray, Robert; Javois, Alex; Love, Barry; Moore, Phil; Nykanen, David; Riegger, Lori; Walker, Scott G; Wilson, Elizabeth C

    2016-11-15

    Current practice of sedation and anesthesia for patients undergoing pediatric congenital cardiac catheterization laboratory (PCCCL) procedures is known to vary among institutions, a multi-society expert panel with representatives from the Congenital Heart Disease Council of the Society for Cardiovascular Angiography and Interventions (SCAI), the Society for Pediatric Anesthesia (SPA) and the Congenital Cardiac Anesthesia Society (CCAS) was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL. The goal of this panel was to provide practitioners and institutions performing these procedures with guidance consistent with national standards and to provide clinicians and institutions with consensus-based recommendations and the supporting references to encourage their application in quality improvement programs. Recommendations can neither encompass all clinical circumstances nor replace the judgment of individual clinicians in the management of each patient. The science of medicine is rooted in evidence, and the art of medicine is based on the application of this evidence to the individual patient. This expert consensus statement has adhered to these principles for optimal management of patients requiring sedation and anesthesia. What follows are recommendations for patient monitoring in the PCCCL regardless of whether minimal or no sedation is being used or general anesthesia is being provided by an anesthesiologist. © 2016 Wiley Periodicals Inc.

  2. Clean intermittent catheterization in patients with neurogenic bladder dysfunction%间歇性清洁导尿在神经源性膀胱功能障碍患者中的应用

    Institute of Scientific and Technical Information of China (English)

    张秀淋

    2012-01-01

    目的:探讨神经源性膀胱功能障碍患者留置尿管和间歇性清洁导尿两种导尿方法的感染和恢复情况.方法:60例神经源性膀胱功能障碍损伤患者随机分为观察组30例和对照组30例,观察组采用间歇性清洁导尿术,对照组采用留置尿管法.在给予规律饮水计划的情况下比较两组患者第2周和第4周的泌尿系统感染率、膀胱容量、膀胱残余尿量以及最后漏尿发生率.结果:观察组留置尿管期间第2周和第4周的感染率均低于对照组;观察组患者的膀胱残余尿量、间歇导尿次数少于对照组,差异均有统计学意义(P<0.05).结论:在神经源性膀胱功能障碍患者在实施间歇性清洁导尿后,感染率下降,膀胱容量增加,膀胱残余尿量减少,有利于患者膀胱功能恢复.%Objective; To compare the infection and recovery of urethral and clean intermittent catheterization in patients with neurogenic bladder dysfunction. Methods: We randomly assigned 60 patients with neurogenic bladder dysfunction to receive intermittent clean catheterization ( observation group, n = 30 ) or urethral catheterization (control group, n = 30). The rates of urinary tract infection, bladder capacity, bladder residual urine and final leakage at weeks 2 and 4 were compared, when regular volume of drinking was allowed. Results; A lower rate of infection, reduced residual urine and the numbers of intermittent catheterization was noted in observation group at weeks 2 and 4 (all P < 0.05). Conclusion-. Clean intermittent catheterization results in reduced rate of infection and bladder residual urine and increased bladder capacity leading to favorable recovery in patients with neurogenic bladder dysfunction.

  3. Retention Catheterization Causes Analysis and Prevention of Urinary Tract Infection%保留导尿造成尿路感染的原因分析与预防

    Institute of Scientific and Technical Information of China (English)

    刘志红

    2014-01-01

    导尿和留置尿管是基础临床护理基本常用的技术操作之,导尿和留置尿管操作不当也是引起尿路感染的主要危险因素,文献报道在医院感染中尿路感染占40%,尿路感染治疗不及时可引起严重并发症因此,降低医院感染,控制留置尿管患者尿路感染至关重要。观察留置导尿与尿路感染的相关因素,严格掌握导尿指征,有效控制和预防留置导尿患者尿路感染的发生,正确的操作和置管后的护理,合理使用抗生素,缩短留置导尿时间是有效减少尿路逆行感染的重要措施。我们必须以严谨的态度和科学的方法进行操作和护理,同时对留置尿管患者尿路感染进行原因分析,并找出预防措施。%Catheterization and indwelling catheter is the basis for clinical nursing basic common technical operation, urethral catheterization and catheterization improper operation is caused by the main risk factors of urinary tract infection, urinary tract infection accounted for 40% of reported in nosocomial infection, not timely treatment can lead to serious complications and urinary tract infection, nosocomial infection, control indwel ing catheter in patients with urinary tract infection is very important. Factors associated with urinary tract infection of catheter indwel ing, strictly grasp the indications for catheterization, ef ective prevention and control of indwel ing urethral catheterization occurred urinary tract infection patients, the correct operation and after catheter nursing, the rational use of antibiotics, shorten the indwel ing catheter time is ef ectively an important measure to reduce urinary tract infections. We must carry out the operation and nursing method of at itude and scientific analysis, at the same time of indwelling catheter patients with urinary tract infection and to find out the cause, prevention measures.

  4. Keywords Spinal Cord Injury Early Intermittent Catheterization Rehabilitation Nursing%脊髓损伤患者早期间歇导尿的康复护理体会

    Institute of Scientific and Technical Information of China (English)

    辛玉英; 徐红

    2015-01-01

    Objective To summarize the methods of rehabilitation nursing of early intermittent catheterization in spinal cord injury patients. Methods From 2012 1 to 2014 10 admitted 7 cases of spinal cord injury leads to voiding dysfunction in patients with early intermittent catheterization,and combined with rehabilitation nursing and health education. Results 7 patients in the intermittent catheterization in the process of implementation have been mastered intermittent catheterization method and the matters needing attention. In 4 patients in the self discharge before hospital discharge. Conclusion For patients with intermittent catheterization for spinal cord injury,while giving the rehabilitation nursing and health education,can protect the kidney of effective prevention of urinary tract infection,and help the patients to resume normal life as soon as possible,improve the quality of life.%目的:总结脊髓损伤患者早期间歇导尿的康复护理方法。方法2012年1月~2014年10月收治的7例不同平面脊髓损伤导致排尿障碍的患者早期行间歇导尿,并配合康复护理和健康教育。结果7例患者在间歇导尿实施过程中均已掌握间歇导尿方法及注意事项。中4例患者在出院前可自行排。结论对于脊髓损伤患者早期实施间歇导尿,同时给予康复护理及健康教育,能有效的预防泌尿系感染,保护肾脏,帮助患者尽早恢复正常生活,提高生活质量。

  5. Classification of Atrial Septal Defect and Ventricular Septal Defect with Documented Hemodynamic Parameters via Cardiac Catheterization by Genetic Algorithms and Multi-Layered Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Mustafa Yıldız

    2012-08-01

    Full Text Available Introduction: We aimed to develop a classification method to discriminate ventricular septal defect and atrial septal defect by using severalhemodynamic parameters.Patients and Methods: Forty three patients (30 atrial septal defect, 13 ventricular septal defect; 26 female, 17 male with documentedhemodynamic parameters via cardiac catheterization are included to study. Such parameters as blood pressure values of different areas,gender, age and Qp/Qs ratios are used for classification. Parameters, we used in classification are determined by divergence analysismethod. Those parameters are; i pulmonary artery diastolic pressure, ii Qp/Qs ratio, iii right atrium pressure, iv age, v pulmonary arterysystolic pressure, vi left ventricular sistolic pressure, vii aorta mean pressure, viii left ventricular diastolic pressure, ix aorta diastolicpressure, x aorta systolic pressure. Those parameters detected from our study population, are uploaded to multi-layered artificial neuralnetwork and the network was trained by genetic algorithm.Results: Trained cluster consists of 14 factors (7 atrial septal defect and 7 ventricular septal defect. Overall success ratio is 79.2%, andwith a proper instruction of artificial neural network this ratio increases up to 89%.Conclusion: Parameters, belonging to artificial neural network, which are needed to be detected by the investigator in classical methods,can easily be detected with the help of genetic algorithms. During the instruction of artificial neural network by genetic algorithms, boththe topology of network and factors of network can be determined. During the test stage, elements, not included in instruction cluster, areassumed as in test cluster, and as a result of this study, we observed that multi-layered artificial neural network can be instructed properly,and neural network is a successful method for aimed classification.

  6. Effects of patient position and depth of urinary catheterization on complications%体位和插入留置导尿管的深度对并发症的影响

    Institute of Scientific and Technical Information of China (English)

    雷红菊; 罗美菊; 罗水仙

    2012-01-01

    目的 探讨体位和插导尿管的深度对一次过置管的影响.方法 将2010年8月至2011年8月在神经内科和肾内科住院的132例需要留置尿管的男性老年患者分为对照组(68例)和实验组(64例).对照组按常规导尿法导尿,并留置导尿管.实验组在对照组的基础上注重体位姿势:协助患者取平仰卧位,臀高(10 ~ 20 cm)屈膝,可在其臀部垫一软枕,双下肢保持弯屈曲呈钝角微向外展位,以患者舒适为宜.和改变插尿管深度:直插导尿管20~22cm,见尿液流出,再继续插至尿管三叉分头处才注水入囊,再将尿管往外拉至不动为止.观察两组一次过管率.结果 观察组插入导尿一次置管率为98.4%,对照组为92.6%,经Wilcoxon 秩和检验,z=-2.489.结论 男性老年患者在插导尿管时稍注意体位姿势和将插尿管至三叉分头处才注水入囊,可以提高一次过置管率.%Objective To explore the effect of patient position and depth of urinary catheterization on primary catheter placement.Methods 132 elderly patients who had been hospitalzed during August 2010 to August 2011 in the Department of Neurology and Department of Nephrology who needed urinary catheterization were divided into control group ( 68 patients ) and study group ( 64 patients ).The control group received conventional urinary catheterization with indwelling catheter.The study group improved postural position,the patient in flat supine with hip elevation ( 10 ~ 20cm ) and knee bend using a soft pillow under their buttom; the lower limbs remaining bent at an obtuse angle with slight abduction,making patients.The depth of the inserted catheter was changed with a depth of 20 ~ 22cm.Aftera a flow of urine occurred,the catheter continued to be inserted into the trigeminal ends and water was injected into the sac,then the catheter was pulled until it did not moved.The primary rate of catheterization was observed in the two groups.Results The primary rate of

  7. 非超声引导下再改良塞丁格技术在 PICC 操作中的应用%Effect of Remodified Seldinger Technique on Peripherally lnserted Central Catheter Catheterization

    Institute of Scientific and Technical Information of China (English)

    朱红; 茅惠丽; 瞿红; 庄莉萍; 张丽花; 王萍

    2014-01-01

    目的:探讨非超声引导下再改良塞丁格技术在外周静脉置入中心静脉导管中的应用效果。方法108例行外周中心静脉置管的恶性肿瘤患者采用随机数字表法,随机分成对照组和观察组各54例。对照组采用改良塞丁格技术穿刺置管,观察组应用再改良塞丁格技术即采用8号头皮针替代塞丁格套件中的20 G 套管针进行置管,观察两组一次穿刺成功率、一次置管成功率、置管中患者疼痛程度、置管后出血或皮下淤血发生率、静脉炎发生率的差异。结果观察组一次穿刺成功率及一次置管成功率明显高于对照组(χ2=7.728,P=0.010;χ2=5.939,P=0.031),而置管中患者疼痛程度、置管后出血或皮下淤血发生率、静脉炎发生率明显低于对照组(χ2=24.240,P=0.000;χ2=5.252,P=0.042;χ2=8.207,P=0.008)。结论再改良塞丁格技术操作简单,一次穿刺及置管成功率高,并发症的发生率低,且可明显减轻患者的疼痛,临床运用效果好,值得临床推广应用。%Objective To compare the clinical effect of remodified Seldinger technique on peripherally inserted central catheter (PICC) catheterization. Methods One hundred and eight malignant tumor patients with regular PICC catheterization were randomly divided into observation group and control group with 54 cases in each group. Remodified Seldinger technique was applied in observation group for PICC catheterization, and modified Seldinger technique in control group. The successful rate of puncture and catheterization, patients’ degree of pain, the incidence rates of hemorrhage or subcutaneous ecchymosis phlebitis were compared between these two groups. Results The successful rate of puncture and catheterization in observation group were significantly higher than that of control group (χ2=7.728, P=0.010; χ2=5.939, P=0.031). While the incidence of hemorrhage or subcutaneous ecchymosis, phlebitis in

  8. 管理小组在中心静脉导管胸腔置管患者护理管理中的作用%The role of management team in nursing management for patients with chest catheterization

    Institute of Scientific and Technical Information of China (English)

    谷小燕; 胡华琼; 陈嘉莉; 杨青成; 陈艳春

    2011-01-01

    目的 探讨管理小组在中心静脉导管胸腔置管患者护理管理中的作用.方法 成立管理小组,对行中心静脉导管胸腔置管治疗的患者实施全程护理管理,并比较管理小组成立前后两组患者胸腔置管期间并发症发生率和患者、医生对护理工作的满意度.结果 置管并发症发生率下降,患者和医生对护理工作的满意度提高(P<0.01或P<0.05).结论 成立管理小组对中心静脉导管胸腔置管患者实施全程护理管理,可提高胸腔置管患者护理质量.%Objective To explore the role of the management team in nursing management for patients with chest catheterization. Methods The management team was established and provided care for patients with chest catheterization in the overall treatment course. The incidence of complication,the degree of satisfaction of patients and doctors to nurses'work were compared before and after the establishment of the team. Results The incidence of complication was decreased and the degree of satisfaction of patients and doctors to nurses'work were increased after the establishment of the team ( P < 0.01 or P < 0.05 ).Conclusion The establishment of management team can improve the quality of nursing service for patients with chest catheterization.

  9. 有静脉注射海洛因病史患者30例中心静脉穿刺置管体会%Experience of central venous catheterization on 30 patients with a history of heroin injection

    Institute of Scientific and Technical Information of China (English)

    何吉飞

    2016-01-01

    目的:探讨有静脉注射海洛因病史的患者行中心静脉穿刺置管术的方法。方法:对30例有静脉注射海洛因病史的患者行中心静脉穿刺置管术。结果:30例中心静脉穿刺置管均成功,其中1次穿刺成功23例,更换部位后穿刺成功7例。穿刺部位:右侧锁骨下19例,右侧颈内8例,左侧颈内3例。结论:静脉注射海洛因患者中心静脉穿刺置管较困难,通过积累经验,充分准备,熟练操作,才能提高对该类患者中心静脉穿刺置管成功率。%Objective:To investigate the method of central venous catheterization in patients with a history of heroin injection. Methods:30 patients with a history of heroin injection were treated with central venous catheterization.Results:All of those 30 cases with central venous catheterization were successful,in which there were 23 cases successful puncture at once,another 7 cases were successful puncture after changing the puncture site.Puncture site:19 cases on the right side of the clavicle,8 cases on the right side of the neck,3 cases on the left side of the internal carotid.Conclusion:Central venous catheterization on patient with a history of intravenous injection of heroin is more difficult,need to accumulate experience,fully prepared and skilled operation,to improve the success rate of the central vein puncture catheter.

  10. Direct ambulance transport to catheterization laboratory reduces door-to-balloon time in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: the DIRECT-STEMI study

    Institute of Scientific and Technical Information of China (English)

    QIU Jian-ping; ZHANG Qi; LU Ji-de; WANG Hai-rong; LIN Jie; GE Zhi-ru; ZHANG Rui-yan; SHEN Wei-feng

    2011-01-01

    Background Primary percutaneous coronary intervention (PCI) has been clearly identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction (STEMI). The importance of reducing door-to-balloon (D2B) time has gained increased recognition. This study aimed to assess the feasibility, safety and efficacy of the strategy of direct ambulance transportation of patients with acute STEMI to catheterization lab to receive primary PCI.Methods The study population included 141 consecutive patients with chest pain and ST-segment elevation who were admitted to the catheterization laboratory directly by the ambulance and underwent primary PCI (DIRECT group).Another 145 patients with STEMI randomly selected from the PCI database, were served as control group (conventional group); they were transported to catheterization laboratory from emergency room (ER). The primary endpoint of D2B time,and secondary endpoint of in-hospital and 30-day major adverse cardiac events (MACE, including death, non-fatal reinfarction, and target vessel revascularization) were compared.Results Baseline and procedural characteristics between the two groups were comparable, except more patients in the DIRECT group presented TIMI 0-1 flow in culprit vessel at initial angiogram (80.1% and 73.8%, P=0.04). Comparing to conventional group, the primary endpoint of D2B time was reduced ((54±18) minutes and (112±55) minutes, P <0.0001)and the percentage of patients with D2B <90 minutes was increased in the DIRECT group (96.9% and 27.0%, P<0.0001).The success rate of primary PCI with stent implantation with final Thrombolysis in Myocardial Infarction (TIMI) 3 flow was significantly higher in the DIRECT group (93.8% and 85.2%, P=0.03). Although no significant difference was found at 30-day MACE free survival rate between the two groups (95.0% and 89.0%, P=0.06), a trend in improving survival status in the DIRECT group was demonstrated by Kaplan-Meier analysis

  11. Pulmonary artery and right ventricle assessment in pulmonary hypertension. Correlation between functional parameters of ECG-gated CT and right-side heart catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Abel, Elodie; Jankowski, Adrien [Clinique univ. de radiologie et imagerie medicale, CHU Grenoble (France); Pison, Christophe [Clinique univ. de pneumologie, CHU Grenoble (France); Bosson, Jean Luc [Dept. of Statistics, CIC, CHU Grenoble (France); Bouvaist, Helene [Clinique univ. de cardiologie, CHU Grenoble (France); Ferretti, Gilbert R. [Clinique univ. de radiologie et imagerie medicale, CHU Grenoble (France); Univ. J. Fourier, Grenoble (France); INSERM U 823, Inst. A. Bonniot, la Tronche (France)], e-mail: gferretti@chu-grenoble.fr

    2012-09-15

    Background: Right ventricular function predicts outcome in patients with pulmonary hypertension (PH). Therefore accurate assessment of right ventricular function is essential to graduate severity, assess follow-up, and response to therapy. Purpose: To evaluate whether PH severity could be assessed using electrocardiography-gated CT (ECG-gated CT) functional parameters. A further objective was to evaluate cardiac output (CO) using two ECG-gated CT methods: the reference Simpson technique and the fully automatic technique generated by commercially available cardiac software. Material and Methods: Our institutional review board approved this study; patient consent was not required. Twenty-seven patients who had undergone ECG-gated CT and right heart catheterization (RHC) were included. Two independent observers measured pulmonary artery (PA) diameter, PA distensibility, aorta diameter, right ventricular cardiac output (CT-RVCO) and right ventricular ejection fraction (CT-RVEF) with automatic and Simpson techniques on ECG-gated CT. RHC-CO and mean pulmonary arterial pressure (mPAP) were measured on RHC. Relationship between ECG-gated CT and RHC measurements was tested with linear regression analysis. Results: Inter-observer agreement was good for all measurements (r > 0.7) except for CT-RVCO calculated with Simpson's technique (r = 0.63). Pulmonary artery (PA) distensibility was significantly correlated to mPAP (r = -0.426, P = 0.027). CT-RVEF was correlated with mPAP only when issued from Simpson technique (r = -0.417, P = 0.034). CT-RVEF was not significantly correlated to RHC-CO (P > 0.2). CT-RVCO measured with Simpson technique (r = 0.487, P = 0.010) and automatic segmentation (r = 0.549, P 0.005) correlated equally with RHC-CO. Conclusion: CT-RVEF and CT-RVCO measured on ECG-gated CT are significantly correlated, respectively, to mPAP and RHC-CO in this population with severe reduction of the right ventricular ejection fraction and could be useful for

  12. 超声引导下深静脉置管体会%Experience of deep venous catheterization guided by ultrasound

    Institute of Scientific and Technical Information of China (English)

    李俊

    2016-01-01

    Objective:To analyze the characteristics of deep venous catheter guided by ultrasound,and to explore its clinical application value.Methods:102 patients with deep venous puncture were selected,all patients were divided into the two groups on average,the ultrasound guided puncture group(the observation group)and the blind puncture group(the control group).We observed the puncture time,surgical bleeding,the success rate of one time intubation of the two groups,and evaluated its therapeutic effect and safety.Results:The success rate(96.1%) of one time intubation of the observation group was higher than that of the control group(70.6%).The puncture time of observation group was significantly shorter than that in control group,the amount of bleeding in operation was less than that in control group,and the incidence of complications were lower than that in control group,the comparisons were statistically significant(P<0.05).Conclusion:Deep venous catheterization guided by ultrasound can reduce the incidence of surgical complications,shorter puncture time,with a higher success rate of one time intubation and less bleeding.%目的:分析超声引导下深静脉置管的特点,并探讨其临床应用价值.方法:收治行深静脉穿刺术患者 102例,平均分为超声引导下穿刺组(观察组)和盲探穿刺组(对照组),观察两组的穿刺时间、手术出血情况、1次插管成功率,评价其治疗效果和安全性.结果:观察组1次插管成功率(96.1%)高于对照组(70.6%);观察组的穿刺时间明显要短于对照组,手术出血量也要小于对照组,各项手术并发症发生率要低于对照组,差异均有统计学意义(P<0.05).结论:超声引导下深静脉置管可以降低手术并发症发生率,其穿刺时间较短,1次置管成功率高,且手术出血量少.

  13. Percutaneous Placement of Central Venous Catheters: Comparing the Anatomical Landmark Method with the Radiologically Guided Technique for Central Venous Catheterization Through the Internal Jugular Vein in Emergent Hemodialysis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Koroglu, M.; Demir, M.; Koroglu, B.K.; Sezer, M.T.; Akhan, O.; Yildiz, H.; Yavuz, L.; Baykal, B.; Oyar, O. [Suleyman Demirel Univ., Isparta (Turkey). Depts. of Radiology, Internal Medicine and Anesthesiology

    2006-02-15

    Purpose: To compare the success and immediate complication rates of the anatomical landmark method (group 1) and the radiologically (combined real-time ultrasound and fluoroscopy) guided technique (group 2) in the placement of central venous catheters in emergent hemodialysis patients. Material and Methods: The study was performed prospectively in a randomized manner. The success and immediate complication rates of radiologically guided placement of central venous access catheters through the internal jugular vein (n = 40) were compared with those of the anatomical landmark method (n 40). The success of placement, the complications, the number of passes required, and whether a single or double-wall puncture occurred were also noted and compared. Results: The groups were comparable in age and sex. The indication for catheter placement was hemodialysis access in all patients. Catheter placement was successful in all patients in group 2 and unsuccessful in 1 (2.5%) patient in group 1. All catheters functioned adequately and immediately after the placement (0% initial failure rate) in group 2, but 3 catheters (7.5% initial failure rate) were non-functional just after placement in group 1. The total number of needle passes, double venous wall puncture, and complication rate were significantly lower in group 2. Conclusion: Percutaneous central venous catheterization via the internal jugular vein can be performed by interventional radiologists with better technical success rates and lower immediate complications. In conclusion, central venous catheterization for emergent dialysis should be performed under both real-time ultrasound and fluoroscopic guidance.

  14. Chitosan pads vs. manual compression to control bleeding sites after transbrachial arterial catheterization in a randomized trial; Randomisierte Untersuchung zur Anwendung eines Chitosan-Gerinnungspads zur Blutstillung bei transbrachialen Angiographien

    Energy Technology Data Exchange (ETDEWEB)

    Poretti, F.; Rosen, T.; Koerner, B.; Vorwerk, D. [Inst. fuer diagnostische und interventionelle Radiologie, Klinikum Ingolstadt (Germany)

    2005-09-01

    Purpose: until now, no mechanical closure devices were available to achieve fast and secure hemostasis for vessel closure after catheterization of small arterial vessels. Material and methods: eighty patients were randomized to evaluate the effect on hemostasis by use of a chitosan pad (Chito-Seal, Abbott Vascular Devices, Galway/Ireland) in comparison to manual compression after diagnostic transbrachial arterial catheterization. Hemostasis after three minutes and one hour as well as local development of a hematoma after one and twenty-four hours were assessed. Results: the use of chitosan pads significantly decreased the bleeding time in the first three minutes after manual compression time (p < 0.01). Significant decrease in bleeding risk at three minutes by use of the chitosan closure pads was also found in subgroups of patients with hypertension (p < 0.001) or diabetes (p < 0.01) and also in patients under anticoagulation therapy (p < 0.01). In addition, long-term protection from bleeding complications such as the risk of hematoma was decreased by the use of chitosan closure pads one hour (p < 0.01) or twenty-four hours (p < 0.001) after catheter removal. Conclusion: the use of an intravascular anchor or suture system is not safely applicable in these vessels due to the small diameter of the brachial artery. Our results document a significant improvement in hemostasis by using chitosan pads in these cases. (orig.)

  15. The analysis on risk factors of misplacement of subclavian venous catheterization into ipsilateral internal jugular vein%锁骨下静脉置管误入同侧颈内静脉的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    邢顺鹏; 皋源; 闻大翔; 何征宇; 杭燕南

    2014-01-01

    Objective To identify the risk factors of misplacement of subclavian venous catheterization into ipsilateral internal jugular vein.Methods From January 2011 to December 2012,subclavian venous catheterization was successfully performed with Seldinger method for 178 patients in department of surgical intensive care unit,Renji Hospital.The patients' sex,age,side and site of paracentesis,direction of puncture needle,direction of puncture needle bevel,direction of the J-Tip of the guidewire and position of the head during puncture were recorded.They were subjected to single factor analysis,and then independent risk factors for subclavian venous catheterization into ipsilateral internal jugular vein were determined with multivariate stepwise non-conditional logstic regression analysis.Results Single factor analysis showed that subclavian venous catheterization into ipsilateral internal jugular vein had no correlation with sex(P=0.504),age(P=0.504),direction of puncture needle (P=0.370),direction of puncture needle bevel (P=0.670),but had a correlation with paracentesis side (P=0.012),paracentesis site (P=0.012),direction of the J-Tip of the guidewire (P=0.000),and position of the patient head (P=0.030).Multivariate stepwise non-conditional logistic regression analysis showed that subclavian venous catheterization on the right side [odds ratio (OR) =55.373,95% confidence interval (CI):5.145-595.845,x2=10.965,P=0.001],J-Tip of the guidewire directed toward internal jugular vein (OR=24.116,95% CI:6.848-84.918,x2=24.558,P=0.000),and the head to the contralateral side of puncture(OR=3.681,95% CI:1.210-11.199,x2=5.268,P=0.022) were independent factors.A total of 29 cases (16.29%) of patients experienced invasion of ipsilateral internal jugular vein during subclavian venous catheterization.Conclusions Subclavian venous catheterization misplacement into ipsilateral internal jugular vein is common.The risk factor of the catheter misplacement into ipsilateral internal

  16. Clinical Observation on moxibustion combined with intermittent urethral catheterization for treatment of neurogenic vesical dysfunction%灸法配合间歇导尿治疗神经原性膀胱功能障碍疗效观察

    Institute of Scientific and Technical Information of China (English)

    冯晓东; 任亚锋; 韦大文; 刘承梅

    2009-01-01

    Objective To observe the effect of moxibustion combined with intermittent urethral catheterization on vesical function in the patient of neurogenic vesical dysfunction. Methods Seventy-six cases were randomly divided into an observation group and a control group, 38 cases in each group. The control group was treated with routine intermittent urethral catheterization and the observation group with the intermittent urethral catheterization and moxibustion on Guanyuan (CV 4), Mingmen (GV 4), Zusanli (ST 36), etc. Changes of residual urine volume, white cell count and the balance state of the urinary bladder were selected as the indexes of therapeutic effect and the therapeutic effects were compared between the two groups. Results The total effective rate was 97. 4% in the observation group and 79. 0% in the control group with a significant difference between the two groups (P0. 05). Conclusion Moxibustion combined with intermittent urethral catheterization can significantly improve vesical function in the patient of neurogenic vesical dysfunction, reducing residual urine volume, increasing volume of bladder, promoting the balance state of vesical function, but it is basically same as intermittent urethral catheterization in prevention of urinary infection and therapeutic effect.%目的:观察灸法配合间歇导尿对神经原性膀胱功能障碍患者膀胱功能的影响.方法:将76例患者随机分为观察组和对照组,各38例.对照组采用常规间歇导尿法,观察组在此基础上加灸法,穴取关元、命门、足三里等.选择残余尿量、尿内白细胞数的定量变化及膀胱平衡状态为观察指标,比较两组的疗效.结果:观察组总有效率为97.4%,对照组为79.0%,两组疗效比较差异有统计学意义(P<0.05);两组治疗后残余尿量、膀胱容量及达到膀胱功能平衡状态例数比较,差异均有统计学意义(均P<0.05);两组治疗后白细胞数的定量变化比较,P>0.05,差异无统计学意

  17. Investigation and analysis on intervention effects of thigh venous catheterization infection to patients of hemodialysis%血液透析患者股静脉置管感染调查与干预效果分析

    Institute of Scientific and Technical Information of China (English)

    杨莉梅; 刘彩霞; 朱庆伟; 李素

    2012-01-01

    Objective To explore the dangerous factors of thigh venous catheterization infection to patients of hemodialysis,and seek the effective methods to prevent and control femoral venepuncture infection.Methods A retrospective survey was carried out to investigate the data of patients of hemodialysis suffering thigh venous catheterization infection,and to analyze the risk factors of thigh venous catheterization infection.Then we took intervention measures to make prospective observation to the effects of infection controls.Results After taking measures,rates of infections declined from 8.8% in 2010 to 2.9% in 2011.Conclusions Risk factors of thigh venous catheterization infection are as below:long-time ( >3 weeks ) of femoral venepuncture;catheters are polluted by wrongful deals; patients often go to public places; diabetes mellitus complication; too long time intervals of medicine dressing change; non-rigorous aseptic technique (self dressing change by patients).Effective measures of controlling thigh venous catheterization inffection are as below:rigorous aseptic technique; emphasizing indwelling catheters and observing; proper catheters nursing; shortening time for catheters indwelling strengthening propaganda and education to patients.%目的 探讨血液透析患者股静脉置管感染的危险因素,寻找预防和控制股静脉置管感染的有效方法.方法 对血液透析股静脉置管患者相关资料进行回顾性调查,分析股静脉置管患者感染危险因素,并采取干预措施,前瞻性观察感染控制效果.结果 采取控制措施后,血液透析患者股静脉置管感染率从2010年的8.8%下降至2011年的2.9%.结论 股静脉置管时间超过3周,局部护理不当、置管处被污染,患者常去公共场所,合并糖尿病,换药时间间隔过长,无菌技术不严格(患者自行换药)是血液透析患者股静脉置管感染的危险因素.严格无菌技术操作、重视留置导管的观察、正确进行导

  18. Optimal Axis View for Ultrasound-Guided Approach to Internal Jugular Vein Catheterization%超声引导颈内静脉穿刺置管穿刺面的选择

    Institute of Scientific and Technical Information of China (English)

    潘露菲; 苏靖诚; 李明惠; 谭宪湖

    2014-01-01

    Objective To observe the clinical effects of ultrasound-guided internal jugular vein catheterization with different axis views ,long axis view ,short axis view ,long-short axis view ,and to identify the optimal axis view for internal jugular vein catheterization .Methods One hundred and eighty patients requiring ultrasound-guided internal jugular vein catheterization were included in this study ,they were randomly divided into three groups ,long axis group , short axis group ,long-short axis group ,with 60 cases in each group .Their baseline characteristics and details of cathe-terization were recorded .Results Needle redirections , venous access time , total procedure time , technical difficulty reduced significantly in the long axis group and long-short axis group compared with short axis group ( P<0 .05 ) .The complication rates of short axis group ,long axis group,long-short axis group were 18.33%(11/60),6.67%(4/60), 1.67%(1/60),respectively.The complication rate in the long-short axis group was significantly lower than that in the short axis group ( P<0 .05 ) .Conclusion The long-short-axis ultrasound-guided technique has the benefits of long-axis and short-axis ultrasound-guided techniques ,with high first-pass success rate and less complication rate ,which is a safe,fast,and the best technique for ultrasound-guided internal jugular vein catheterization .%目的:比较超声引导下行颈内静脉穿刺置管术短轴面、长轴面和长短轴面法的临床效果,探讨最佳穿刺面。方法择期手术需行超声引导下颈内静脉穿刺置管术的患者180例,按随机数字表法分为短轴面组、长轴面组和长短轴面组,每组60例,记录一般资料和穿刺情况。结果长轴面组和长短轴面组改变方向次数、成功刺入颈内静脉时间、总穿刺时间、技术难度评分明显少于短轴面组(P<0.05)。短轴面组、长轴面组、长短轴面组并发症发生率为18.33%(11/60)、6.67

  19. 鱼骨图分析法在提高急性尿潴留导尿成功率中的应用%The Application of Fishbone Diagram Analysis in Improving the Success Rate of Catheterization for Acute Urinary Retention

    Institute of Scientific and Technical Information of China (English)

    陈桂英

    2014-01-01

    目的:探讨鱼骨图分析法在导尿中的应用。方法:选取2012年2-12月急性尿潴留患者104例作为对照组,使用常规方法导尿;另选取2013年2-12月急性尿潴留患者117例作为观察组,采用鱼骨图分析法进行导尿。观察比较两组的导尿成功率。结果:对照组有95例导尿成功,成功率91.35%;观察组中114例导尿成功,成功率97.44%,观察组的导尿成功率明显高于对照组,差异有统计学意义(χ2=3.98,P<0.05)。结论:鱼骨图分析法能直观反映出急性尿潴留患者导尿失败原因,是提高导尿成功率的有效手段。%To investigate the application of fishbone diagram analysis in catheterization.Method:104 patients with acute urinary retention from February 2012 to December 2012 were selected as the control group,which were given the conventional catheterization,and 117 patients with acute urinary retention from February 2013 to December 2013 were selected as the observation group,they were given the fishbone diagram analysis method for urethral catheterization.The success rate of catheterization between the two groups were observed and compared.Result:There were 95 cases in the control group achieved success in catheterization,the success rate was 91.35%.While there were 114 cases succeeded in the observation group,the success rate was 97.44%.The success rate of catheterization was significantly higher than that of the control group,the difference was statistically significant( χ2=3.98,P<0.05). Conclusion:Fishbone diagram can directly reflect the reasons of failure to perform urethral catheterization in patients with acute urinary retention.It is an effective means to improve the success rate of urethral catheterization.

  20. Application of Domestic Bladder Capacity Scanner in Intermittent Catheterization in Patients with Neurogenic Bladder%国产膀胱容量测定仪在神经源性膀胱间歇导尿患者中的应用研究

    Institute of Scientific and Technical Information of China (English)

    高丽娟; 陈国庆; 李秀华; 罗丽丽; 骆琳琳; 廖利民

    2013-01-01

    Objective To explore the application of domestic bladder capacity scanner in intermittent catheterization in patients with neurogenic bladder. Methods 40 patients with neurogenic bladder accepted intermittent catheterization. Their bladder volume was tested with domestic and imported bladder capacity scanner (Padscan and Bladderscan) and catheterization respectively. Results The bladder vol-ume was (262.592 ± 6.3012) ml tested by Padscan, and was (262.570 ± 6.3006) ml by Bladderscan (P>0.05). The bladder volume tested by bladder catheterization was (245.549±6.0511) ml, which was significantly lower than the other methods (P0.05);导尿法测得膀胱容量为(245.549±6.0511) ml,显著低于另两种方法测得的膀胱容量(P<0.001),但平均差值仅为17 ml。结论国产膀胱容量测定仪(Padscan)测量神经源性膀胱患者膀胱容积的准确性与进口仪器非常相近,与导尿法测量值的差异无临床意义。

  1. 股动脉穿刺置管术后快速手法压迫止血的体会%Rapid manual compression for puncturing site hemostasis after femoral catheterization: preliminary experience

    Institute of Scientific and Technical Information of China (English)

    杨卷红

    2013-01-01

    目的 探讨股动脉穿刺置管术后快速手法压迫止血的止血效果及并发症.方法 总结了一套快速手法压迫止血的方法(平均止血时间约2 min),并对324例行介入股动脉穿刺置管患者术后立即进行快速手法压迫止血,术后1 d对患者穿刺点周围的皮肤观察并行相应的触诊检查.结果 324例经股动脉穿刺置管介入术后患者均用了快速手法压迫止血,其中4例患者穿刺点周围皮下片状淤青,余患者穿刺点周围未见明显淤青,其有效止血率高达98.8%(320/324).320例患者中6例患者穿刺点周围出现局部皮肤轻度压伤,未予处理1周后均自行修复.结论 股动脉穿刺置管介入诊疗术后快速手法压迫止血是一种省时、省力、安全、经济、可重复、环保、实用的止血方法.%Objective To discuss the hemostasis effect of rapid manual compression performed immediately after the catheterization through femoral artery, and to analyze its complications. Methods Based on the author's experience obtained from dozens of years' practice in interventional field, the author summarized an effective hemostasis technique, which was performed through rapid manual compression on the pun cturing point. The mean compression time with hand was only about two minutes. This manipulation procedure for hemostasis had been carried out in 324 patients immediately after the catheterization through femoral artery was finished. One day after the catheterization, observation of the skin around the puncture point and palpation of the puncturing site were conducted. Results Rapid manual compression hemostasis was successfully carried out in all 324 patients, of whom subcutaneous ecchymosis around the puncture site was seen in only four. The effective hemostasis rate was 98.8% (320/324). In another six patients mild skin injury due to compression around the puncture site was observed, which, without any medication, recovered spontaneously in one week

  2. Complication Analysis of Further Modified Seldinger Technique for Peripherally Inserted Central Catheter Catheterization%再改良塞丁格技术降低 PICC 置管后的并发症分析

    Institute of Scientific and Technical Information of China (English)

    茅惠丽; 朱红

    2015-01-01

    Objective To discuss the complication of further modified seldinger technique for peripherally inserted cen‐tral catheter (PICC) catheterization .Methods 128 patients with malignant tumor performed regular PICC catheterization were randomly divided into the observation group and the control group ,with 64 cases in each group .Patients in the obser‐vation group were applied with further modified seldinger technique for PICC catheterization , and patients in the control group were applied with modified seldinger method . The successful rate of puncture once and the complication of further modified seldinger technique for peripherally inserted central catheter (PICC) catheterization between two groups were analyzed .Results The successful rate of puncture once of patients in the observation group was 93 .8% ,and it was significantly higher than that of the control group (P < 0 .05) .Catheter heterotopia rate was 3 .1% ,punctured hemorrhage rate was 14 .1% ,phlebitis rate was 4 .7% ,vein thrombosis rate was 6 .3% ,unplanned extubation rate was 6 .3% ,the plug‐ging pipe rate was 7 .8% ,and the incidence of catheter related infections was 1 .6% ,and they were all significantly lower than those of control group (P<0 .05) .Conclusion The complication of further modified seldinger technique for PICC cath‐eterization has been reduced significantly .It is high worthy of clinical application .%目的:探讨再改良塞丁格技术降低外周中心静脉置管(PICC )置管后的并发症发生率。方法选取128例行PICC置管的恶性肿瘤患者作为研究对象,随机分为对照组和观察组,各64例。对照组采用改良塞丁格技术穿刺置管。观察组采用再改良塞丁格技术穿刺置管。比较两组置管一次穿刺成功率及PICC置管后和带管期间并发症发生情况。结果观察组一次穿刺成功率93.8%,显著高于对照组(P<0.05),且观察组导管异位率3.1%,穿刺点出血14.1

  3. 右颈内静脉加压对颈内静脉穿刺置管术的影响%Effect of Right Internal Jugular Vein Pressure on Internal Jugular Vein Catheterization

    Institute of Scientific and Technical Information of China (English)

    高恺; 张月秋; 高言国

    2016-01-01

    目的:探讨右颈内静脉加压对颈内静脉穿刺置管术的影响。方法:选取需进行右颈内静脉穿刺置管的低血容量性或脓毒性休克患者79例作为研究对象,随机分为对照组(C组)40例和颈内静脉加压组(P组)39例。所有患者均去枕平卧、Trendelenburg体位和头左侧偏转15°~30°,C组进行常规右颈内静脉穿刺置管,P组在C组基础上于患者右侧锁骨上窝靠近胸锁关节外侧凹陷处以食指中指二指并拢向内下方用力按压颈内静脉,以颈内静脉压瘪为宜。记录两组患者三次穿刺置管成功率、回血通畅率、穿刺失败率及血肿发生率。结果:P组穿刺置管成功率、回血通畅率、穿刺失败率及血肿发生率均优于C组,比较差异均有统计学意义(P<0.05)。结论:颈内静脉压迫明显有助于颈内静脉穿刺置管术的成功,减少了并发症。%Objective:To discuss the effect of right internal jugular vein pressure on internal jugular vein catheterization.Method:From May 2013 to March 2016,79 cases of low blood volume or septic shock with right internal jugular vein catheterization were selected as the research objects,they were divided into 40 cases of the control group(group C) and 39 cases of the internal jugular venous pressure group(group P).All patients had to lie,Trendelenburg position and the left side of the head deflection 15°-30°,group C were treated with conventional right internal jugular vein catheterization,group P was treated with an index finger and a middle finger were put together to push jugular veins hard inward and downward on the ipsilateral supraclavicular fossa near lateral recess of joints of the sternoclavicular joint until the veins were squashed based on group C,internal jugular vein press to make flat was appropriate.Three times puncture catheter success rate,the rate of return to blood,puncture failure rate and incidence of hematoma of two groups were

  4. B超引导下改良塞丁格技术在PICC置管术中的临床应用%Modified Seldinger technique under ultrasound guidance in PICC catheterization

    Institute of Scientific and Technical Information of China (English)

    张英燕

    2015-01-01

    Objective To evaluate the effect of modified Seldinger technique under ultrasound guidance in PICC catheterization.Methods 200 patients undergoing PICC catheterization were randomly divided into a control group and an observation group,100 cases for each group.The conventional catheter puncture method under naked eyes was used in the control group and modified Seldinger technique under ultrasound guidance in the observation group.The catheterization success rate,the bleeding rate of puncture point,the pain rate of puncture point,the comfort score,and the mechanical phlebitis rate were compared between the two groups.Results The one-time catheterization success rates of the observation group and the control group were 89.0% (89/100) and 75.0% (75/100),respectively,with a statistical difference (P<0.05).The bleeding rate ofpuncture point,the pain rate of puncture point,and the comfort score of the observation group were 31.0% (31/100),4.0% (4/100),and (27.9±2.4);and those of the control group were 48.0% (48/100),12.0% (12/100),and (20.5±3.0);with statistical differences (P<0.05).The mechanical phlebitis rate of the observation group was significantly lower than that of the control group (2.0% vs.27.0%),with a statistical difference was ly significant (P<0.05).Conclusions Using modified Seldinger technique under ultrasound guidance in PICC catheterization can improve the success rate of catheterization and reduce adverse reactions and mechanical phlebitis and in worth being clinically generalized.%目的 探讨B超引导下改良塞丁格技术在PICC置管中的应用及效果.方法 选取200例拟行PICC患者,随机分为观察组和对照组,每组100例.对照组给予传统盲穿置管法,观察组给予B超引导下改良塞丁格技术置管法.比较两组患者置管成功率、穿刺点渗血率、穿刺点疼痛率、舒适度评分、机械性静脉炎发生率.结果 观察组和对照组一次置管成功率分别为89.0%(89

  5. Difference observation of catheterization before and after combined spinal-epidural anesthesia in patients of Caesarean Section%腰硬联合麻醉前后留置导尿对剖宫产患者的影响观察

    Institute of Scientific and Technical Information of China (English)

    印夏微

    2011-01-01

    Objective To explore the difference of catheterization before and after anaesthesia in patients of Caesarean Section.Methods One hundred Caesarean Section patients undergoing Combined Spinal- epidural Anesthesia M were divided into two groups randomly.Fifty patients of observation group were accepted detaining urethral catheterization after anaesthesia.Fifty patients of control group were accepted detaining urethral catheterization before anaesthesia.The heart rate,blood pressure, pain rating and success rates of first catheterization were observed.Results The heart rate, blood pressure, and pain rating of observation group were lower than the control group.Success rates of first catheterization in observation group was 98%, the control group was 82%.Conclusions It is better to take catheterization after anaesthesia in patients of Caesarean Section.%目的 探讨对剖宫产患者在麻醉前后留置导尿的影响.方法 选择100例在腰硬联合麻醉前后的剖宫产患者,随机分为观察组和对照组各50例.对照组患者在麻醉前行导尿术,观察组患者在麻醉后行导尿术,比较两组患者留置导尿前后心率、血压变化,疼痛分级以及一次性置管的成功率.结果 与基础值比较,对照组患者在留置导尿后心率、血压均明显增加,而观察组增加不明显;对照组疼痛感受明显高于观察组;一次置管成功率对照组为82%,观察组为98%.结论 剖宫产患者宜麻醉后留置导尿.

  6. B超引导下改良塞丁格技术在急性白血病患者PICC置管的应用%The application of PICC catheterization with modified Seldinger technique under the guidance of ultrasound in acute leukemia patients

    Institute of Scientific and Technical Information of China (English)

    杨健舟; 汪颖; 张玉洁; 胡赛男

    2015-01-01

    Objective To research the effect of modified Seldinger technique under the guidance of ultrasound for peripherally inserted central venous catheter(PICC) catheterization compared with the traditional method of PICC catheterization in acute leukemia patients. Methods Forty six patients with acute leukemia were randomly divided into control group applied with traditional method of PICC catheterization and observation group applied with modified Seldinger technique for PICC catheterization under the guidance of ultrasound. The incidence rates of local hematoma,infection through vessel,puncture velocity,and successful rate of puncture were compared between these two groups. The incidence rates of hematoma and infection between group of repeated puncture and group of disposable puncture. Results The incidence rates of local hematoma,infection through vessel and,puncture velocity were significantly lower than those of control group. The successful rate in observation group was significantly higher than that of control group. Conclusion The PICC catheterization under the guidance of ultrasound, which was worthy to popularized in acute leukemia treatment,has higher successful rate with less complication than the traditional method of PICC catheterization.%目的::探讨B超引导下改良塞丁格技术经外周中心静脉置管(PICC置管)和传统PICC置管在急性白血病患者中的效果。方法将46例急性白血病患者随机分为两组,分别采用B超引导下PICC置管和传统PICC置管,观察两组的局部血肿、导管感染、穿刺时间、1次到位数的发生率和反复穿刺组、1次到位组的血肿、感染发生率。结果观察组的局部血肿、导管感染数、穿刺时间明显低于对照组,1次到位数明显高于对照组,1次到位组的血肿、感染数明显低于反复穿刺组。结论 B超引导下PICC置管,较传统PICC置管成功率高,并发症少,在急性白血病治疗中值得推广。

  7. Fatores associados à bacteriúria após sondagem vesical na cirurgia ginecológica Factors associated with bacteriuria after indwelling urethral catheterization in gynecologic surgery

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    Sonia Cristina Araújo Hinrichsen

    2009-01-01

    Full Text Available OBJETIVOS: Determinar a frequência e os principais fatores associados à bacteriúria após a sondagem vesical em mulheres submetidas à cirurgia ginecológica eletiva. MÉTODOS: Realizou-se um estudo do tipo coorte em mulheres submetidas à cirurgia ginecológica após sondagem vesical no Instituto de Medicina Integral Prof. Fernando Figueira, no período de janeiro a maio de 2007. As uroculturas foram coletadas até 24 horas após a retirada da sonda e 7/10 dias após a sondagem vesical. A análise estatística bivariada e multivariada foi realizada calculando-se a razão de risco e os seus intervalos de confiança a 95%. RESULTADOS: Foram incluídas no estudo 249 mulheres. A frequência de uroculturas positivas até 24 horas depois da retirada da sonda foi de 23,6%, diminuindo para 11,1% 7/10 dias após a sondagem. Destas, apenas 2,4% eram sintomáticas. Verificou-se menor risco de bacteriúria com 7/10 dias após a sondagem vesical quando a paciente referiu vulvovaginite tratada nos últimos três meses, não permanecendo estatisticamente significativa após a análise multivariada. Não houve associação significativa com idade, escolaridade, número de gestações, paridade, fase da vida reprodutiva, tipo e duração da cirurgia, tipo da anestesia, uso de antibiótico profilático, profissional que colocou a sonda e o tempo de permanência da sonda vesical. CONCLUSÃO: A frequência de bacteriúria foi de 23,6% e 11,1% com 24 horas e 7/10 dias, respectivamente. Não se encontrou associação significativa das variáveis pesquisadas com a bacteriúria evidenciada na urocultura com 7/10 dias.OBJECTIVES: To determine the frequency and risk factors associated to bacteriuria after urinary catheterization in women submitted to elective gynecological surgery. METHODS: A cohort study was carried out among women submitted to gynecological surgery after urinary catheterization. This study took place at the "Instituto de Medicina Integral Professor

  8. 心导管介入治疗先天性心脏病复合畸形的护理%Nursing care of patients with congenital compound heart abnormality treated by interventional therapy of cardiac catheterization

    Institute of Scientific and Technical Information of China (English)

    杨学凤

    2016-01-01

    Objective:To analyze the nursing care of patients with congenital compound heart abnormality treated by interventional therapy of cardiac catheterization.Methods:25 patients with congenital compound heart abnormality treated by interventional therapy of cardiac catheterization were selected.We summarized nursing experience.Results:Closure operation was successful in 24 patients, and 2 patients received cardiac surgery after surgery;1 case of failure due to serious defect. There were 2 cases of hematoma in the puncture site after operation,and the hematoma disappeared after treatment.Mechanical hemolysis,deep venous thrombosis,brachial plexus injury and other serious complications were not occurred in patients. Conclusion:To strengthen the perioperative nursing of patients with congenital heart disease combined malformation in perioperative care can effectively improve the success rate of surgical closure,and avoid the incidence of serious complications.%目的:分析心导管介入治疗先天性心脏病复合畸形的护理。方法:收治心导管介入治疗先天性心脏病复合畸形患者25例,总结护理体会。结果:24例患者封堵手术成功,术后转入心脏外科接受治疗2例;因缺损严重封堵失败1例;术后出现穿刺部位血肿,处理后血肿消失2例;患者未出现机械性溶血、深静脉血栓、臂丛神经损伤等严重并发症。结论:加强先天性心脏病复合畸形患者介入手术的围手术期护理可有效提高手术封堵成功率,避免和减少术后严重并发症发生。

  9. Studies on Catheterization of Fetal Arteria Mbilicalis Uterus of Pregant Sheep%妊娠山羊宫内胎儿脐动脉插管手术方法的研究

    Institute of Scientific and Technical Information of China (English)

    谭聪; 杨淑华; 何剑斌

    2014-01-01

    为了优化山羊胎儿脐动脉插管模型,本试验采用医用硬膜外导管对单胎妊娠120日龄的山羊进行胎儿脐动脉插管手术,对其手术途径、导管类型、插管方法、麻醉和术后护理进行研究。术后可顺利采集胎儿血液样本,1周后母山羊正常分娩。本试验建立的山羊胎儿脐动脉插管模型的手术方案,可为胎儿疾病的诊断及临床用药等提供试验基础。%In order to optimize the model of catheterization in goat fetal umbilical artery,medi-cal epidural catheter was used on the 120 days age single pregnant goats fetal umbilical artery. The surgical approach, types of catheter, anesthesia and postoperative care were investigated. Blood samples were successfully collected after surgery and one week later stepmother goat could normally be delivered.Surgical options of goats umbilical artery model was established in this test to provides an experimental basis for the diagnosis and clinical treatment of diseases such as fetal.

  10. Explanatory digital video disc with patients undergoing diagnostic cardiac catheterization Disco digital explicativo para pacientes sometidos al cateterismo cardiaco diagnóstico Digital video disc explicativo em pacientes submetidos ao cateterismo cardíaco diagnóstico

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    Sabrina Koehler Torrano

    2011-08-01

    Full Text Available The aim of this study was to evaluate knowledge of patients before outpatient diagnostic cardiac catheterization after viewing an explanatory Digital Video Disc, in a cardiology reference hospital. This cross-sectional study was carried out with patients undergoing their first cardiac catheterization and was performed from May to June 2009 in the hemodynamic sector. An instrument was used with questions (12 regarding the patients' understanding of the procedure. The intervention was a five-minute video prepared by the researchers. The sample was composed of 94 patients, divided into an intervention group (45 and a control group (49, with a mean age of 55±9 years and predominantly male. The patients of the IG had a higher rate of correct answers (74.6±17.1 compared to the CG (31.6±18.8, P=.000. The results demonstrated the efficacy of the presentation of a guidance video for patients undergoing a hemodynamic procedure.El objetivo de este estudio fue evaluar el conocimiento de los pacientes sometidos a cateterismo cardiaco tipo diagnóstico en ambulatorio después de ser presentado un DVD explicativo, en un hospital de referencia en cardiología. Se trata de un estudio transversal, con pacientes sometidos al primer cateterismo cardiaco, realizado de mayo a junio de 2009, en el sector de hemodinámica. Fue utilizado un instrumento con 12 preguntas referentes a la atención de los pacientes sobre el procedimiento. La intervención fue un vídeo con duración de cinco minutos elaborado por los investigadores. La muestra constituida de 94 pacientes, fue dividida en grupo intervención (45 y grupo control (49; la edad promedio fue de 55±9 años con predominancia del sexo masculino. Los pacientes del GI presentaron un mayor índice de aciertos (74,6±17,1, cuando comparados al GC (31,6±18,8, P=0,000. Los resultados demostraron la eficacia de la presentación de un vídeo de orientaciones para pacientes sometidos al procedimiento hemodin

  11. Comparison of two kinds of PICC catheterization methods in the hospitalized patients of the department of gastroenterology%两种PICC置管方法在消化科住院患者中的应用效果比较

    Institute of Scientific and Technical Information of China (English)

    李惠惠; 李志慧; 孙小萌

    2014-01-01

    目的 比较普通PICC置管与超声引导PICC置管方法在消化科住院患者中的应用情况.方法 106例消化科住院患者行PICC置管,分为普通置管组(n=71)和超声引导组(n=35),比较两组患者穿刺成功率、舒适度和并发症发生率.结果 普通置管组和超声引导组PICC置管一次穿刺成功率(94.4%比94.3%)和总穿刺成功率(98.6%比100%)差异无统计学意义(x2分别为0.03,0.50;P>0.05);PICC超声引导组穿刺并发症(2/35,5.7%)显著低于普通置管组(22/71,31.0%),差异有统计学意义(x2 =8.548,P <0.01).肿瘤化疗患者超声引导置管方法舒适度明显优于普通置管组,但急、慢性胰腺炎患者两组无明显差异.结论 与普通PICC置管比较,超声引导PICC置管成功率相当,但可显著降低并发症发生率,提高肿瘤患者带管生存的舒适度.%Objective To compare the application of common and ultrasound-guided peripherally inserted central venous catheters (PICC) catheterization methods in the hospitalized patients of the department of gastroenterology.Methods One hundred and six the hospitalized patients of the department of gastroenterology with PICC catheterization were divided into the common group (n =71) and the ultrasound-guided group (n =35).The success rate of puncture,the degree of comfort and the incidence rate of complication were compared between two groups.Results No differences were found in the success rate of first puncture (94.4% vs 94.3%) and the total success rate of puncture (98.6% vs 100%) between the common group and the ultrasound-guided group (x2 =0.03,0.50,respectively; P > 0.05).The incidence of complication in the ultrasound-guided group (2/35,5.7%) was significantly lower than that of the common group (22/71,31.0%),and the difference was statistically significant (x2 =8.548,P <0.01).The degree of comfort in the ultrasound-guided group was significantly better than that of the common group in the tumor

  12. Perfil dos microrganismos isolados no trato urinário após sondagem vesical em cirurgia ginecológica Profile of microorganisms found in urocultures after urinary catheterization in patients undergoing elective gynecological surgery

    Directory of Open Access Journals (Sweden)

    Sônia Cristina Hinrichsen

    2009-03-01

    Full Text Available OBJETIVOS: determinar os microrganismosfreqüentemente encontrados nas uroculturas apóssondagem vesical e o perfil de sensibilidade aos antibióticos em mulheres submetidas a cirurgia ginecológica eletiva. MÉTODOS: estudo de corte transversal em mulheres submetidas a cirurgia ginecológica com sondagem vesical, no Instituto de Medicina Integral Professor Fernando Figueira (IMIP, em Recife, Pernambuco, Brasil, de janeiro a maio de 2007. As uroculturas foram coletadas em dois períodos: até 24h da retirada do cateter e após sete/10 dias. RESULTADOS: amostras de urina foram colhidas em 249 mulheres. Encontrouse 23,6% (n=46 de uroculturas positivas com até 24h da retirada da sonda e 11,1% (n=25 com sete/10 dias após sondagem vesical. Não foi observada diferença significativa em relação aos microrganismos, quando se compararamas duas uroculturas. A Klebsiella spp. foi o principal microrganismo em ambas uroculturas (até 24h=47,8% vs sete/10 dias=44,0%; p=0,76, seguido de Escherichia coli e outros Gram-negativos. Os antibióticos amicacina, cefepima, ciprofloxacina, meropenem e ticarcilina-clavulanato foram os que apresentaram sensibilidade igual ou superior a 75%para os principais microrganismos isolados. CONCLUSÕES: Klebsiella spp. foi o microrganismo mais encontrado nas uroculturas após sondagem vesical em cirurgias ginecológicas e o antibiótico com sensibilidade igual ou maior a 95% com via de administração oral foi a ciprofloxacina.OBJECTIVES: to determine the microorganisms mostfrequently found in urocultures after urinary catheterization and their antibiotic sensitivities in women undergoing elective gynecological surgery. METHODS: the study was carried out at theInstituto de Medicina Integral Professor FernandoFigueira, IMIP, in Recife, Pernambuco, Brazil, between January and May 2007. Urine cultures wereobtained from these patients on two occasions subsequent to the removal of the catheter: within the first 24h and 710 days

  13. 股静脉穿刺置管在晚期癌症病人生命维持中的作用%Role of femoral vein catheterization in the maintenance of life in patients with advanced cancer

    Institute of Scientific and Technical Information of China (English)

    张丽琴

    2015-01-01

    静脉通道的建立,在危重病人,特别是晚期癌症病人的生命维持中显得至关重要。晚期癌症病人由于机体处于极度衰竭状态,全是症状明显,使病人痛苦不堪。每天机体所必需的营养物质、微量元素和电解质的补充,以及各种只来药物的输注,是不可缺少的。而这类病人由于反复化疗及营养不良,使周围静脉静脉穿刺条件极差,很难穿刺成功,甚至无处可穿。股静脉穿刺置管是为晚期癌症病人建立起可靠的静脉通道,保证治疗和营养,并最大限度的减轻这类病人痛苦的有效措施。%the establishment of the venous channels in the critical patients, especially in the late stage cancer patient's life support is very important. Advanced cancer patients due to the body in a state of extreme exhaustion, all the symptoms, so that the patient suffering. The essential nutrients, trace elements, and electrolytes, as well as the infusion of drugs, are indispensable to the daily body. And this kind of patient due to repeated chemotherapy and malnutrition, so that the surrounding venous puncture condition is very poor, it is difficult to puncture success, and even no place to wear. Femoral vein catheterization is an effective treatment for advanced cancer patients and to ensure the treatment and nutrition, and to maximize the effective measures to reduce the pain.

  14. Association among leukocyte count, mortality, and bleeding in patients with non-ST-segment elevation acute coronary syndromes (from the Acute Catheterization and Urgent Intervention Triage StrategY [ACUITY] trial).

    Science.gov (United States)

    Palmerini, Tullio; Généreux, Philippe; Mehran, Roxana; Dangas, George; Caixeta, Adriano; Riva, Diego Della; Mariani, Andrea; Xu, Ke; Stone, Gregg W

    2013-05-01

    Although inflammation is involved in the pathogenesis of acute coronary syndromes, the extent of inflammation is not routinely assessed, and its prognostic implications in patients with non-ST-segment elevation acute coronary syndrome have not been investigated in depth. We analyzed the prognostic implications of an elevated white blood cell count (WBCc) in patients with moderate and high-risk non-ST-segment elevation acute coronary syndrome undergoing an early invasive strategy in the large-scale Acute Catheterization and Urgent Intervention Triage StrategY trial. The WBCc at admission was available for 13,678 of 13,819 patients (98.9%). The patients in the upper tertile of the WBCc had an increased risk of 30-day major bleeding, 1-year mortality, and definite/probable stent thrombosis compared to those in the mid or lower tertiles. On multivariate analysis, the WBCc was an independent predictor of 30-day major bleeding and 1-year cardiac, noncardiac, and all-cause mortality. The association between the WBCc and cardiac mortality was present in multiple prespecified subgroups, with no significant interaction between the WBCc and age, gender, diabetes, smoking, renal dysfunction, elevated baseline biomarkers, antithrombotic therapy, revascularization, and Thrombolysis In Myocardial Infarction risk score. The WBCc remained an independent predictor of mortality after adjusting for bleeding, C-reactive protein level, and angiographic variables, including left ventricular ejection fraction, Thrombolysis In Myocardial Infarction flow, and number of diseased vessels. The WBCc significantly improved the prognostic accuracy of the Thrombolysis In Myocardial Infarction risk score, with a net reclassification improvement of 11% (p segment elevation acute coronary syndrome, an elevated admission WBCc was an independent predictor of 30-day major bleeding, and 1-year cardiac, noncardiac, and all-cause mortality.

  15. Usefulness of the Sum of Pulmonary Capillary Wedge Pressure and Right Atrial Pressure as a Congestion Index that Prognosticates Heart Failure Survival (from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness Trial).

    Science.gov (United States)

    Ma, Tony S; Paniagua, David; Denktas, Ali E; Jneid, Hani; Kar, Biswajit; Chan, Wenyaw; Bozkurt, Biykem

    2016-09-15

    In the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial, use of a pulmonary artery catheter did not significantly affect advanced heart failure outcomes. However, the success of achieving the targeted hemodynamic goals of pulmonary capillary wedge pressure (PCWP) of 15 mm Hg and right atrial pressure (RAP) of 8 mm Hg and the association of these goals with clinical outcomes were not addressed. Furthermore, goals with 2 independent variables, PCWP and RAP, left room for uncertainties. We assessed the ability of a single hemodynamic target to achieve a threshold sum of PCWP and RAP as a predictor of all-cause mortality, death-or-transplantation (DT), or death-or-rehospitalization (DR) at 6 months in the pulmonary artery catheter-guided treatment arm of ESCAPE (n = 206). Patients with a posttreatment PCWP + RAP of <30 mm Hg had characteristics similar to those of the population who achieved the ESCAPE hemodynamic goals. This group had 8.7% mortality, 13.0% DT, and 58.7% DR at 6 months. The contrasting cohort with PCWP + RAP of ≥30 mm Hg had 45.3% mortality, 54.7% DT, and 84.9% DR at 6 months, with greater relative risk (RR) of death (RR 5.76), DT (RR 4.92), and DR (RR 1.80) and higher prevalence of jugular venous pulsation, edema, hepatomegaly, and ascites at admission and discharge. In conclusion, PCWP + RAP of 30 mm Hg posttreatment, obtained early in the index hospitalization, may represent as a simple congestion index that has prognostic value for heart failure survival and readmission rates at 6 months and as a warning signal for more aggressive intervention, thus warranting further validation.

  16. 改良塞丁格技术与传统 PICC 置管在化疗患者中应用效果对比观察%Comparative observation of application effects between modified Seldinger technique and traditional PICC catheterization in chemotherapy patients

    Institute of Scientific and Technical Information of China (English)

    叶静; 涂晶; 许阳子

    2015-01-01

    Objective To investigate the application effects of modified Seldinger technique and traditional peripherally inserted central catheter (PICC) in chemotherapy patients. Methods There were 92 patients under chemotherapy as study subjects, and they were divided by different catheterization methods into modified group and conventional group. The modified group received superficial vein-guided modified Seldinger technique, and the conventional group received traditional PICC. The first puncture success rate, first catheterization success rate and incidence of adverse reactions were compared between the two groups. Results The modified group had obviously better first puncture success rate, first catheterization success rate and incidence of adverse reactions than the conventional group, and their difference had statistical significance (P<0.05). Conclusion In the absence B ultrasound machine for PICC catheterization, implement of modified Seldinger technique for PICC catheterization can provide high first puncture success rate and first catheterization success rate with good safety. This method is worthy of clinical promotion and application.%目的:探讨改良塞丁格技术与传统经外周静脉穿刺中心静脉置管(PICC)在化疗患者中的应用效果。方法选择92例化疗患者作为研究对象,根据其在化疗过程中选择的置管方式不同分为改良组和常规组,各46例,改良组患者采用浅静脉引导的改良塞丁格技术穿刺置管,常规组采用传统盲穿PICC 置管法。比较两组患者的一次穿刺成功率、一次置管成功率以及不良反应的发生率。结果改良组患者的一次穿刺成功率、一次置管成功率以及不良反应发生率等指标均显著优于常规组患者,比较差异有统计学意义(P<0.05)。结论在没有购置 PICC 置管专用 B 超机的情况下,采用改良塞丁格技术行PICC 置管的方法,不仅一次穿刺成功率和一次置管成功率显著

  17. Ultrasound-guided Techniques for Puncture and Catheterization of Internal Jugular Vein in Patients with Severe Trauma%超声引导颈内静脉穿刺置管术在重症创伤患者中的应用

    Institute of Scientific and Technical Information of China (English)

    范娟; 李宏; 杜建文

    2013-01-01

    Objective To explore the value of ultrasound-guided puncture and catheterization of the internal jugular vein in patients with severe trauma. Methods The right internal jugular vein was identified with ultrasound and centered on the screen. Ultrasound-Guided puncture and catheterization of the internal jugular vein was performed in real time after local anesthesia. Results In 50 cases, the success rate of puncture and catheterization at the first attempt was 100% during 1 to 3 min, without any complications including artery injury, hemorrhage, pneumothorax and nerve injury. Conclusion First-aid fast track can save time for emergency operation. Ultrasound-guided techniques can significantly improve the safety and effectiveness of catheterization. Compared with traditional method of anatomy, ultrasound -guided techniques have the significant advantages of improvement of successful rate of first attempt, reduction of the complication and time, which are the powerful tool of vascular access, especially for the critically ill.%目的:探讨超声引导技术对严重创伤患者行颈内静脉穿刺置管的应用价值.方法:首先选择并用超声技术定位右侧颈内静脉,局麻后,超声引导直视完成颈内静脉穿刺插管.结果:50例患者均1次穿刺成功并顺利置入中心静脉导管,成功率100%,穿刺时间为1~3 min;无动脉损伤、出血、气胸、神经损伤等并发症.结论:绿色通道手术目的是争取抢救时间,超声引导是提高血管置管安全性和有效性的有效手段.相对于传统的解剖定位法,它可以提高一针到位率、总成功率、降低并发症和减少置管时间,其已成为建立血管通路的有力工具,特别适合应用于危重患者的快速抢救.

  18. Punção percutênea da veia subclávia em crianças e adolescentes: sucesso, complicações e fatores associados Percutaneous subclavian central venous catheterization in children and adolescents: success, complications and related factors

    Directory of Open Access Journals (Sweden)

    Claudia C. Araujo

    2007-02-01

    Full Text Available OBJETIVO: O objetivo do estudo foi verificar a freqüência de sucesso e de complicações da punção percutânea da veia subclávia em crianças e adolescentes e identificar os fatores associados. MÉTODOS: Estudou-se uma série de 204 punções percutâneas da veia subclávia, utilizando cateter de cloreto de polivinil (Intracath® em crianças e adolescentes no Instituto Materno-Infantil Professor Fernando Figueira no período de 01/12/2003 a 30/04/2004. Foram analisadas variáveis relacionadas ao paciente, como idade, e relacionadas ao procedimento, como sucesso, tipo de anestesia, complicações, quem realizou e número de tentativas de punção. RESULTADOS: Houve sucesso em 89,2% das punções. O percentual de sucesso foi significantemente maior nas punções realizadas com a criança sob narcose (94%. Cerca de 43,2% das punções evoluíram com complicações relacionadas à inserção do cateter; no entanto, complicações de maior gravidade ocorreram em apenas 3,5% dos casos. Houve um maior número de complicações nas punções realizadas pelo residente do primeiro ano (58,8%, sendo que este realizou um percentual de procedimentos significativamente maior em crianças menores de 1 ano e com a realização de um maior número de tentativas no mesmo paciente. CONCLUSÕES: A realização do procedimento com o paciente sob narcose mostrou aumentar a chance de sucesso. Há maior chance de complicações relacionadas à inserção do cateter em punções de veia subclávia realizadas por médicos menos experientes, sendo prudente selecionar as punções em situações de maior risco para cirurgiões com maior experiência no procedimento.OBJECTIVE: The objective of this study was to investigate the rates of success and of complications of percutaneous subclavian central venous catheterization in children and adolescents and to identify factors associated with them. METHODS: This was a study of a series of 204 percutaneous subclavian

  19. 2种途径深静脉穿刺中心静脉置管的Meta分析%Meta analysis of two approaches for central venous catheterization through deep vein puncture

    Institute of Scientific and Technical Information of China (English)

    张莉芳; 赵小平; 蔡益民; 贺丽春

    2008-01-01

    Objective The incidence rate of complication during central venous catheterization through internal jugular vein (IJV) and subclavian vein (SV) puncture. Methods Clinical controlled trials about IJV and SV puncture were collected and related literatures were screened according to the criteria of inclusion. The literatures underwent Meta analysis and subsequent analysis of sensitivity. Results A total of 18 literatures were included. Meta analysis indicated that statistical difference existed in the related infection rate [RR=1.74, 95%CI (1.32, 2.30)] and arterial puncture [RR=3.19, 95%CI (1.70, 5.99)], but not in the one-time-puncture success rate [RR=1.06, 95%CI (0.90, 1.24)] between IJV and SV puncture. Conclusions The rate of related infection and arterial puncture was higher by IJV than by SV puncture. But we could not confirm if any difference existed in the one-time-puncture success rate between the two methods. The results still needs evaluation by high-quality randomly controlled experiments.%目的 比较颈内静脉(IJV)与锁骨下静脉(SV)穿刺中心静脉置管部分并发症发生率.方法 收集有关IJV与SV穿刺中心静脉置管的临床对照研究,根据纳入标准纳入文献.对纳入文献进行Meta分析并对结果行敏感性分析.结果 纳入18篇文献. Meta分析结果提示IJV与SV穿刺中心静脉置管导管相关性感染率差异有统计学意义[RR=1.74,95%CI(1.32,2.30)],误入动脉率差异有统计学意义[RR=3.19,95%CI(1.70,5.99)],一次穿刺成功率差异无统计学意义[RR=1.06,95%CI(0.90,1.24)].结论 IJV穿刺中心静脉置管导管相关性感染率及误入动脉率高于SV穿刺;尚不能认为2组一次穿刺成功率有差别;本结果仍需要高质量的随机对照试验来评价.

  20. Application of Electrocardiogram in Central Venous Catheterization for Patients with Tumors%心电导联中心静脉置管技术在肿瘤患者中的应用体会

    Institute of Scientific and Technical Information of China (English)

    吴耀红; 俞新燕

    2013-01-01

    This paper introduced the application of electrocardiogram in central venous catheterization for 326 patients with tumors and its nursing care. With the change of P wave of electrocardiography, the central venous catheter tip could be inspected, which contributed to the improvement of success rate and there was less radioactive pollution from X-ray and less local hemorrhage in puncture point. All catheters were successfully placed and the success rate was improved. Since no change of P wave was detected, the central venous catheter was placed with X-ray positioning among six patients. Oozing lasted in puncture point among 78 patients for 2 to 3 days and stopped after treatment. The communication between patients and nurses played a critical part in the whole process. Successful completion of chemotherapy was witnessed in all patients in the study.%  总结326例肿瘤患者在中心静脉置管过程中应用心电导联技术的护理经验。通过穿刺过程中加强护患沟通,利用心电图P波改变及时调整导管尖端位置,改变穿刺方法,提高了穿刺成功率,减少了X线的放射性污染及穿刺点的局部出血。本组326例患者均成功置管,1次置管成功率相比传统中心静脉置管提高了约4%。本组6例患者在未见P波改变情况下,改用 X线定位;78例患者穿刺处少量渗血持续2~3 d,经积极处理后,出血停止。所有病例均顺利完成化疗。

  1. Coronary physiology assessment in the catheterization laboratory

    Institute of Scientific and Technical Information of China (English)

    Felipe; Díez-delhoyo; Enrique; Gutiérrez-Iba?es; Gerard; Loughlin; Ricardo; Sanz-Ruiz; María; Eugenia; Vázquez-álvarez; Fernando; Sarnago-Cebada; Rocío; Angulo-Llanos; Ana; Casado-Plasencia; Jaime; Elízaga; Francisco; Fernández; Avilés; Diáz

    2015-01-01

    Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology.

  2. Thyrocervical trunk pseudoaneurysm following central venous catheterization.

    Science.gov (United States)

    Mazzei, Valerio; Benvenuto, Domenico; Gagliardi, Massimo; Guarracini, Stefano; Di Mauro, Michele

    2011-11-01

    A 71-year-old female developed a painless neck mass three months following an aortic valve replacement, mitral commissurotomy, and coronary artery bypass. A cervical trunk angio revealed a pseudoaneurysm supplied from a branch of the thyrocervical trunk, which was successfully excised.

  3. Heparinization during percutaneous cardiac catheterization in children.

    Science.gov (United States)

    Netz, H; Madu, B; Röhner, G

    1987-01-01

    The effect of heparin on blood clotting was studied by measuring the activated clotting time (ACT) in 120 infants and children with congenital heart disease after a single intravenous bolus of 100 IU heparin/kg body weight. Before heparinization, infants and children with cyanotic heart disease showed signs of hypocoagulation. Heparin bolus led to a threefold increase of ACT after 15 min. After 1 h, the ACT was still two times the normal value. Any further administration of heparin may be based on ACT monitoring.

  4. What to Expect during Cardiac Catheterization

    Science.gov (United States)

    ... Search Donate Circulation My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Doodle → Blip the Doodle Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  5. Swan-Ganz - right heart catheterization

    Science.gov (United States)

    ... be due to: Blood flow problems, such as heart failure or shock Heart valve disease Lung disease Structural problems with the ... Burns Cardiac tamponade Congenital heart disease Heart attack Heart failure - overview Pulmonary ... Review Date 8/12/2014 Updated by: Michael ...

  6. Study on correlation between residual urine volume after catheterization and body positions for patients with spinal cord injury using B-ultrasonography%B超检测脊髓损伤患者导尿后膀胱残余尿量与体位的相关性探讨

    Institute of Scientific and Technical Information of China (English)

    孙彩霞; 何丽雅; 何凡; 朱如璜

    2009-01-01

    Objective To discuss the correlation between residual urine volume after catheterization and body positions for patients with spinal cord injury using B-ultrasonography. Methods 34 patients with spinal cord injury were randomly selected, the residual urine volume in urinary bladder was detected with bed-side B-ultrasonography under different body positions such as supine position, lateral position and fowler position, the results underwent variance analysis. Results No significant difference was seen in residual urine volume in urinary bladder under different body positions. Conclusions Body positions play no significant influence on residual urine volume in urinary bladder after catheterization.%目的 探讨不同体位与导尿后脊髓损伤患者残余尿量的相关性.方法 随机抽取脊髓损伤患者34例,采用床旁超声仪对其进行平卧位、侧卧位、斜坡卧位的导尿后膀胱残余尿量的检测并对结果进行方差分析.结果 不同体位导尿后膀胱残余尿量比较无显著差异.结论 体位对导尿后的膀胱残余尿量无显著影响.

  7. Brief discussion of influencing factors and ursing intervention for femoral venous catheterization-related lower extremity deep vein thrombosis%浅谈股静脉置管相关的下肢深静脉血栓形成的影响因素及护理干预

    Institute of Scientific and Technical Information of China (English)

    丛文青

    2015-01-01

    Occurrence of femoral venous catheterization-related lower extremity deep vein thrombosis (DVT) is affected by multiple factors. Correct cognition of thrombosis by nurse, individual difference of patients, nursing health education, maintenance of catheter are all the important factors. Therefore, implement of comprehensive nursing intervention measures provides active and effective effect in reducing incidence of femoral venous catheterization-related lower extremity deep vein thrombosis.%股静脉置管相关的下肢深静脉血栓(DVT)的发生受多种因素影响。护士对血栓形成的正确认知、患者个体差异、护理健康教育、导管的维护等各个环节都起着至关重要的作用。因此,采取全面的护理干预措施,对降低股静脉置管相关的下肢深静脉血栓的发生率,起着积极、有效的作用。

  8. Efficacy of thrombolytic therapy on superior mesenteric vein thrombosis by percutaneous transhepatic portal vein catheterization%选择性门静脉系统置管溶栓治疗肠系膜上静脉血栓疗效观察

    Institute of Scientific and Technical Information of China (English)

    杨涛; 陈俊卯; 陈建立; 张国志

    2012-01-01

    Objective To evaluate the therapeutic efficacy of percutaneous transhepatic portal vein catheterization and thrombolysis on superior mesenteric vein thrombosis.Methods The treatment and therapeutic efficacy of 15 cases of patients with superior mesenteric vein thrombosis underwent percutaneous transhepatic portal vein catheterization and thrombolysis from January 2000 to April 2011 were retrospectively analyzed.Results Percutaneous transhepatic portal vein catheterization was performed successfully in 15patients,without pneumothorax,bile leakage and intra-abdominal hemorrhage after catheterization.Eleven patients had good thrombolytic effect,with majority or complete recanalization on superior mesenteric vein,portal vein and splenic vein.The rate of recanalization Was 73.3%,total mortality was 13.3%.The total amount of urokinase was not more than 500 million U,and there was no cases with systemic bleeding.From 6 months to 36months follow-up,there was no increased portal vein system thrombosis and recurrent cases.Conclnsion Thrombolysis technique of percutaneous transhepatic portal vein catheterization is easy to master,and with good effect of local infusion thrombolytic therapy and lower complication rate.It's a selectable treatment for superior mesenteric vein thrombosis.%目的 探讨经皮经肝穿刺门静脉-肠系膜上静脉置管溶栓治疗肠系膜上静脉血栓(MVT)的临床效果.方法 回顾性分析2000年1月至2011年4月通过经皮肝穿门静脉置管溶栓对15例MVT患者的治疗情况及疗效.结果 15例患者均成功经皮肝穿门静脉置管,置管后无气胸、胆漏及腹腔内出血.11例患者溶栓效果佳,肠系膜上静脉、门静脉及脾静脉大部分或完全再通,再通率73.3% (11/15),病死率为13.3%.尿激酶总量未超过500万U,未出现全身各系统出血病例.随访6~36个月,无门静脉系统血栓加重和复发病例.结论 经皮经肝穿刺门静脉系统置管溶栓技术容易掌握,局

  9. 分时段中心静脉置管在极低出生体质量儿中的应用%Application of Combined Central Venous Catheterization in Divided Period in Very Low Birth Weight Infants

    Institute of Scientific and Technical Information of China (English)

    黄朝梅; 邵巧仪; 罗英; 邓桂珍

    2013-01-01

    Objective To explore the application of umbilical venous catheter (UVC) combined with peripherally inserted central catheter (PICC) in divided period in very low birth weight infants (VLBWI). Methods One hundred and eleven VLBWIs from January 2010 to December 2011 were divided into combined catheter group (UVC and PICC) with 51 cases and PIV (peripheral vein) plus PICC group with 60 cases. Venous catheter situation, physical indications and catheter infection during hospitalization were monitored. Results The one-shot success rate in combined catheter group was higher than that of PIV plus PICC group, but lower incidence of infusion extravasation in combined catheter group. Correction time of hypoglycemia had no significant difference between the two groups, however but the frequency of apnoea and the time of weight up to 2 kg had (P<0.01). Conclusion With combined central venous catheterization, a higher success rate of intravenous puncture could be achieved with longer retention time, but lower incidence of infusion extravasation, which provides a safe and effective venous channel for VLBWI.%  目的探讨分时段脐静脉置管和经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)置管在极低出生体质量儿中的应用效果。方法选取2010年1月—2011年12月入院的极低出生体质量儿111例,分为分时段应用脐静脉置管、PICC组(观察组)51例和外周静脉置管加PICC组(对照组)60例,监测两组住院期间的静脉置管情况、患儿身体指征反应及导管感染情况。结果观察组PICC 1次置管成功率高于对照组,输液外渗发生率低(P<0.01);两组患儿纠正低血糖所需时间差异无统计学意义;呼吸暂停次数、体质量增长至2 kg时间经比较差异有统计学意义(P<0.01)。结论采用分时段中心静脉置管具有穿刺成功率高,留置时间长,输液外渗发生率低,且不增加感染的优点,能最大限

  10. Evaluation of the safety of right heart catheterization in patients with pulmonary hypertension%肺高压患者行右心导管检查及急性肺血管扩张试验的安全性

    Institute of Scientific and Technical Information of China (English)

    刘永太; 田庄; 郭潇潇; 李梦涛; 曾小峰; 朱文玲; 方全

    2012-01-01

    Objective To evaluate the safety of right heart catheterization ( RHC) and acute vasodilator test in patients with pulmonary hypertension. Methods A prospective research of the patients diagnosed as pulmonary hypertension by RHC between January 2007 and September 2010 was performed, Acute vasodilator test was done if necessary. The complications of RHC and side effects of acute vasodilator test were recorded. Results There were 152 patients enrolled with a median age of (41. 7 ?13. 2) years. The median time of RHC was 21 minutes. Incidence of complications or side effects of acute vasodilator test was 12% (18/152). There were no pneumothoraxes, pulmonary hemorrhage, or deaths related to the procedure. Complications occurred in 8 patients (5% ) including carotid artery mistake puncture ( n = 1) , hematoma (n =2) , arrhythmia (n =4) and vasovagal reaction (n = 1 ) which disappeared spontaneously without hemodynamic changes. Side effects occurred in 10 patients (7%) during acute vasodilator test, which included tachycardia (n =5) , severe hypotension (n =3) and acute pulmonary edema (n =2). After discontinuation of vasodilator and usage of vasoactive agent, the side effects disappeared. Conclusions When performed by experienced operators, RIIC in patients wilh pulmonary hypertension is safe with low morbidity and mortality rates.%目的 探讨肺高压患者行右心导管检查和急性肺血管扩张试验的安全性.方法 前瞻性入选2007年1月至2010年9月间经右心导管检查证实为肺高压的患者,并根据临床情况进行急性肺血管扩张试验.记录操作并发症和急性肺血管扩张试验的不良反应.结果 152例患者入选,其中女性122例,男性30例,平均年龄(41.7±13 2)岁.右心导管操作的平均时间为21 min.102例患者进行了急性肺血管扩张试验.共18例(12%)患者出现了并发症或不良反应,8例(5%)并发症包括穿刺至颈动脉(1例)、局部血肿(2例)、快速性心律失常(4

  11. 改良膀胱冲洗技术预防清洁间歇导尿患者尿路感染的临床效果%Effect of Innovative Bladder Irrigation Method on Prevention of Urinary Tract Infection in Neurogenic Bladder Patients with Clean Intermittent Catheterization

    Institute of Scientific and Technical Information of China (English)

    张建梅; 蒋春燕; 李娜; 杜春萍

    2015-01-01

    Objective To explore the clinical effect of innovative bladder irrigation on prevention of urinary tract infection in neurogenic bladder patients with clean intermittent catheterization after spinal cord injury (SCI). Methods 40 neurogenic bladder patients with clean in-termittent catheterization after SCI were divided into observation group (n=20) and control group (n=20). The observation group received in-novative bladder irrigation with normal saline 500 ml every other day, and the control group received normal bladder irrigation with normal saline 500 ml every day. Results 4 weeks and 6 weeks after treatment, the incidence of urinary tract infection was lower in the observation group than in the control group (P<0.05). Conclusion The innovative bladder irrigation method can decrease the rate of urinary tract infec-tion in neurogenic bladder patients with clean intermittent catheterization after SCI.%目的:观察改良膀胱冲洗技术预防脊髓损伤后神经源性膀胱清洁间歇导尿患者尿路感染的临床效果。方法将40例脊髓损伤后神经源性膀胱清洁间歇导尿患者分为观察组(n=20)和对照组(n=20)。观察组采用生理盐水500 ml改良膀胱冲洗,隔天1次;对照组采用生理盐水500 ml传统膀胱冲洗,每天1次。结果治疗后4周和6周,观察组尿路感染率低于对照组(P<0.05)。结论改良膀胱冲洗技术可降低脊髓损伤后神经源性膀胱清洁间歇导尿患者尿路感染率。

  12. Effects of sedative music on anxiety, heart rates and skin-surface temperature in patients awaiting cardiac catheterization examination%镇静音乐对等待心导管检查患者焦虑水平与心率及皮肤温度的影响

    Institute of Scientific and Technical Information of China (English)

    周荣; 刘皇军; 金立军; 何小玲; 黄敏

    2012-01-01

    Objective To explore the effects of sedative music on-anxiety, heart rates and fingertip skin-surface temperature in patients awaiting cardiac catheterization examination. Methods Forty subjects scheduled for cardiac catheterization examination were commensurately and randomly assigned to two groups. The control group were given conventional care, while the music group additionally received sedative music: patients were asked to listen to their favorable music for 30 min with the music rhythm ranging from 40 to 60 beats/min. Results Heart rates and fingertip skin-surface temperature changed significantly at all time points after the intervention in both groups (P<0. 05,P<0. 01), with the changes being more noticeable in the music group (P<0. 05). Conclusion Sedative music applied to patients awaiting cardiac catheterization examination, can reduce anxiety and heart rates, and increase fingertip skin-surface temperature. It is a safe and effective intervention against anxiety.%目的 探讨镇静音乐对等待心导管检查患者焦虑水平、心率(HR)及指端皮肤温度(ST)的影响.方法 将40例行心导管检查的患者随机分为音乐组和对照组,各20例.对照组按常规护理;音乐组在此基础上采用镇静音乐疗法,即助患者从CD中选择自己喜欢的一种镇静音乐播放,音乐节奏为40~60次/min,持续30min.结果 两组干预后的HR与ST在每个时间点(T1~T6)均有明显改变(P<0.05,P<0.01),但音乐组效果更显著(P<0.05).结论 镇静音乐可显著降低等待心导管检查患者的焦虑水平,减慢HR及提高指端ST,是对抗焦虑安全、有效的干预措施.

  13. 间歇性导尿配合音频电疗、微波治疗脊髓损伤后痉挛性膀胱的效果研究%Research in intermittent urethral catheterization combined with audio frequency electrotherapy and microwave therapy in the treatment of patients with spastic bladder after spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    应燕萍

    2008-01-01

    目的 探讨脊髓损伤(SCI)后痉挛性膀胱患者恢复膀胱功能和自主排尿的方法.方法 对实验组30例患者间歇导尿6次/d,音频电疗、微波治疗各2次/d;对照组30例患者采用传统的留置尿管方法,观察2组患者膀胱功能恢复的情况.结果 实验组患者恢复自行排尿成功率显著高于对照组,差异有统计学意义(P<0.01).实验组膀胱容量增加、残余尿量减少优于对照组(P<0.05).结论 间歇性导尿结合音频电疗、微波进行膀胱功能训练能有效地促进SCI后痉挛性膀胱患者膀胱功能的恢复.%Objective To discuss methods for recovery of bladder function and autonomous urination for patients with spastic bladder after spinal cord injury. Methods Patients in the experimental group(30 cases)received intermittent urethral catheterization 6 times per day,audio frequency electrotherapy and microwave therapy 2 times per day.The control group(30 cases)adopted routine urethral catheterization.The recovery of bladder function of the two groups Was observed.Results The rate of autonomous urination in the experimental group was higher than that of the control group(P<0.01).Increase of bladder capacity and decrease of remnant urine volume in the experimental group was better than that of the control group(P<0.05).Conclusions Intermittent urethral catheterization combined with audio frequency electrotherapy and microwave therapy could effectively promote the recovery of bladder function for patients with spastic bladder after spinal cord injury.

  14. 间歇导尿更换卧位对脊髓伤致神经源性膀胱患者泌尿系感染的影响%Intermittent catheterization to replace lie on spinal cord injury patients with neurogenic bladder Urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    黄学英; 王丽华; 柳尧花

    2013-01-01

    目的:探讨无菌间歇导尿(Sterile Intermittent Catheterization,SIC)更换卧位对脊髓损伤(spinal cord injury ,SCI)致神经源性膀胱功能障碍( neurogenic bladder ,NB),泌尿系感染( urinary tract infection ,UTI)并发症的影响。方法:SCI符合美国脊髓损伤学会(American Spinal Injury Association , ASIA)2011年标准;NB符合亚洲神经源性膀胱诊断治疗指南(2011版)的诊断标准。患者115例患者分为对照组56例,观察组59例,2组患者制定饮水计划并书写排尿日记,接受常用的膀胱功能训练,SIC,观察组导尿后采取更换卧位,分别叩击耻骨上、骶尾部和右侧/或左侧臀部,2次夹闭尿管、3次开放彻底引流尿液。观察指标:血常规、尿常规、细菌培养、肾功能、B超等辅助检查,每次导尿时观察尿液的物理状态。结果:2组患者UTI的发生随间歇导尿呈减少趋势,但对照组经过3周的间歇导尿UTI发生并无减少。观察组与照组比较3周后有显著性差异(P∠0.01)。结论:SIC更换卧位引流尿液,能有效降低SCI致NB患者UTI的发生。%Objective:To discuss sterile Intermittent Catheterization replace the lying position of spinal cord injury , cause neurogenic bladder dysfunction urinary tract infection complications.Methods:SCL conforms to the American Spinal Injury Association 2011 standard;NB in Asian neurogenic bladder guide (2011) diagnostic criteria for the diagnosis and treatment.56 cases patients, 115 patients were divided into control group, 59 cases of observation group, 2 groups of patients developed a plan of drinking water and voiding diary writing , commonly used bladder function training, SIC, Observation group after urethral catheterization to replace recumbent position , respectively the taps on the pubic bone, the tail and/or on the right side on the left side of the hips,, turn off 2 times, 3 times open drainage of urine

  15. Comparison of Two Kinds of Application of Puncture Approach Ways of Central Vein Catheterization in Critically Ill Patients%两种穿刺入路方式中心静脉置管术在危重症抢救中的应用比较

    Institute of Scientific and Technical Information of China (English)

    谢德东; 周莉娟; 陈力; 戴领

    2014-01-01

    Objective To compare two kinds of puncture approach ways of central vein catheterization in the critically ill rescue application, in the way of central vein to seek for optimal rescue critically ill patients. Methods A retrospective analysis from 2008 March to 2013 year in March 900 cases of critically ill patients in our center of central venous catheterization patients clinical data, which take the internal jugular vein puncture approach in 420 cases, puncture of subclavian vein approach in 480 cases, based on the two kinds of puncture approach ways of central vein catheterization occurred in quick puncture success rate and puncture related complications rate analysis. Results The success rate of puncture of internal jugular vein puncture ap-proach: 336 cases (80% ); puncture of subclavian vein approach in 456 cases (95% ); the incidence rate of puncture related complications: internal jugular vein puncture approach in 69 cases (16. 4% ), puncture of subclavian vein in 20 cases (4. 2% ). Conclusion In critically ill patients subclavian vein puncture approach ways of central vein catheterization rate is better than that of internal jugular vein puncture approach in fast puncture success rate and puncture related complications.%目的:比较两种穿刺入路方式中心静脉置管术在危重症抢救中的应用,寻求适用于危重症患者抢救中最优的中心静脉置管入路方式。方法回顾性分析2008年3月至2013年3月我中心900例危重抢救患者中心静脉置管术临床资料,其中采取颈内静脉穿刺入路方式420例,锁骨下静脉穿刺入路方式480例,通过对两种穿刺入路方式中心静脉置管术在快速穿刺成功率及穿刺相关并发症发生率方面进行分析比较。结果一针穿刺成功率:颈内静脉穿刺入路方式336例(80%);锁骨下静脉穿刺入路方式456例(95%);穿刺相关并发症发生率:颈内静脉穿刺入路方式69例(16.4%),锁

  16. Correlation of Echocardiography and Right Heart Catheterization in Measure of Total Pulmonary Resistance in Idiopathic Pulmonary Arterial Hypertension%超声心动图与右心导管对特发性肺动脉高压全肺阻力测量的相关性分析

    Institute of Scientific and Technical Information of China (English)

    王斌; 马小静; 张刚成; 何俊; 阳前华; 郑立娜; 严薇

    2014-01-01

    Objective To explore the correlation of echocardiography and right heart catheterization in measure of total pulmonary resistance ( TPR) in idiopathic pulmonary arterial hypertension ( IPAH) . Methods A total of IPAH 32 patients confirmed by right heart catheterization examination from January to December 2013 were recruited in the study. The values of pulmonary diagnostic endocardial surface of the inner diameter in the annulus ( Dpv ) , systolic pulmo-nary blood flow before the valve orifice speed ( Vpv ) and right atrial systolic tricuspid regurgitation of peak velocity max imum ( Vmax TR) were detected with ultrasoundcardiogram diagnostic apparatus, and the heart rates were recorded. The values of area of the pulmonary valve annulus ( APV ) , the pulmonary valve flow velocity-time integral ( VTIPV ) and mean pulmonary artery pressure ( PAMP) were calculated on the basis of the measure results, and values of pulmonary blood flow ( QP) and TPR were calculated according to the formula, and then the measure results of right heart catheterization were compared. Results Ultrasoundcardiogram diagnostic apparatus showed that values of PAMP, TPR and QP had a high positive correlation with the measure values of right heart catheterization by calculating with a formula ( r=0. 898, 0. 819, 0. 918, P<0. 01). Conclusion Ultrasoundcardiogram diagnostic apparatus is of important significance in clini-cal noninvasive diagnosis of IPAH by TPR measure.%目的:探讨超声心动图与右心导管测量特发性肺动脉高压( idiopathic pulmonary arterial hypertension, IPAH)全肺阻力( TPR)的相关性。方法对2013年1-12月在我院经右心导管检查确诊的IPAH 32例应用超声心动图诊断仪测量肺动脉瓣环心内膜面内径( DPV )、收缩期肺动脉瓣口前向血流速度( APV )和收缩期三尖瓣口右心房侧最大反流峰值速度( Vmax TR)并记录心率,根据测量结果计算肺动脉瓣环面积( APV )、

  17. The application of quality control circles in reducing skin allergy rate on sticking spots after PICC catheterization%品管圈在降低PICC置管术后敷贴部位皮肤过敏率中的应用

    Institute of Scientific and Technical Information of China (English)

    邓琴; 易敏; 黄国会; 张月; 刘为; 陈文均

    2015-01-01

    目的:探讨品管圈活动对PICC置管患者敷贴部位皮肤过敏率的影响。方法选取2014年1月1日至2014年6月30日在某三级甲等医院行PICC导管维护的肿瘤患者581例,实施品管圈活动前(2014年1月1日至3月15日)305例,实施品管圈活动后(2014年3月16日至6月30日)280例。观察实施品管圈前后皮肤过敏情况,评价品管活动前后QCC成员个人能力及团队功能。结果品管圈活动前后PICC置管患者敷贴部位皮肤过敏率由12.6%(38/301)降低到4.3%(12/280),差异有统计学意义(χ2=12.825,P<0.01);QCC成员个人能力及团队功能得以提升。结论通过运用品管圈的管理方法,降低了PICC置管术后敷贴部位皮肤过敏率,说明QCC是护理工作有效科学管理方法。%Objective To study the effects of quality control circles(QCC) activities in reducing skin allergy rate on stick-ing spots after PICC catheterization. Methods A total of 581 tumor patients treated with PICC catheterization admitted by a cer-tain grade A class 3 hospital from January 1,2014 to June 30,2014 were collected,including 305 cases before joining in quality control circles(QCC) activities(January 1,2014-March 15,2014) and 280 cases after joining in quality control circles(QCC) activities(March 16,2014-June 30,2014). It is observed the skin allergy condition, personal abilities and team functions of QCC members before and after the implementation of QCC activities. Results The skin allergy rate[12.6%(38/301)] of the patients with PICC catheterization before QCC activities was reduced to 4.3%(12/280)] after QCC activities. The difference had statistical sig nificance(χ2=12.825,P<0.01). The individual abilities and team functions of QCC members were improved. Conclusion The ap-plication of QCC activities may reduce the allergy rate of the PICC catheterization ,demonstrating that QCC is a scientific man-agement method for nursing work.

  18. 两种换药方法用于老年患者中心静脉置管处皮肤过敏的效果观察%Observation of effect of two dressing change methods for skin allergy in central venous catheterization area in elderly patients

    Institute of Scientific and Technical Information of China (English)

    高杰; 张艳君; 冯丽芳; 梁锡铭; 侯惠如

    2013-01-01

    Objective To observe the treatment effect of the Compound Dexamethasone Acetate Cream coating combined with gauze fixation and the Meipikang method for the skin allergy in the central venous catheterization area in elderly patients. Methods 38 patients with skin allergy in the central venous catheterization area were divided into the Dexamethasone group and the Meipikang group with 19 patients in each group according to the occurrence time. The Dexamethasone group was given Dexamethasone acetate cream coating and gauze fixation after the local disinfection using conventional compound iodine. The Meipikang group was given Meipikang fixation after the local disinfection using conventional compound iodine. Results In the Dexamethasone group, 5 patients (26.3%) were cured, 14 patients (73.7%) relieved and none was ineffective, with the total effective rate of 100.0%. In the Meipikang group, 17 patients (89.5%) were cured, 1 patient (5.3%) relieved and 1 patient was ineffective, with the total effective rate of 94.7%. The effective rates of the two groups were not significantly different (P > 0.05), but the cure rate of the Meipikang group was significantly superior to that of the control group (P 0.05),但美皮康组的治愈率明显优于对照组(P < 0.05).结论复方醋酸地塞米松乳膏对皮肤过敏的有效率高,但起效时间较长;美皮康的治愈率显著且简便易行,但有过敏现象发生,且价格昂贵,需掌握应用对象和应用时机.

  19. 兔经股动脉插管自体血栓大脑中动脉栓塞模型%Establishment of rabbit model of embolic middle cerebral artery occlusion stroke through selective transfemoral internal carotid catheterization

    Institute of Scientific and Technical Information of China (English)

    刘振生; 张新江; 周龙江; 高珊玉; 刘一辉; 王苇; 李澄

    2013-01-01

    Objective To establish rabbit model of embolic middle cerebral artery occlusion stroke with clots through selective transfemoral internal carotid catheterization(ICA), and evaluate the feasibility and stability of the technique. Methods A total of 30 New Zealand white rabbits were enrolled, either gender, with mean age of 14-month old and mean body weight of 4.1 kg, which were divided into control group(n=10) and experimental group(n = 20). Both groups received selective transfemoral ICA and angiography, with 1-5 clots injected in experimental group and only the contrast media injected in control group. Digital subtraction angiography (DSA) was performed to observe cerebral vascular obstruction, the modified Bederson scoring was used to observe neurologic impairment, CT perfusion was performed to observe cerebral blood perfusion, and diffusion weighted imaging (DWI) and 2, 3, 5 -triphenyltetrazolium chloride (TTC) staining were used to observe cerebral infarction. Results Seventeen (85 %) embolic rabbit stroke models in experimental group were successfully established, which manifested occlusion of middle cerebral arteries, neurologic deficits, abnormalities of perfusion, DWI and TTC staining. Three embolic rabbit stroke models were failed, because internal carotid arteries were occluded in 2 rabbits and recanalization occurred in occluded middle cerebral artery in 1 rabbit. No abnormality was observed in control animals. There was obvious difference in CT parameters between 2 groups. Conclusion It is demonstrated that the technique for establishing rabbit models of embolic middle cerebral arteries occlusion stroke with clots through selective transfemoral ICA is simple, micro invasive and reliable. Selection of appropriate clots and familiarity with the anatomy and variation of ICA could obviously improve the stability and reproducibility of focal cerebral ischemia model in rabbits.%目的 经股动脉途径行选择性颈内动脉插管建立兔大脑中动

  20. 脊髓损伤患者间歇性导尿预防泌尿系统感染的效果分析%Effect of intermittent catheterization for prevention of urinary tract infections in patients with spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    杜小芳; 王芳; 王延荣; 齐鹏; 唐福爱; 崔福玲

    2016-01-01

    OBJECTIVE To investigate the effect of intermittent catheterization for prevention and control of infec-tions after bladder function damage in patients with spinal cord injury .METHODS Totally 98 patients with spinal cord-related injury in our hospital from Jan .2012 to Jan .2015 were selected and were randomly divided into the intermittent catheterization group (intervention group) of 49 cases and the indwelling catheter group (control group) of 49 cases .The intermittent catheterization was used in the intervention group and the method of indwell-ing urethral catheterization was adopted in the control group .The residual urine volume ,the bacteria counting and the urinary tract infection rate as well as the urinary white blood cell count at 7 d and 14 d were investigated and analyzed .The software SPSS 19 .0 was used for statistical analysis RESULTS The urinary infection rate was 24 .5% in the intervention group and 77 .6% in the control group ,with significance (P<0 .05) .The urinary bac-terial count was significantly lower in the intervention group than in the control group at 15 d and 30 d after differ-ent catheterizations (P<0 .05) .There were 11 cases of white blood cells (+ ) in the intervention group and 33 such cases in the control group after treatment for 7 d ,with significance after removal of catheter (P< 0 .05) . There were 14 cases of white blood cells (+ ) in the intervention group and 40 such cases in the control group after treatment for 14 d ,with significance (P<0 .05) .CONCLUSION .Intermittent catheterization in patients with spi-nal cord injury has better control effect on the disease ,reduces the infection rate of patients and can effectively re-duce the residual urine volume .%目的 研究脊髓损伤患者间歇性导尿对膀胱功能损坏后感染预防控制效果.方法 选择2012年1月-2015年1月医院进行治疗的脊髓受损的98例患者,将其随机分为干预组及对照组,每组各49例;干预组患者采用间歇性导

  1. Herzkathetereingriffe in Österreich im Jahr 2014 (mit Audit bis 2015 // Austrian National CathLab Registry (ANCALAR: Cardiac Catheterization, Coronary Angiography (CA and PCI in Austria during the Year 2014 (Registry Data with Audit including 2015

    Directory of Open Access Journals (Sweden)

    Mühlberger V

    2016-01-01

    .5% occurred during 2010 to 2014, a possible benefit of the radial approach.br Multi-vessel PCI during the same session (n = 3.094 cases in 2013 increased to n = 4.309 cases in 2014, implantation of multiple stents from 5.668 to 8.021 cases as well. Reintervention (REDO – due to restenosis – reporting centres observed a reduction during 2003–2014 from 6.6% to 4.2% in such cases. From 2010 (15.2% to 2014 (16.6% the relative percentage of stent thromboses stayed constant (could not be improved in those REDO cases.br Left ventricular angiography during diagnostic catheterization decreased rapidly and for the first time from 2013 to 2014 (from n = 18.572 to n = 11.834 cases apparently due to multiple other possibilities of left ventricular imaging. Percutaneous Renal Denervation suffered the expected downslope in 2014.br Interestingly, not only in Austria, it is still observed that scientific knowledge, recommended as Class I Indications in the guidelines, takes several years to establish itself nationwide. This is evident 2014 again concerning intra-arterial balloon pump or antithrombotic management in the CathLab.br The data for 2014 are presented in Krems (November 27th–28th, 2015 at the autumn meeting of the working group “Interventional Cardiology of the Austrian Society of Cardiology” (ÖKG, as a basis for discussion. The presentation will also be placed under the website a href="http://iik.i-med.ac.at"http://iik.i-med.ac.at/a.p bKurzfassung:/b Im internationalen Vergleich für das Jahr 2014 liegt Österreich (A/AUT mit 6534 diagnostischen Koronarangiographien (CA, 2686 perkutanen Koronareninterventionen (PCI, 379 elektrophysiologischen Ablationen und 70 transarteriellen Aortenklappenimplantationen (TAVI bezogen auf eine Million Einwohner im europäischen Spitzenfeld. Alle Parameter zeigten eine Zunahme gegenüber dem Vorjahr.br Die erhöhte Mortalität von 31,2 % bei Patienten mit PCI wegen ST-Hebungsinfarkten (STEMI und konsekutivem Schock ist hauptverantwortlich f

  2. 特发性肺动脉高压患儿心导管检查及急性肺血管反应试验效果评价%Cardiac catheterization and pulmonary vasoreactivity testing in children with idiopathic pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    张陈; 李强强; 刘天洋; 顾虹

    2014-01-01

    Objective As an important method of hemodynamic assessment in idiopathic pulmonary arterial hypertension (IPAH),cardiac catheterization combined with pulmonary vasoreactivity testing remains with limited experience in children,and the acute pulmonary vasodilator agents as well as response criteria for vasoreactivity testing remain controversial.The aim of this study was to investigate the clinical importance,agent selection,and responder definition of cardiac catheterization combined with pulmonary vasoreactivity testing in pediatric IPAH.Method The patients admitted to Department of Pediatric Cardiology of Beijing Anzhen Hospital between April 2009 and September 2013 with suspected IPAH,under 18 years of age,with WHO functional class Ⅱ or Ⅲ,were enrolled.All the patients were arranged to receive left and right heart catheterization and pulmonary vasoreactivity testing with inhalation of pure oxygen and iloprost (PGI2) respectively.Hemodynamic changes were analyzed,and two criteria,the European Society of Cardiology recommendation criteria (Sitbon criteria) and traditional application criteria (Barst criteria),were used to evaluate the test results.Result Thirty-nine cases of children with suspected IPAH underwent cardiac catheterization.In 4 patients IPAH was excluded; 4 patients developed pulmonary hypertension crisis.The other 31 patients received standard cardiac catheterization and pulmonary vasoreactivity testing.Baseline mean pulmonary artery pressure (mPAP) was (66 ± 16) mmHg (1 mmHg =0.133 kPa),and pulmonary vascular resistance index (PVRI) (17 ± 8) Wood U m2.After inhalation of pure oxygen,mPAP fell to (59 ± 16) mmHg,and PVRI to (14 ± 8) Wood U · m2 (t =4.88 and 4.56,both P <0.001).After inhalation of PGI2,mPAP fell to (49 ±21) mmHg,and PVRI to (12±9) Wood U · m2(t =7.04 and 6.33,both P <0.001).According to the Sitbon criteria,the proportion of pure oxygen responders was 6.5% (3/31),while PGI2 responders was 35.5%,and the difference

  3. Influence of PICC placement through different veins and arms on catheterization success rate and complications: a systematic review%PICC经不同静脉和上肢置入对穿刺成功与并发症发生影响的系统评价

    Institute of Scientific and Technical Information of China (English)

    李全磊; 颜美琼; 张晓菊; 陆箴琦; 林岑

    2012-01-01

    Objective To evaluate the influence of PICC placement through different veins and arms on catheterization success rate and complications. Methods Research papers which were about PICC placement through different veins and arms and discussed catheterization success rate and complications were searched in the Cochrane Library, JBI Library, MEDLINE, EMbase, CBM, CNKI and Internet sites, and these researches were limited to randomized controlled trails, quasi-randomized controlled trials, case-control stu-dies, or cohort studies. Papers were screened according to the inclusion and exclusion criteria by two reviewers,and quality of enrolled papers was evaluated based on the Cochrane Handbook and Newcastle-Ottawa Scale. Meta-analysis was conducted by u-sing Rev Man 5. 1, or descriptive analysis was performed. Results Four quasi-randomized controlled trials and 14 cohort studies involving 6233 patients were included. The results of meta-analysis showed that PICCs inserted through the cephalic vein developed significantly higher incidence of phlebitis than through the basilic vein[OR = 0. 12, 95%CI(0. 04,0. 38) ,P = 0. 0002]. PICCs placed via the cephalic vein had more significant difficulty in advancing the catheters than via the basilic veins[OR = 0. 26,95%CI(0. 10, 0. 67) ,P = 0. 005]. No statistical differences were found in catheterization success rate and incidence of complications when PICCs inserted in both arms. Conclusion PICC placement through basilic vein shows advantages in improving catheterization success rate and reducing complications. Influence of PICC placement through different arms on catheterization success rate and complications should be further studied. PICCs placed on the affected arm of breast cancer surgery should be very cautious.%目的 系统评价经不同静脉和上肢置入PICC对穿刺置管成功率、并发症发生率的影响.方法 计算机检索Cochrane图书馆、JBI循证护理中心图书馆、MEDLINE、EMbase、CBM、CNKI辅

  4. Puncture and catheterization between by transurethral endoscopy of seminal vesicle and ultrasound guide on the treatment of obstinate hemospermia%尿道精囊镜与超声引导下精囊穿刺置管诊治顽固性血精的效果观察

    Institute of Scientific and Technical Information of China (English)

    苏学勇; 潘翔; 刘永昌

    2016-01-01

    Objective To investigate effect of puncture and catheterization between by transurethral endoscopy of seminal vesi-cle and ultrasound guide on the treatment of obstinate hemospermia.Methods Fifty cases of obstinate hemospermia patients,were randomly divided to control group and the observation group,treated by using puncture and catheterization between by transurethral en-doscopy of seminal vesicle and ultrasound guide,to observe the curative effect of two groups.Results In the observation group,the operation time and intraoperative blood loss were significantly longer (more)than those in the control group (P <0.01),sperm density in both groups after treatment significantly improved after treatment (P <0.01),and sperm density of the observation group improved significantly more than that of the control group (P <0.01);sperm survival rate in the two groups significantly increased after treat-ment (P <0.01),survival rate of the observation group is higher than that of the control group (P <0.01).Postoperative complication rate and recurrence rate of the observation group were lower than those of control group (P <0.05).Conclusions Puncture and cathe-terization by transurethral endoscopy of seminal vesicle is worthy to promote.%目的:探讨尿道精囊镜与超声引导下精囊穿刺置管诊治顽固性血精的临床效果。方法将50例顽固性血精患者随机分为两组,各25例。对照组采用超声引导下精囊穿刺置管治疗,观察组采用尿道精囊镜治疗,观察两组临床效果。结果观察组患者手术时间长于对照组(P <0.01),术中出血量多于对照组(P <0.01);治疗后,两组患者精子密度、精子存活率均较治疗前增加(P <0.01),且观察组治疗后精子密度、精子存活率增加幅度均大于对照组(P <0.01);观察组术后并发症发生率及术后3个月时复发率均低于对照组(P <0.05)。结论尿道精囊镜较超声引导下精囊穿刺置

  5. Efficacy of catheterization of left atrium for postoperative management in pediatric patients undergoing congenital heart disease complicated with moderate to severe pulmonary hypertension%术中置入左心房导管用于合并中重度肺动脉高压患儿先天性心脏病修复术后管理的效果

    Institute of Scientific and Technical Information of China (English)

    李中云; 陆健君

    2013-01-01

    Objective To evaluate the efficacy of catheterization of left atrium for postoperative management in pediatric patients undergoing congenital heart disease complicated with moderate to severe pulmonary hypertension.Methods Sixty ASA Ⅲ or Ⅳ pediatric patients of both sexes,aged 9 months-14 yr,scheduled for elective congenital heart disease complicated with moderate-to-severe pulmonary hypertension under cardiopulmonary bypass,were randomly divided into 2 groups (n =30 each):central venous catheterzation group (C group)and catheterization of left atrium group (L group).After induction of anesthesia,triple-lumen central venous catheters were inserted in both groups.In group L,the right internal jugular vein was cannulated with a single lumen venous catheter passed through the left atrium for monitoring postoperative left atrial pressure (LAP) and administration of vasoactive drug and LAP was maintained at 8-12 mm Hg after operation.Duration of mechanical ventilation and duration of stay in intensive care unit were recorded.The amount of dopamine,dobutamine,nitroprusside,milrinone,and alprostadil consumed within 48 h after operation was also recorded.Results Compared with C group,the amount of dopamine,dobutamine,nitroprusside,milrinone,and alprostadil consumed was significantly reduced and duration of mechanical ventilation and duration of stay in intensive care unit were significantly shortened in group L.Conclusion Catheterization of left atrium is used for monitoring postoperative LAP,which can provide a basis for reasonable clinical prescription and optimize the efficacy of postoperative management in pediatric patients undergoing congenital heart disease complicated with moderate to severe pulmonary hypertension.%目的 评价术中置入左心房导管用于合并中重度肺动脉高压患儿先天性心脏病修复术后管理的效果.方法 择期CPB下行心脏修复术的先天性心脏病合并中重度肺动脉高压患儿60例,性别不限,年龄9

  6. Anatomical features of the urethra and urinary bladder catheterization in female mice and rats. An essential translational tool Características anatômicas da cateterização da uretra e bexiga de camundongos e ratos fêmeas. Instrumento essencial na pesquisa pré clínica

    Directory of Open Access Journals (Sweden)

    Leonardo Oliveira Reis

    2011-01-01

    Full Text Available PURPOSE: To present fundamental anatomical aspects and technical skills necessary to urethra and urinary bladder catheterization in female mice and rats. METHODS: Urethral and bladder catheterization has been widely utilized for carcinogenesis and cancer research and still remains very useful in several applications: from toxicological purposes as well as inflammatory and infectious conditions to functional aspects as bladder dynamics and vesicoureteral reflux, among many others. RESULTS: Animal models are in the center of translational research and those involving rodents are the most important nowadays due to several advantages including human reproducibility, easy handling and low cost. CONCLUSIONS: Although technical and anatomical pearls for rodent urethral and bladder access are presented as tackles to the advancement of lower urinary tract preclinical investigation in a broaden sight, restriction to female animals hampers the male microenvironment, demanding future advances.OBJETIVO: Apresentar aspectos anatômicos fundamentais e habilidades técnicas necessárias para cateterismo da uretra e bexiga em ratos e camundongos fêmeas. MÉTODOS: Cateterismo vesical tem sido amplamente utilizado na pesquisa do câncer e carcinogênese, além de várias outras aplicações, desde fins toxicológicos, condições inflamatórias e infecciosas até aspectos funcionais como a dinâmica vesical e refluxo vesico-ureteral, entre muitos outros. RESULTADOS: Os modelos animais estão no centro da investigação de translação e os roedores são os mais importantes devido a várias vantagens, incluindo reprodutibilidade humana, o fácil manuseio e baixo custo. CONCLUSÕES: Apesar de permitir o desenvolvimento da investigação pré-clínica do trato urinário inferior, o modelo se restringe aos animais do sexo feminino, de modo que avanços futuros são necessários.

  7. Intermittent Urethral Catheterization Combined With Nursing Function Training in Rehabilitation Effect Analysis of Urinary Retention of Neurogenic Bladder%间歇性导尿配合功能训练的护理方式在尿潴留性神经源性膀胱的康复效果分析

    Institute of Scientific and Technical Information of China (English)

    张小琴; 李瑞芳

    2016-01-01

    Objective To analyze the intermittent catheterization combined with function training of nursing in the retention of urine neurogenic bladder rehabilitation nursing effect.Methods 258 cases of urinary retention neurogenic bladder in our hospital were randomly divided into experimental group and control group, the control group and the traditional nursing mode. Comparison of two groups of patients 2 months after the improvement of the bladder and complications.Results Compared with the modiifed PAP index score of the experimental group was higher than the control group,P<0.05, compared with the complications of the two groups, the incidence of experimental group was lower than that of the control group,P<0.05.Conclusion The use of intermittent urethral catheterization combined with nursing function training in the rehabilitation process of urinary retention of neurogenic bladder can reduce bladder residual urine volume, the overall effect is good.%目的:分析间歇性导尿配合功能训练的护理方式在尿潴留性神经源性膀胱的康复护理效果。方法随机将我院收治的258例尿潴留性神经源性膀胱患者平均分为实验组与对照组,对照组实施传统的护理方式。对比两组患者2个月后膀胱改善情况及并发症情况。结果对比改良巴氏指数评分可见实验组高于对照组,P<0.05;对比两组患者的并发症情况,可见实验组的发生率低于对照组,P<0.05。结论使用间歇性导尿配合功能训练的护理方式在尿潴留性神经源性膀胱的康复过程可减少膀胱残留尿量,总体效果较好。

  8. 心导管及多普勒超声评价正常新生儿肺动脉压力的研究进展%Development of application of catheterization and Doppler ultrasound in assessing pulmonary artery pressure in newborns

    Institute of Scientific and Technical Information of China (English)

    任思婳

    2014-01-01

    It is well established that pulmonary vascular resistance plays a pivotal role in the postnatal decrease of pulmonary arterial pressure in neonates.Catheterization has been demonstrated that mean pulmonary arterial pressure(PAP) equals or exceeds systemic for as long as 1 hour after birth.Thereafter,a gradual decrease in pressure occurs with the major fall taking place during the first 24 hours.By 3 days of age,the mean pulmonary arterial pressure is less than 50 per cent of that in the systemic circulation.Tricuspid regurgitation(TR) and ductal flow velocity(PDA) have the largest number of confidence steps in the expected range of values.The most repeatable technique is TR,but PDA might also be useful for a serial studies owing to the potential for large change.This paper reviews the PAP of normal full-term infants after birth by catheterization and Doppler ultrasound,in order to provide some clinic basis for pulmonary hypertension identification.%新生儿肺动脉压力高于正常成年人,公认的主要原因是由于新生儿肺血管阻力变化形成的.对这一时期肺动脉压力的定量评价中,心导管研究显示:生后lh平均肺动脉压力等于或者超过体循环压力,之后逐渐下降,下降最明显的阶段发生在生后的24 h内,出生后3d,平均肺动脉压力小于体循环压力的一半.多普勒超声心动图对这一下降过程的研究得到了相似的结果,而且通过三尖瓣反流和动脉导管得到的肺动脉压力的结果的可重复性最佳.该文主要阐述心导管和多普勒超声心动图定量评价正常足月新生儿出生后肺动脉压力的变化情况,以期为临床鉴别新生儿是否存在肺动脉高压提供依据.

  9. The perioperative application of using norepinephrine through the catheterization of left atrium in patients of congenital heart disease with sever pulmonary arteries hypertension%左心房导管输注去甲肾上腺素在先天性心脏病合并重度肺动脉高压患者围术期的应用

    Institute of Scientific and Technical Information of China (English)

    张义轩; 李亚楠; 张挚; 马传根

    2014-01-01

    Objective To evaluate the curative effects of using norepinephrine through the catheterization of left atrium in patients of congenital heart disease with sever pulmonary arteries hypertension (SPAH) during perioperative period.Methods Forty pediatric patients of both sexes scheduled for elective congenital heart disease complicated with moderate-to-severe pulmonary hypertension under cardiopulmonary bypass,were randomly diveded into 2 groups(n =20 each):control group (C group) and transfusing the norepinephrine through the catheterization of left atrium group (L group).After the cardiac resuscitation,C and L groups were continuous given infusion of dopamine,dobutamine,epinephrine,nitroglycerin and at the same time the L group were transfused the norepinephrine through the catheterization of left atrium.The hemodynamic parameters,blood lactate values of each group at parallel loop (T1),15 min after CPB shutdown (T2),end of the surgery (T3),24 h after the surgery (T4) were recorded.The main and pulmonary artery pressure inversion rate of the patients,the incidence of right heart failure,duration of mechanical ventilation and duration of stay in intensive care unit,the the incidence of postoperative pulmonary complications,mortality were also recorded.Results In group C and L,the main and pulmonary artery pressure inversion rate of the patients were 55% and 5%,the incidence of right heart failure were 80% and 5%,the duration of mechanical ventilation were (123.00 ± 13.50) h and (76.00 ±7.25) h,the duration of stay in intensive care unit were (8.00 ± 1.60) d and (5.00 ± 0.70) d,the incidence of postoperative pulmonary complications were 70% and 10%,and the mortality were 10% and 0%.Compared with C group,the results of group L were much belower (P < 0.05).Conclusion The therapeutic idea that using norepinephrine through the catheterization of left atrium to maintain adequate cardiac output and peripheral vascular resistance is superior for

  10. Sedação com sufentanil e clonidina em pacientes submetidos a cateterismo cardíaco Sedación con sufentanil y clonidina en pacientes sometidos a cateterismo cardíaco Sedation with sufentanil and clonidine in patients undergoing heart catheterization

    Directory of Open Access Journals (Sweden)

    Anita Perpetua Carvalho Rocha

    2011-03-01

    , entre tanto, cada uno de estos medicamentos posee ventajas y desventajas. OBJETIVO: Evaluar la eficacia del sufentanil y de la clonidina como sedativos en pacientes sometidos a cateterismo cardíaco, observando el impacto de los mismos sobre los parámetros hemodinámicos y respiratorios, la presencia de efectos colaterales, además de la satisfacción del paciente y del hemodinamista con el examen. MÉTODOS: Se trata de un ensayo clínico prospectivo, doble ciego, randomizado y controlado, que incluyó 60 pacientes que recibieron 0,1 µg/kg de sufentanil o 0,5 µg/kg de clonidina antes de la realización del cateterismo cardíaco. El escore de sedación según la escala de Ramsay, la necesidad de utilización de midazolam, los efectos colaterales, los parámetros hemodinámicos y respiratorios fueron registrados, siendo los datos analizados en 6 diferentes momentos. RESULTADOS: El comportamiento de la presión arterial, de la frecuencia cardíaca y de la frecuencia respiratoria fue semejante en los dos grupos, entre tanto, en el momento 2, los pacientes del grupo sufentanil (Grupo S presentaron menor escore de sedación según la escala de Ramsay, y la saturación periférica de la oxihemoglobina fue menor que el grupo clonidina (Grupo C en el momento 6. Los pacientes del Grupo S presentaron mayor incidencia de náusea y vomito post operatorio que los pacientes del Grupo C. La satisfacción de los pacientes fue mayor en el grupo clonidina. Los hemodinamistas se mostraron satisfechos en los dos grupos. CONCLUSIÓN: El sufentanil y la clonidina fueron efectivos como sedativos en pacientes sometidos a cateterismo cardíaco.BACKGROUND: Sedation for heart catheterization has been a cause for concern. Benzodiazepines, alpha-2 adrenergic agonists and opioids are used for this purpose. However, each drug has advantages and disadvantages. OBJECTIVE: To evaluate the efficacy of sufentanil and clonidine as sedative in patients undergoing heart catheterization, observing their

  11. Relationship between pre-operative non-fasting and its complications in cardiac Catheterization%经皮冠状动脉介入手术前患者禁食时间与并发症发生的关系

    Institute of Scientific and Technical Information of China (English)

    马君秀

    2010-01-01

    Objective To obsereve the impact of the time of pre-operative non-fasting on its complicaions in cardiac catheterization. Methods Dividing 656 cases into group A and group B at random.In group A, the operative patients in the morning eat normal food the night before last, semifluid food at the second day breakfast. The operative patients in the afternoon eat normal food at amount.In group B, the operative patients in the morning eat normal food the night before last, non-fasting at the second day breakfast, the operative patients in the afternoon eat normal food at breakfast,non-fasting at lunch. Results The average time of non-fasting was (2.0±1.2) hours in group A, (14.0±1.5) hours in group B;the time of non-fasting in group B was longer than that in group A,and the complications increased obviously in group B. Conclusions Shortening the time of pre-operative non-fasting can reduce its complications in cardiac catheterization.%目的 观察冠状动脉介入手术前禁食时间的长短对并发症的影响.方法 采用随机分组的方法,将656例择期介入手术的患者分为A、B两组,A组上午手术者术前晚正常进食,次日早餐进半流质饮食,下午手术者早餐正常进食水,午餐进半流质饮食,进食量为平日食量的80%左右,术后再让患者进食水.B组上午手术者术前晚正常进食,次日早餐禁食水,下午手术者术前早餐正常进食,中午禁食水,术后均正常进食水.结果 A组术前平均禁食时间为(2.0±1.2)h,B组术前平均禁食时间(14.0±1.5)h,B组禁食时间明显长于A组,且B组并发症的发生明显高于A组.结论 行冠状动脉介入手术的患者,术前尽可能缩短禁食水时间,能有效减少并发症的发生.

  12. Significance of 6 Sigma management methods to reduce post-catheterization risk of infection in patients with cerebral infarction%6 Sigma 管理方法对降低脑梗死后留置导尿患者感染风险的意义

    Institute of Scientific and Technical Information of China (English)

    党艳艳; 王阿静

    2014-01-01

    目的:探讨6 Sigma管理方法对降低脑梗死后留置导尿患者感染风险的意义。方法选择到我院就诊的98例脑梗死合并尿潴留患者,分为对照组及观察组,分别有47、51例。对照组患者采用常规护理方式进行护理,观察组在此基础上采用6 Sigma管理方法进行护理。对护理后APACHE Ⅱ评分、感染情况、感染时间、导尿管留置时间进行评估。结果置管后5、7 d观察组置管后APACHE Ⅱ评分较对照组均显著性下降(P<0.05)。观察组中段尿、尿道口、接口处感染情况较对照组均有显著性下降(χ2=4.653、3.765、5.129,P<0.05)。观察组感染时间较对照组显著性缩短(P<0.05),导尿管留置时间较对照组有显著性差异(P<0.05)。结论6 Sigma管理方法可降低脑梗死后留置导尿患者感染的发生率并缩短拔管时间。%Objective To evaluate significance of 6 Sigma management methods to reduce post-catheterization risk of infection in patients with cerebral infarction .Methods 98 cases of urinary retention patients with cerebral infarction were divided into observation group and control group ,there were 47 and 51 cases respectively .The con-trol group were treated with routine care ,observation group accepted 6 Sigma management methods .APACHE Ⅱscore after care ,infection ,infection time ,catheterization time were evaluated .Results After 5 d ,7 d APACHEⅡ score of observation group than the control group significantly decreased (P<0 .05) .Urine ,urethra ,interface infection of observation group than the control group significantly decreased (χ2 =4 .653 ,3 .765 ,5 .129 , P<0 .05) . Observation group significantly shorten the time of infection compared with the control group (P<0 .05) ,compared with the control catheter indwelling time showed significant difference ( P<0 .05 ) groups .Conclusion 6 Sigma management approach can reduce incidence of infection and shorten

  13. Integrative review: evidences on the practice of intermittent/indwelling urinary catheterization Revisión integrativa: evidencias en la práctica del cateterismo urinario intermitente/demora Revisão integrativa: evidências na prática do cateterismo urinário intermitente/demora

    Directory of Open Access Journals (Sweden)

    Flávia Falci Ercole

    2013-02-01

    Full Text Available OBJECTIVE: to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. METHOD: the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. RESULTS: the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection . CONCLUSIONS: there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This review's results represent an updating of the nurse's conducts and decision-making for the prevention of urinary tract infections in urinary catheterization.OBJETIVO: buscar las mejores evidencias disponibles en la literatura sobre el conocimiento producido y relacionado a la técnica de cateterismo urinario intermitente y de demora para apoyar científicamente el cuidado de enfermería prestado al paciente sometido al

  14. 苯扎氯铵溶液膀胱冲洗预防留置导尿患者尿路感染的实效性评价%Effectiveness of bladder irrigation with benzalkonium chloride solution in prevention of urinary tract infections in indwelling catheterization patients

    Institute of Scientific and Technical Information of China (English)

    黄达飞; 周青英; 孙学斌; 郑定钦; 徐乃奋

    2015-01-01

    目的:评价苯扎氯铵溶液膀胱冲洗预防长期留置导尿患者尿路感染的实效性,探讨苯扎氯铵对尿路感染的预防效果。方法选择2013年5月-2014年5月在医院治疗需要长期留置导尿患者76例,按照膀胱冲洗方式的不同将其随机分为A、B组,每组各38例;A组患者采用0.0025%苯扎氯铵溶液进行膀胱冲洗,B组患者采用0.9%生理盐水溶液进行膀胱冲洗,观察并比较两组患者尿路感染情况。结果膀胱冲洗第1周和第2周后A组患者尿液细菌培养阳性率分别为15.79%和21.05%,明显低于B组的52.63%和71.05%,两组比较差异有统计学意义(P<0.05);A组患者尿液中白细胞计数分别为(6.7±3.0)个/HP和(8.7±4.0)个/HP ,均低于相应B组的(11.5±4.4)个/HP和(16.7±6.7)个/HP ,两组比较差异有统计学意义(P<0.05);A组中段尿中总细菌数少于B组,其各类菌株构成比差异有统计学意义(P<0.05)。结论苯扎氯铵溶液膀胱冲洗在预防长期留置导尿患者下尿路感染方面具有很好的效果,冲洗后细菌阳性率低,值得临床推广应用。%OBJECTIVE To evaluate the effectiveness of bladder irrigation with benzalkonium chloride solution in prevention of lower urinary tract infections in patients undergoing long‐term indwelling catheterization and observe the effect of benzalkonium chloride on prevention of the urinary tract infections .METHODS A total of 76 patients who needed to be treated with long‐term indwelling catheterization from May 2013 to May 2014 were enrolled in the study and randomly divided into the group A and group B according to the approach of bladder irrigation ,with 38 cases in each group .The group A was treated with bladder irrigation with 0 .0025% benzalkonium chloride so‐lution ,while the group B was given the bladder irrigation with 0 .9% normal saline solution .The

  15. Therapeutic effects of intermittent catheterization coupled with resiniferatoxin intravesical instillations in children with neurogenic detrusor overactivity%CIC联合膀胱内灌注RTX治疗儿童神经源性膀胱并逼尿肌过度活动疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡金华; 罗真东; 李忠民; 刘国昌; 张丽瑜; 龙旺军; 李京军

    2014-01-01

    Objective To explore the effects of clean intermittent catheterization (CIC) coupled with resiniferatoxin (RTX) intravesical instillations in children with neurogenic detrusor overactivity (DO).Methods A total of 38 patients with neurogenic detrusor overactivity were enrolled and randomly divided into experimental (n =20) and control (n =18) groups.The experimental group underwent CIC and 4 weekly intravesical instillations of 10 nmol/L resiniferatoxin while the control group CIC and 4 weekly intravesical instillations of 30% ethanol.The urodynamic parameters were assessed after 1 year follow-up.Results The resiniferatoxin treatment group had a significantly lower percent of DO compared to the control group (3 months:40% vs 94.4%; 12 months:10% vs 88.9%,P<0.01).Bladder capacity for the first DO [(107.8 ± 46.3)vs (68.2 ± 31.5)ml] and safety bladder capacity (SBC) [(206.8 ± 50.6) vs (166.3 ± 54.2) ml] significantly increased 12 months after treatment in the resiniferatoxin group than in the control group while the bladder compliance (BC)[(20.8 ± 11.5)vs (24 ± 15.4)ml/cmH2O]-and maximum flow rate (MFR) [(9.5 ± 5.1)ml/s vs (8.2 ± 3.2)ml/s] had no statistical significance between two groups (P>0.05).Conclusions Intermittent catheterization plus resiniferatoxin intravesical instillations can reduce DO in children with neurogenic bladder.%目的 探讨清洁间歇导尿(clean intermittent self-catheterization,CIC)联合膀胱灌注辣椒辣素类似物(resiniferatoxin,RTX)治疗儿童神经源性膀胱(neurogenic bladder,NB)并逼尿肌过度活动(detrusoroveractivity,DO)的疗效.方法 将NB并DO患儿38例,按随机数字表法分为CIC联合RTX灌注组(实验组,20例)和CIC联合30%乙醇灌注组(对照组,18例).采用前瞻性双盲平行对照试验,所有患儿在CIC期间每4周行1次灌注治疗,每3个月行尿动力学检查随访,治疗1年后对比两组患儿尿动力学参数异同.结果 治疗后3个月及12个月实验组

  16. Clinical features and outcome of eight patients with mediastinal and neck hematoma after transradial cardiac catheterization approach%经桡动脉途径冠状动脉介入诊疗并发纵隔和颈部血肿八例分析

    Institute of Scientific and Technical Information of China (English)

    杨伟宪; 乔树宾; 刘蓉; 胡奉环; 秦学文; 窦克非; 高力健; 刘海波; 吴元

    2014-01-01

    目的 对经桡动脉途径行冠状动脉介入诊疗中发生纵隔和颈部血肿并发症病例进行分析,提高临床医师对该并发症的认识.方法 2005年1月1日至2012年12月31日,在阜外心血管医院冠心病诊疗中心和介入中心经桡动脉途径冠状动脉造影和介入治疗中有病历记录的发生纵隔、颈部血肿的患者共8例,1例患者单纯行冠状动脉造影,另外7例患者行冠状动脉介入治疗,其中6例患者置入药物洗脱支架.对这些患者的临床资料进行回顾性分析.结果 所有患者术中均使用有亲水涂层的泥鳅超滑导丝.术后临床表现包括胸痛、胸闷、颈部或咽部紧缩感.胸颈部CT证实,8例患者均有纵隔血肿,其中4例患者合并颈部血肿,2例患者发现可疑右锁骨下动脉或无名动脉分支血管破口.患者术后血红蛋白均明显下降.2例患者术后完全停用抗血小板药物至出院,4例患者双联抗血小板治疗药物减量或暂停,2例患者使用鱼精蛋白中和术中肝素,无患者进行输血.所有置入支架的患者均未发生急性或亚急性支架内血栓形成,无患者进行外科手术.8例患者住院期间以及远期随访预后均良好.结论 经桡动脉途径行冠状动脉介入诊疗中并发纵隔和颈部血肿罕见,与操作过程中超滑导丝或导管误入分支小血管造成损伤有关;尽早进行胸颈部增强CT扫描有助于及早诊断和处理纵隔和颈部血肿.%Objective The clinical features of patients with mediastinal and/or neck hematoma after transradial cardiac catheterization were reviewed and analyzed to help the clinicians to recognize this complication,and try their best to avoid the complication and treat the complication properly.Methods A total of 8 patients with mediastinal and/or neck hematoma after right transradial cardiac catheterization in Fuwai hospital from January 1,2005 to the end of 2012 were included in this study.Among these 8 patients,1

  17. Aspectos técnicos da cateterização do seio coronariano baseada no componente atrial do eletrograma intracavitário e anatomia radiológica durante o procedimento de implante de marcapasso biventricular Technical aspects of coronary sinus catheterization based on the atrial component of the intracavitary electrogram and radiological anatomy during the implantation procedure of a biventricular pacemaker

    Directory of Open Access Journals (Sweden)

    Fernando Sérgio Oliva de Souza

    2006-04-01

    Full Text Available OBJETIVO: Apresentar uma proposição técnica baseada na experiência de 130 implantes utilizando técnica simplificada para cateterização do seio coronariano, baseada no componente atrial do eletrograma intracavi-tário e anatomia radiológica. MÉTODOS: De outubro de 2001 a outubro de 2004 foram realiza-dos 130 implantes de marcapasso biventricular, utilizando-se anatomia radiológica e observação de eletrograma intracavitário, com prioridade ao componente atrial. RESULTADOS: O implante do sistema, utilizando-se a estimulação do ventrículo esquerdo via seio coronariano, não foi possível em 8 pacientes. Em 12 pacientes foram observadas dificuldades na canulação do óstio coronário e em 15 pacientes observaram-se dificuldades de progressão do eletrodo através do seio coronariano. O tempo médio de utilização de radioscopia foi de 18,69 min. CONCLUSÃO: A técnica de implante, utilizando a morfologia do componente atrial do eletrograma intracavitário e anatomia radiológica, demonstrou ser pouco trabalhosa, segura e eficaz para canulação do óstio do seio coronariano, necessitando de reduzido tempo de radioscopia.OBJECTIVE: To present a technical proposal based on the experience of 130 implantations using a simplified technique for coronary sinus catheterization, based on the atrial component of the intracavitary electrogram and radiological anatomy. METHODS: From October, 2001 to October, 2004, 130 biventricular pacemaker implantations were performed, using radiological anatomy and observation of the intracavitary electrogram, focusing on the atrial component. RESULTS: The implantation of the system using left ventricular pacing via coronary sinus was not possible in 8 patients. Difficulties on the cannulation of the coronary ostium were felt in 12 patients and difficulties of lead advancement through the coronary sinus were felt in 15 patients. The mean time of radioscopy utilization was 18.69 min. CONCLUSION: The

  18. Massive cerebral arterial air embolism following arterial catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Yang, C.W. [Northwestem University Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Yang, B.P. [Northwestern University Feinberg School of Medicine, Department of Neurological Surgery, Chicago, IL (United States)

    2005-12-01

    Microscopic cerebral arterial air embolism (CAAE) has been described in many patients undergoing cardiac surgery as well as other invasive diagnostic and therapeutic procedures. However, massive CAAE is rare. We report a 42-year-old woman who initially presented with thalamic and basal ganglia hemorrhages. Shortly after a radial arterial catheter was inserted, the patient suffered a generalized seizure and CT demonstrated intra-arterial air in bilateral cerebral hemispheres. (orig.)

  19. Venous anomalies as potentially lethal risk factors during ordinary catheterization

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    Savino Occhionorelli

    2015-06-01

    Full Text Available Venous malformations are rare but possible findings too, constituting a further risk factor for central venous catheter procedures. Herein we describe a case of death because of an innominate vein perforation by a catheter that incidentally was tucked into a sacciform malformation. Even if the technology advancement is constantly offering us new investigation tools, up to now diagnostic options are limited in the detection of those malformations that could potentially lead to dramatic complications as the described one. The present work raises the awareness about rare venous anomalies and their potential clinical implications. A proper literature review and diagnostic implementation proposal are reported.

  20. [Adverse events during diagnostic and therapeutic pediatric cardiac catheterization].

    Science.gov (United States)

    Zepeda-Arámbula, Armando; Gutiérrez-Cobian, Lorenzo; Villatoro-Fernández, Jorge Luis; Pacheco-López, Sandra Livier; Tlacuilo-Parra, Alberto

    2016-01-01

    Introducción: el objetivo de este trabajo fue determinar la frecuencia de eventos adversos durante la realización de cateterismo cardíaco tanto diagnóstico, como terapéutico pediátrico. Métodos: se revisaron los expedientes de pacientes sometidos a cateterismo cardiaco durante el periodo del 1 de Mayo al 31 de Octubre de 2014, para determinar la frecuencia de eventos adversos presentados en las primeras 24 horas posteriores al procedimiento. Resultados: durante el periodo de seis meses se realizaron 143 procedimientos, de los cuales cumplieron criterios de inclusión 126, según el tipo de procedimiento se dividieron en: diagnósticos 68 (54%) y terapéuticos 58 (46%). Se presentó algún evento adverso en 16 pacientes (13% de los procedimientos), 11.7% durante cateterismo diagnóstico y 14% durante el procedimiento terapéutico. Se clasificaron como: serios 7 (5.5%), que ponen en peligro la vida 5 (3.9%) y como catastróficos 1 (0.79%). Los factores que se asociaron con el desarrollo de algún evento adverso fueron: edad menor de un año (OR = 5.45), ingreso a sala de hemodinamia no programado (OR = 1.2), y manejo con inotrópico (OR = 7). Conclusiones: el cateterismo cardiaco realizado en nuestra unidad es un procedimiento seguro, con un porcentaje de eventos adversos similar a lo reportado a nivel mundial. Es primordial efectuar una valoración adecuada e integral del paciente antes del ingreso a sala, considerando la estratificación según las categorías de riesgo, así como el estado de gravedad del niño.

  1. Therapeutic Cardiac Catheterizations for Children with Congenital Heart Disease

    Science.gov (United States)

    ... tight narrowing (red arrow). This condition is called coarctation of the aorta. Figure 3b: Picture in the ... aorta (AO) shows a tight narrowing (arrow) called coarctation of the aorta. Figure 6b: After stent placement ...

  2. Umbilical and portal vein calcification following umbilical vein catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, K.; Fendel, H.; Hartl, M.

    1989-07-01

    Calcifications of the umbilical vein and intrahepatic branches of the portal vein developed in a newborn who had inserted an umbilical vein catheter for 11 days postnatally. The calcified intrahepatic portal veins can still be demonstrated sonographically at the age of three years, whereby these calcifications were no longer detectable radiologically. (orig.).

  3. Epidural catheterization in cardiac surgery: The 2012 risk assessment

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    Thomas M Hemmerling

    2013-01-01

    Full Text Available Aims and Objectives: The risk assessment of epidural hematoma due to catheter placement in patients undergoing cardiac surgery is essential since its benefits have to be weighed against risks, such as the risk of paraplegia. We determined the risk of the catheter-related epidural hematoma in cardiac surgery based on the cases reported in the literature up to September 2012. Materials and Methods: We included all reported cases of epidural catheter placement for cardiac surgery in web and in literature from 1966 to September 2012. Risks of other medical and non-medical activities were retrieved from recent reviews or national statistical reports. Results: Based on our analysis the risk of catheter-related epidural hematoma is 1 in 5493 with a 95% confidence interval (CI of 1/970-1/31114. The risk of catheter-related epidural hematoma in cardiac surgery is similar to the risk in the general surgery population at 1 in 6,628 (95% CI 1/1,170-1/37,552. Conclusions: The present risk calculation does not justify not offering epidural analgesia as part of a multimodal analgesia protocol in cardiac surgery.

  4. Vestibular system paresis due to emergency endovascular catheterization.

    Science.gov (United States)

    Simoceli, Lucinda; Sguillar, Danilo Anunciatto; Santos, Henrique Mendes Paiva; Caputti, Camilla

    2012-04-01

    Objetivo: O objetivo deste relato de caso é descrever uma causa incomum de vestibulopatia periférica associada à perda auditiva unilateral em paciente idoso pós- cateterismo de urgência.Relato de caso: Paciente do gênero masculino, 82 anos, submetido à correção de aneurisma roto de aorta abdominal, no intra-operatório sofreu infarto agudo do miocárdio necessitando de angioplastia primária. Após alta hospitalar refere queixa de hipoacusia acentuada à direita e vertigem incapacitante, sem sinais neurológicos focais. Ao exame clínico otorrinolaringológico apresentava: Teste de Weber lateralizado para a esquerda, nistagmo espontâneo para a esquerda , marcha oscilante, leve disbasia e ataxia, índex-nariz e diadococinesia normais, Teste de Romberg com oscilação sem queda e Fukuda com desvio lateral para a direita. O exame audiométrico evidenciava anacusia à direita e perda neurossensorial à esquerda em agudos, arreflexia vestibular à direita na prova calórica e, na tomografia computadorizada dos ossos temporais e tronco-encefálico, presença de haste metálica atravessando o osso temporal direito, a partir da veia jugular interna e bulbo jugular, atravessando os canais semicirculares posterior, superior e vestíbulo, projetando-se em lobo temporal. O diagnóstico radiológico foi lesão traumática por guia endovascular metálico durante cateterismo de urgência e a conduta, considerando que o paciente não havia compensado o equilíbrio, foi reabilitação vestibular.Conclusão: Queixas de tontura no paciente idoso devem ser criteriosamente avaliadas diante do seu histórico clínico patológico pois os antecedentes de doenças e tratamentos prévios, em geral, direcionam as hipóteses diagnósticas porém podem trazer alterações inesperadas.

  5. Bilateral pleural effusion after central venous catheterization- A rare complication.

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    Reyaz Ahmed Para

    2015-12-01

    Full Text Available Central venous Catherization (CVC is rarely complicated by pleural effusion. It is usually due to malpositioned catheter. Our patient was a 35-year-old man admitted with Menningoencephalitis.A cervical central vein catheter was placed into his right jugular vein after induction of anaesthesia in Emergency Room. In chest x ray we encountered bilateral pleural effusion and drained it with a chest tube. During following days the patient has daily drainage of almost 1.7 liter of clear yellowish fluid from chest tube. Fluid analysis was not diagnostic. We removed the central vein catheter and plural drainage was stopped. [Natl J Med Res 2015; 5(4.000: 329-331

  6. [Femoral venous catheterization. Does it really need to be avoided?].

    Science.gov (United States)

    Lorente, L; León, C

    2009-12-01

    The guidelines to prevent central venous catheter related bloodstream infections (CVCBSI) of the Centers for Disease Control and Prevention (CDC) of 2002, Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias/ Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEMICYUC/SEIMC) of 2004, and the recently published guidelines of the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA(IDSA) of 2008 have recommended using the subclavian vein and avoiding the use of the femoral vein. They also recommend considering the use of antiseptic- or antimicrobial-impregnated CVCs for hospital units or groups of patients with a high incidence of CVCBSI. When implementing these guidelines, two questions could be asked: 1) Could the abuse of the subclavian vein and avoiding the use of the femoral vein imply a decrease in the incidence of CVCBSI, but an increase in the rate of mechanical complications as pneumothorax and/or hemothorax? 2) Couldn't antimicrobial-impregnated CVCs be used to prevent CVCBSI when the femoral venous access is used?

  7. Nurses' attitudinal and normative beliefs concerning hemodynamic assessement by pulmonary artery catheterization Creencias normativas y de actitud de los enfermeros sobre el estudio hemodinámico por medio del catéter de arteria pulmonar Crenças atitudinais e normativas dos enfermeiros sobre o estudo hemodinâmico por meio do cateter de artéria pulmonar

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    Cristiano José Mendes Pinto

    2006-12-01

    Full Text Available The objective of this study was to identify, by using the Theory of Reasoned Action/Theory of Planned Behavior, the attitude and normative beliefs that influence the behavioral intention of the nurse to perform a hemodynamic assessment using the pulmonary artery catheterization. Data were collected through semi-structured interviews involving 23 nurses from three hospitals in the city of Campinas, São Paulo. The data were analyzed according to a qualitative methodology. Among the Attitude Beliefs, affective beliefs and those related to the advantages and disadvantages of performing the behavior stand out. Among the Normative Beliefs social referents were identified for the behavior, as well as the behavior-stimulating factors and the factors that discourage the performance of the behavior.El objetivo de este estudio fue identificar, por medio de la Teoría del Comportamiento Planificado, las creencias normativas y de actitud que contribuyen para la formación de la intención de comportamiento del enfermero en realizar el estudio hemodinámico (EH por medio del catéter de la arteria pulmonar. Los datos fueron obtenidos atraves de entrevista semi estructurada de 23 enfermeros de unidades de terapia intensiva de tres hospitales del municipio de Campinas-São Paulo. Los datos fueron analizados según la metodología cualitativa. Entre las Creencias de Actitud se destacaron las creencias afectivas y aquellas relativas a las ventajas y desventajas de la realización del comportamiento. En las Creencias Normativas se evidenciaron los referentes sociales para la ejecución del comportamiento, así como factores estimulantes y que no estimulan la realización del EH.O objetivo deste estudo foi identificar, por meio da Teoria da Ação Racional/Teoria do Comportamento Planejado, as crenças de atitude e normativas que contribuem para a formação da intenção comportamental do enfermeiro em realizar o estudo hemodinâmico (EH por meio do cateter de

  8. Cuidados de enfermagem na prevenção da insuficiência renal provocada por contraste após cateterismo Cuidados de enfermagem na prevenção da insuficiência renal provocada por contraste após cateterismo Nursing care in the prevention of renal failure caused by post-catheterism contrast

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    Flavia Giron Camerini

    2008-01-01

    Full Text Available O estudo teve como objetivo identificar produções científicas de enfermagem sobre insuficiência renal aguda provocada por contraste iodado após cateterismo cardíaco, no período de 2002 a 2007, analisando sua aplicabilidade à prática. Foi realizada ainda uma análise crítica das produções científicas selecionadas, delineando os cuidados de enfermagem. Este estudo é uma pesquisa bibliográfica de artigos de enfermagem, encontrados através de busca computadorizada. Dos 47 artigos encontrados, 10 foram selecionados por terem atendido os critérios de inclusão. Após a análise dos artigos, verificamos a importância da atuação do enfermeiro na prevenção da insuficiência renal aguda provocada por contraste. Além disso, evidenciamos a melhor prática de enfermagem para a prevenção da insuficiência renal aguda provocada por contraste.El presente estudio tuvo como objetivo identificar producciones científicas de enfermería sobre la insuficiencia renal aguda provocada por contraste yodado después del cateterismo cardíaco, en el período de 2002 a 2007, analizando su aplicabilidad a la práctica. Se realizó además el análisis crítico de las producciones científicas seleccionadas, delineando los cuidados de enfermería. Este estudio es una investigación bibliográfica de artículos de enfermería, encontrados por medio de búsqueda computarizada. De los 47 artículos encontrados, 10 fueron seleccionados por haber atendido a los criterios de inclusión. Después del análisis de los artículos, verificamos la importancia de la actuación del enfermero en la prevención de la insuficiencia renal aguda provocada por contraste. Además de lo referido, evidenciamos una mejor práctica de enfermería para la prevención de la insuficiencia renal aguda provocada por contraste.The purpose of this study was to identify the nursing scientific production on acute renal failure caused by post-catheterism iodized cardiac contrast

  9. Safety of a training program for ultrasound-guided internal jugular vein catheterization in critically ill patients Segurança de um programa de treinamento para punção de veia jugular interna guiada por ultrassom em pacientes críticos

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    Felippe Leopoldo Dexheimer Neto

    2011-08-01

    Full Text Available OBJECTIVES: Evaluate the safety and effectiveness of a training program for performing ultrasound-guided internal jugular vein cannulation in critically ill patients. METHODS: Cohort prospective study, evaluating adult patients admitted in a teaching intensive care unit (ICU. Catheter placement was performed by an ICU medical resident. The patient's baseline characteristics, vessel's position and operator experience were the evaluated variables. The main outcomes were cannulation success rate and incidence of major complications. RESULTS: A total of 118 consecutive patients were enrolled between May 2008 and November 2009. The success rate of ultrasound guided catheter placement was 90% (106/118, 77% in the first attempt. Major complications occurred in 4% of the cases (n = 5 and were not associated with the analyzed variables. Inability to place the guide wire was the reason for 58% (7/12 of the failures. Operators with more than 15 previous ultrasound guided cannulations had an increased success rate (95% vs. 79%, p = 0.01 and increased failure was related to previous catheterization (26% vs. 7%, p = 0.02. CONCLUSION: Learning ultrasound guidance for IJV vein cannulation was safe and feasible in ICU patients. This process was not associated to complications and better results were achieved across the spectrum of operator experienceOBJETIVO: Avaliar a segurança e efetividade de um programa de treinamento para cateterização da veia jugular interna guiada por ultrassom em pacientes críticos. MÉTODOS: Estudo de coorte prospectivo, avaliando pacientes adultos internados em uma unidade de terapia intensiva com programa de ensino. Os médicos residentes do serviço realizaram as punções de veia jugular interna guiadas por ultrassom. Foram avaliadas as características de base dos pacientes, sintopia dos vasos e experiência dos operadores. Os desfechos primários foram a taxa de sucesso da cateterização e a incidência de complica

  10. Estudo comparativo sobre dois tipos de cateteres para cateterismo intermitente limpo em crianças estomizadas Estudio comparativo sobre dos tipos de catéteres para cateterismo intermitente limpio en niños entomizados A comparison between two catheters for clean intermittent catheterization in continent children with a urostomy

    Directory of Open Access Journals (Sweden)

    Maristela Santini Martins

    2009-12-01

    ños completaron el estudio. Los resultados mostraron diferencias estadísticamente significativas apenas en lo que se refiere a costos directos (p=0,003, superiores para el catéter lubrificado.The objective of this crossover study was to compare the use of two catheters for clean intermittent catheterization in continent children with a urostomy, in terms of their handling, complications and direct costs. This study complied with all ethical requirements and was developed at a Children's Hospital in the city of São Paulo. The children who, together with their guardians, agreed to participate in the study were submitted to the consecutive use of both the traditional and the pre-lubricated catheter, for one month each. During that period, the children completed the data collection instruments and were followed by the researchers once a week through home visits and hospital consultations, including quantitative and qualitative urine cultures that were performed every other week. Data analysis was performed using Wilcoxon and Kaplan-Meier tests. Eleven children completed the study. Statistical significant differences were found only for costs (p=0.003, which were higher for pre-lubricated catheters.

  11. Diagnósticos de Enfermagem em pacientes pós-cateterismo cardíaco: contribuição de Orem Diagnósticos de Enfermería en pacientes post-cateterismo cardiaco: contribuición de Orem Nursing Diagnoses in patients after heart catheterization: contribution of Orem

    Directory of Open Access Journals (Sweden)

    Luciano Ramos de Lima

    2006-06-01

    paciente en el propio cuidado, en las cuestiones de autoconocimiento y autocontrol de la salud.Sectional study of multiple cases involving 30 patients after heart catheterization aiming to establish the nursing diagnoses according to the North American Nursing Diagnoses Association (NANDA. The method of data collection was the Nursing Process based on the Self-care Deficit Theory. Twenty- five different nursing diagnoses had been established. All patients presented Impaired tissue integrity, Risk of infection, Pain incisive in the area inguinal, Injured physical mobility, Self-care deficit related to personal hygiene, and Risk of organic renal lesion. It has been concluded that the Self-care Deficit theory allowed the classification of all nursing diagnoses according to NANDA. It contributed to the nursing assistance individualization, humanization, and qualification. Beyond advance self-knowledge, self-control and patient participation on his/her self-car.

  12. Evaluation of a hemostatic device with percutaneous collagen application (VasoSeal {sup trademark}) compared to a mechanical compression system (Compressar {sup trademark} -) after transfemoral catheterization of patients suffering from arterial occlusive disease; Evaluation eines Verschlusssystems mit perkutaner Kollageneinbringung (VasoSeal {sup trademark}) im Vergleich zu einem mechanischen Kompressionssystem (Compressar {sup trademark} -) nach Femoralispunktion bei Patienten mit AVK

    Energy Technology Data Exchange (ETDEWEB)

    Neudecker, A.; Lenhart, M.; Zorger, N.; Paetzel, C.; Feuerbach, S.; Link, J. [Inst. fuer Roentgendiagnostik, Klinikum der Univ. Regensburg (Germany); Manke, C. [Klinik fuer Diagnostische und Interventionelle Radiologie, Klinikum Fulda (Germany)

    2003-05-01

    Purpose: Comparison of the efficacy of VasoSeal {sup trademark} and a mechanical compression system (Compressar {sup trademark}) for percutaneous hemostasis after femoral arterial catheterization of patients with arterial occlusive disease. Materials and Methods: 60 patients underwent either diagnostic angiography or interventional procedures. The level of anticoagulation, blood pressure, and activation clotting time were recorded, and the time to hemostasis after sheath removal was measured. VasoSeal {sup trademark} application was considered ''successful'' if the compression time was less than two minutes. On the subsequent day as well as 4 months later, color coded Doppler ultrasound was performed to register treatment success and potential (late) complications. Results: 57 patients qualified for inclusion in this study. In 21 of the 26 patients who underwent the procedure with the VasoSeal {sup trademark}, immediate hemostasis was achieved within 1.75 minutes. In all 31 patients who had the Compressar {sup trademark} applied, hemostasis was successful with a mean compression time of 17.4 minutes. Thus, VasoSeal {sup trademark} significantly reduced hemostasis time irrespective of anticoagulation status, but it had a much higher incidence of minor local complications (bleeding, hematoma) compared to the control group (34.6% vs. 5.8%). The technical success was lower with VasoSeal {sup trademark} than with Compressar {sup trademark} (81% vs. 100%). Both groups had no severe or late complications. Conclusion: According to our results, VasoSeal {sup trademark} does not provide a suitable alternative compared to the effective, safe and cheap application of Compressar {sup trademark} as a hemostatic device. (orig.) [German] Ziel: Effizienz von VasoSeal trademark als perkutanes Verschlusssystem nach Punktion der Femoralarterie bei Patienten mit AVK im Vergleich zur mechanischen Kompressionshilfe Compressar trademark. Material und Methoden

  13. Assistência de enfermagem a idosos que realizam cateterismo cardíaco: uma proposta a partir do modelo de adaptação de Calista Roy Asistencia de enfermería a ancianos que realizan cateterismo cardíaco: una propuesta a partir del modelo de adaptación de Calista Roy Nursing care to elderly patients undergoing heart catheterization: a proposal according to the Adaptation model of Calista Roy

    Directory of Open Access Journals (Sweden)

    Maria Célia de Freitas

    2006-10-01

    cardiac catheterization, according to the Adaptation Theory of Calista Roy. It was developed in a cardiology unit in a hospital in Fortaleza, CE, from January to July, 2005. A semi-structured interview was used, with 18 elderly patients, in pre-catheterization period. The analysis identified the nursing diagnoses: alteration in the maintenance of the health, anxiety, fear and alteration in the family process. The nursing actions were: to create a trust climate for the aged before the exam; to listen and to respect feelings faiths and referring values to the situation; to guide the patient with relationships to the procedure. The use of this theory, allowed in recognizing that patients, by means of incentives, can unchain answers some positive times other negative times, fitting to the nurse to act as mediator.

  14. 经颈动脉途径肝动脉插管及脾内注射肝细胞移植治疗急性肝衰大鼠的疗效比较%Comparison of therapeutic effects between catheterization of hepatic artery via carotid route and intrasplenic injection for hepatocyte transplantation in acute hepatic failure rats

    Institute of Scientific and Technical Information of China (English)

    冯渊; 李德卫; 杨晓波; 陈睿; 杜文俊; 樊斌

    2012-01-01

    Objective:To establish the animal model of hepatocyte transplantation via hepatic artery in SD rats;to evaluate the treatment effects of hepatocyte transplantation by hepatic artery and intrasplenic injection in rats with acute hepatic failure. Methods :A-cute hepatic failure(AHF) was induced by D-gal in SD rats. After 24 hours,a cather was inserted into the hepatic artery in 65 rats with AHF. Then the 60 rats were randomly divided into 3 groups. Group Ⅰ received 2×107 hepatocytes through intraplenic injection and 0.4 ml Hank's solution was infused through hepatic artery;Group Ⅱ received 0.4 ml Hank's solution through intraplenic injection and 2×107 hepatocytes was infused through hepatic artery;Group Ⅲ received 0.4 ml Hank's solution through intraplenic injection and 0.4 ml Hank's solution through hepatic artery .Surviving rate was observed at 14 days and liver function was measured at different time points. The distribution of transplanted CFDA-SE-labeled hepatocytes through hepatic artery was observed.Secretion of albumin and liver histopathological change were observed in spleen by immunofluorescence and HE staining. Results:Al 14 days,the survival of Group Ⅰ rats was significantly higher than that of Group Ⅱ rats (P=0.031 ,<0.05); the survival of Group Ⅱ was significantly higher than that of Group Ⅲ (P=0.048,<0.05).Hepatic function of Groups Ⅰ and Ⅱ had improved,especially of Group Ⅰ . In Group Ⅱ ,24 h after transplantation of CFDA-SE-labeled hepatocytes,scattered green fluorescence region was found under fluorescent microscopy. In Group Ⅰ ,at 30 days post-lransplatation,immflnofluorescent staining of albumin demonstrated some positive cells in spleen;at 7 days post-transplatation,transplanted hepatocytes was found in spleen. Conclusion:Hepatocyte transplantation through catheteriza-tion hepatic artery via carotid route can improve the survival of rats with AHF and ameliorate hepatic function,but intrasplenic injection is

  15. 不同途径置管洗胃对口服中毒患者影响的系统评价及试验序贯分析%Effects of different catheterization on patients with oral poisoning gastric lavage:a meta-analysis with trial sequential analysis

    Institute of Scientific and Technical Information of China (English)

    曾艳丽; 王国富; 胡秀英; 刚海菊; 李望

    2016-01-01

    Objective To assess on the effect of the different catheterization on patients with oral poisoning gastric lavage systematically and objectively. Methods A computerized search of PubMed, the Cochrane Library, EMBASE, Springer Link, Science Direct,China Biology Medicine (CBM),China National Knowledge Internet(CNKI), Wanfang Data and VIP database was performed for relevant randomized controlled trials (RCTs) which investigated the effects of the oral intubation gastric lavage on patients with oral poisoning relative to nasogastric lavage, retrieval to January 2016, and back into the study of references. According to include and exclude standard to screening literature, literature which met inclusion criteria was selected for quality evaluation and data extraction. Meta-analysis and trial sequential analysis were performed by using Rev-Man 5.3 and TSA soft-ware to estimate the required information size (RIS). Results 13 studies incorporated into Meta-analysis including a total o 1 296 patients. Meta-analysis results showed that the oral intubation gastric lavage group was better than nasogastric lavage in shortening the time of intubation [MD=-9.05, 95% CI(-12.86--5.23), P=0.00], improving the rate of intubation for the first time [MD=1.36, 95% CI (1.14-1.62), P =0.00], mucosal bleeding complication [MD=0.11, 95% CI (0.04-0.64), P=0.010], nausea and vomiting [MD=0.60, 95%CI (0.37-0.98), P=0.04], kinking [MD=0.14, 95% CI (0.02-0.80), P=0.03], reflex cardiac arrest [MD=0.24, 95% CI (0.08-0.71), P=0.01] and asphyxia [MD=0.45, 95% CI (0.26-0.80), P=0.007], the difference were statistically significant. But no significant difference existed in gastric tube fall off. Conclusions The oral intubation gastric lavage could shorten intubation time of patients, improve the first time intubation rate and reduce certain complications. It suggests that the oral intubation be extensively applied to care patients with oral poisoning.%目的:系统评价不同途径置管洗胃对

  16. Localization of aldosterone-producing tumours in primary aldosteronism by adrenal and renal vein catheterization

    DEFF Research Database (Denmark)

    Lund, J O; Nielsen, M D; Giese, Jacob;

    1980-01-01

    Regional venous plasma aldosterone concentrations were determined and assessed against concurrent arterial levels in 16 patients with primary aldosteronism. The results obtained by sampling from the left adrenal vein or the left renal vein allowed correct side prediction of the presupposed adenom...

  17. [Can bladder catheterization in pediatrics cause complications? The case of a urethral dysuria cystograph].

    Science.gov (United States)

    Alcázar García, A; Daviu Llorens, E; Daza Laguna, A; Durán Feliubadalo, C; Pons Torrents, X

    2009-10-01

    A urethral dysuria cystograph (CUMS (Cistografia Ureteral Miccional Seriada)) is the first diagnostic procedure, by means of x-rays, to evaluate bladder-urethral reflux. It consists of a bladder catheter to administer a radiopaque contrast dye through the ureter. To use the aforementioned technique without any asepsis measures and without knowledge about it can lead to possible complications. By means of a retrospective study using a sample of 181 patients, the authors have evaluated the incidence of possible complications and/or subsequent discomfort due to a urethral dysuria cystograph (CUMS). As final results, by means of an after test telephone call, the authors observed that 96.7% of the children who underwent this technique did not manifest any type of complication nor urinary discomfort.

  18. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Blondiaux, Eleonore; Miquel, Julie [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); Thomas, Pascale; Watelet, Jacques [Rouen University Hospital Charles Nicolle, Department of Vascular Surgery, Rouen (France); Laloum, Denis [Caen University Hospital, Pediatric Intensive Care Unit, Department of Neonatal Medicine, Caen (France); Dacher, Jean-Nicolas [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); UFR Medecine et Pharmacie, Laboratoire Quant-If, Rouen Cedex 01 (France)

    2008-02-15

    We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment. (orig.)

  19. [Technical solution to a complication caused by intra-arterial catheterization].

    Science.gov (United States)

    Oliu Torres, O; Pedroso Mendoza, L E; Figueredo Barreras, F; Corteguera Fonte, M E

    1990-01-01

    Knot formation in the distal segment of an angiographic catheter is not very frequent. Its early recognition, as well as domination of several techniques in order to untie it, may avoid surgery. An unique technique in order to untie a knot in a catheter is described, which consists in using other more rigid catheter with "J" shaped end by contralateral femoral via and under direct fluoroscopic visualization, with image magnifier and fitted TV.

  20. Long-term catheterization: current approaches in the diagnosis and treatment of port-related infections

    Directory of Open Access Journals (Sweden)

    Bustos C

    2014-02-01

    Full Text Available Cesar Bustos,1 Aitziber Aguinaga,1 Francisco Carmona-Torre,2 Jose Luis Del Pozo1,3 1Department of Clinical Microbiology, 2Department of Internal Medicine, 3Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain Abstract: Since the first description in 1982, totally implanted venous access ports have progressively improved patients' quality of life and medical assistance when a medical condition requires the use of long-term venous access. Currently, they are part of the standard medical care for oncohematologic patients. However, apart from mechanical and thrombotic complications, there are also complications associated with biofilm development inside the catheters. These biofilms increase the cost of medical assistance and extend hospitalization. The most frequently involved micro-organisms in these infections are gram-positive cocci. Many efforts have been made to understand biofilm formation within the lumen catheters, and to resolve catheter-related infection once it has been established. Apart from systemic antibiotic treatment, the use of local catheter treatment (ie, antibiotic lock technique is widely employed. Many different antimicrobial options have been tested, with different outcomes, in clinical and in in vitro assays. The stability of antibiotic concentration in the lock solution once instilled inside the catheter lumen remains unresolved. To prevent infection, it is mandatory to perform hand hygiene before catheter insertion and manipulation, and to disinfect catheter hubs, connectors, and injection ports before accessing the catheter. At present, there are still unresolved questions regarding the best antimicrobial agent for catheter-related bloodstream infection treatment and the duration of concentration stability of the antibiotic solution within the lumen of the port. Keywords: catheter-related infection, bacteremia, biofilm

  1. PROLONGED RADIAL ARTERY SPASM IN THE CATHETERIZATION LABORATORY - RELIEF BY PHARMACOLOGICAL INTERVENTION

    Directory of Open Access Journals (Sweden)

    Krishna Kumar

    2010-11-01

    Full Text Available Radial spasm is often very prolonged and painful to the patient. Here, we describe a novel way to deal with the same. The total spasm lasted over 4 hours. A 3.4 6 JR catheter was introduced via the femoral route and papav arine one ampoule was injected directly into the right subclavian artery. After about 10 min we were able to pull out the radial catheter. Radial angiography is a simple procedure with reportedly less complications 1,2. How ever ,it has one major complication radial spasm. We describe here a patient with radial spasm that persisted for more than 2 hours and how we dealt with it.

  2. Balloon catheterization for hemostasis during the operation of ruptured femoral artery pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    SHI De-bing; FU Wei-guo; WANG Yu-qi; GUO Da-qiao; CHEN Bin; SHI Zhen-yu

    2007-01-01

    @@ Pseudoaneurysms of the femoral artery usually progress and can rupture if left untreated. Therefore,intraoperative hemostasis is of the paramount importance in the management of these emergent situations,especially for the patients with poor general health.

  3. Medical management of urethral and colonic perforation associated with urinary catheterization in a kitten.

    Science.gov (United States)

    Whittemore, Jacqueline C; Zucca, Lynda

    2003-09-15

    A 6-week-old male kitten was evaluated because of stranguria and possible urethral blockage; a urinary catheter placed during general anesthesia penetrated the urethral and colonic walls and entered the colon. Treatment was conservative, with fluids administered i.v., administration of piperacillin, and supportive care. The kitten never became febrile or clinically ill and continued to thrive. There was no development of clinical signs consistent with stricture, diverticulum, or fistula formation. Complications from urethral perforation include infection and urethral stricture. Reconstructive surgery is considered the treatment of choice for traumatic urethral-colonic perforation. However, surgery may not be feasible or may be cost-prohibitive in certain situations. In such instances, medical management may provide a reasonable alternative to euthanasia.

  4. Deep vein thrombosis after spine operation in prone position with subclavian venous catheterization: a case report.

    Science.gov (United States)

    Cho, Jae Kyung; Han, Jin Hee; Park, Sung Wook; Kim, Keon Sik

    2014-07-01

    We experienced a case of deep vein thrombosis after spine surgery in the prone position with a central venous catheter (CVC). Posterior lumbar interbody fusion was performed on a 73-year-old female patient who was diagnosed with spinal stenosis. Accordingly, in the operation room under general anesthesia, two-lumen CVC were inserted into the left subclavian vein. The surgery was performed in the prone position with a Wilson frame. On the next day, there was a sudden occurrence of severe edema in the patient's left arm. By ultrasonography and computed tomography scanning, extensive deep vein thrombosis was observed in the left subclavian vein. The existence of a factor affecting blood flow such as the prone position may increase the risk of thrombus formation. Therefore, careful perioperative evaluation should be implemented.

  5. Repeated Hemothorax Following Ipsilateral Left Internal Jugular and Left Subclavian Venous Catheterization(Olgu Bildirimi)

    OpenAIRE

    ÜLGER,, F.; SARIHASAN, B.; ŞENEL, A.

    2009-01-01

    Aynı Taraf Sol İnternal Jugular ve Subklavian Venöz Kateterizasyondan Sonra Tekrarlayan Hemotoraks Kritik hastada en sık kullanılan invaziv girişimlerden birisi de santral kateterizasyon işlemidir. Kateterizasyon sıklıkla internal juguler ve subklavian vene uygulanır. Bu venler hemo-dinamik monitorizasyona izin verdiği gibi ilaç ve sıvı tedavileri, kan transfüzyonu ve total pa-renteral beslenmeye için de olanak sağlar. Komplikasyonlar internal juguler vende %1-4 sıklıkla arter delinmesi ve...

  6. Guide-wire embolism during subclavian vein catheterization by Seldinger technique

    Directory of Open Access Journals (Sweden)

    Narendra H

    2006-01-01

    Full Text Available Percutaneous cannulation of central veins by Seldinger technique is a popular approach in intensive care settings. We report a case of embolization of a complete guide-wire during such a procedure. Our case differs from the few earlier reported cases in that subclavian vein was the entry site. While reviewing the available literature, we discuss few reasons and management of such a mishap.

  7. Guide-wire embolism during subclavian vein catheterization by Seldinger technique

    OpenAIRE

    2006-01-01

    Percutaneous cannulation of central veins by Seldinger technique is a popular approach in intensive care settings. We report a case of embolization of a complete guide-wire during such a procedure. Our case differs from the few earlier reported cases in that subclavian vein was the entry site. While reviewing the available literature, we discuss few reasons and management of such a mishap.

  8. Activation of catheterization lab in ambulance: new direction in ST-elevation myocardial infarction care

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing

    2011-01-01

    @@ Primary percutaneous coronary intervention (PPCI) is the cornerstone of treatment to reduce infarct size and improve outcomes in patients with ST-elevation myocardial infarction (STEMI).1 The optimal site for initiation of reperfusion strategies is the patient's home or place where the infarction occurs.

  9. Accuracy of the 'Paedfusor' in children undergoing cardiac surgery or catheterization

    NARCIS (Netherlands)

    Absalom, A; Amutike, D; Lal, A; White, M; Kenny, GNC

    2003-01-01

    Background. A prototype paediatric propofol target-controlled infusion (TCI) system, the 'Paedfusor' has been developed. This system incorporates a paediatric pharmacokinetic data set and algorithm specific for children in a Graseby 3500 anaesthesia syringe driver. In this study we have evaluated th

  10. Comparing the Cost-Effectiveness of Simulation Modalities: A Case Study of Peripheral Intravenous Catheterization Training

    Science.gov (United States)

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-01-01

    While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three…

  11. Effect of benzoic acid supplementation on acid-base status and mineralmetabolism in catheterized growing pigs

    DEFF Research Database (Denmark)

    Nørgaard, Jan Værum; Fernández, José Adalberto; Sørensen, Kristina Ulrich;

    2010-01-01

    Benzoic acid (BA) in diets for growing pigs results in urinary acidification and reduced ammonia emission. The objective was to study the impact of BA supplementation on the acid-base status and mineral metabolism in pigs. Eight female 50-kg pigs, fitted with a catheter in the abdominal aorta, were...

  12. Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery

    DEFF Research Database (Denmark)

    Tønnesen, K H; Sager, P; Karle, A;

    1988-01-01

    We report the results of 50 angioplasty procedures via the popliteal artery. A 3-year follow-up including control of blood pressures at ankle and toe levels show results comparable to reports in the literature. This new approach for angioplasty of the superficial femoral artery and eventually...

  13. Plasma concentrations of corticosterone and buprenorphine in rats subjected to jugular vein catheterization

    DEFF Research Database (Denmark)

    Goldkuhl, Renée; Jacobsen, Kirsten Rosenmaj; Kalliokoski, Otto Henrik;

    2010-01-01

    The present study investigated the postoperative plasma concentrations of corticosterone and buprenorphine in male Wistar and Sprague-Dawley rats, treated with buprenorphine administered either through subcutaneous (SC) injection or through voluntary ingestion (VI). The animals were treated...... with buprenorphine for pre-emptive analgesia prior to surgical placement of a jugular catheter, followed by automated blood sampling during 96 h. Buprenorphine was administered on a regular basis throughout the experiment, and blood was collected on selected time points. Body weight was measured before and 96 h...... after surgery. It was found that the two rat stocks responded in a similar manner to both buprenorphine treatments, with the exception of body weight change in Wistar rats, in which body weight was reduced after SC treatment. The plasma concentration of corticosterone was significantly higher in the SC...

  14. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease

    Directory of Open Access Journals (Sweden)

    Youmna E. DiStefano

    2015-01-01

    Full Text Available Peripheral nerve blockade (PNB is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR. Evidence on the safety of PNB in patients with coagulopathy is lacking. We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD. Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year-old female undergoing TKR. A Humate-P intravenous infusion was started and the patient was positioned supinely. Using sterile technique with ultrasound guidance, a Contiplex 18 Gauge Tuohy needle was advanced in plane through the fascia iliaca towards the femoral nerve. A nerve catheter was threaded through the needle and secured without complications. Postoperatively, a levobupivacaine femoral catheter infusion was maintained, and twice daily Humate-P intravenous infusions were administered for 48 hours; enoxaparin thromboprophylaxis was initiated thereafter. The patient was discharged uneventfully on postoperative day 4. Given documentation of delayed, unheralded bleeding from PNB in coagulopathic patients, we recommend individualized PNB in vWD patients. Multidisciplinary team involvement is required to guide factor supplementation and thromboprophylaxis, as is close follow-up to elicit signs of bleeding throughout the delayed postoperative period.

  15. A SA study on complications in ultrasound guided catheterization of the internal jugular vein

    Directory of Open Access Journals (Sweden)

    Henjarappa KS

    2015-06-01

    Full Text Available Background: With the advanced knowledge in medical monitoring, ever increasing value has been placed on the establishment of central venous catheter. During the past few years, monitoring of central venous pressure has become an important aid in the management of critically ill patients. Doppler ultrasound was first used to assist central venous catheter insertion in 1984. Ultrasound has been applied to describe the anatomy of the IJV and to evaluate various techniques for percutaneous cannulation. Real time sonography improves access to the vein compared with the traditional method. Ultrasound guided cannulation limits complications and also the decreases the cannulation time. For reducing the complication in traditional method we have conducted the study through ultrasound guide and observed the complications in new method. Methods: Thirty critical care patients were selected for IJV cannulation either by ultrasound guided technique. This study conducted in department of anesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. Results: In our study there was 100% success rate for first attempt cannulation in USG technique. The mean access time in USG technique was 152.50 +/- 63.90 sec. in USG technique arrhythmias were noted in 1 (3.3% case during the study. No cases of haematoma, pneumothorax, haemothorax, nerve Injury, carotid artery puncture and catheter malposition were noted during the study in USG technique. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure. [Int J Res Med Sci 2015; 3(3.000: 693-697

  16. [Prolonged reversible cortical blindness over 5 days after cardiac catheterization].

    Science.gov (United States)

    Wedekind, H; Özgün, M

    2016-12-20

    We present a case of a 49-year-old man with angina pectoris. He developed transient cortical blindness (TCB) with focal neurological symptoms following coronary angiography. Two cranial magnet resonance studies within 3 days showed no morphological changes. Clinically the patient developed complex focal epilepsy, which was symptomatically treated. Under intensive monitoring, including hypertension control, the patient improved after 5 days of blindness with restoration of his vision on day 6. The exact mechanism of TCB is still speculative, but could be caused in this case by a toxic effect of contrast dye that was administered. There is no definitive evidence to suggest that a certain treatment regime improves the natural history of the disease. However, control of risk factors and prevention of selective cerebral angiography may increase preventive strategies for this highly devastating complication.

  17. Stored-fluorography mode reduces radiation dose during cardiac catheterization measured with OSLD dosimeter

    Science.gov (United States)

    Ting, Chien-Yi; Chen, Zhih-Cherng; Tang, Kuo-Ting; Liu, Wei-Chung; Lin, Chun-Chih; Wang, Hsin-Ell

    2015-12-01

    Coronary angiogram is an imperative tool for diagnosis of coronary artery diseases, in which cine-angiography is a commonly used method. Although the angiography proceeds under radiation, the potential risk of radiation exposure for both the patients and the operators was seldom noticed. In this study, the absorbed radiation dose in stored-fluorography mode was compared with that in cine-angiography mode by using optically simulated luminescent dosimeters to realize their effects on radiation dose. Patients received coronary angiogram via radial artery approach were randomized into the stored-fluorography group (N=30) or the cine-angiography group (N=30). The excluded criteria were: 1. women at pregnancy or on breast feeding, 2. chronic kidney diseases with glomerular filtration rate less than 60 mL/min. During the coronary angiogram, absorbed dose of the patients and the operator radiation exposure was measured with optically simulated luminescent dosimeter (OSLD). The absorbed dose of the patients in the stored-fluorography group (3.13±0.25 mGy) was apparently lower than that in the cine-angiography group (65.57±5.37 mGy; Pcine-angiography (0.6519μGy). Compared with traditional cine-angiography mode, the stored-fluorography mode can apparently reduce radiation exposure of the patients and the operator in coronary angiogram.

  18. Cardiac catheterization: What causes a pseudoaneurysm? Should a pseudoaneurysm always be treated?

    Science.gov (United States)

    ... FC, et al., eds. Thoracic aneurysms and aortic dissection. In: Schwartz's Principles of Surgery. 9th ed. New ... logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo Foundation for Medical ...

  19. Ultrasound-guided central venous catheterization in cancer patients improves the success rate of cannulation and reduces mechanical complications: A prospective observational study of 1,978 consecutive catheterizations

    Directory of Open Access Journals (Sweden)

    Gorgni Silvia

    2010-10-01

    Full Text Available Abstract Background A central venous catheter (CVC currently represents the most frequently adopted intravenous line for patients undergoing infusional chemotherapy and/or high-dose chemotherapy with hematopoietic stem-cell transplantation and parenteral nutrition. CVC insertion represents a risk for pneumothorax, nerve or arterial punctures. The aim of this prospective observational study was to explore the safety and efficacy of CVC insertion under ultrasound (US guidance and to confirm its utility in clinical practice in cancer patients. Methods Consecutive adult patients attending the oncology-hematology department were eligible if they had solid or hematologic malignancies and required CVC insertion. Four types of possible complication were defined a priore: mechanical, thrombotic, infection and malfunctioning. The patient was placed in Trendelenburg's position, a 7.5 MHZ puncturing US probe was placed in the supraclavicular site and a 16-gauge needle was advanced under real-time US guidance into the last portion of internal jugular vein. The Seldinger technique was used to place the catheter, which was advanced into the superior vena cava until insertion into right atrium. Within two hours after each procedure, an upright chest X-ray and ultrasound scanning were carried out to confirm the CVC position and to rule out a pneumotorax. CVC-related infections, symptomatic vein thrombosis and malfunctioning were recorded. Results From December 2000 to January 2009, 1,978 CVC insertional procedures were applied to 1,660 consecutive patients. The procedure was performed 580 times in patients with hematologic malignancies and 1,398 times those with solid tumors. A single-needle puncture of the vein was performed on 1,948 of 1,978 procedures (98.48%; only eighteen attempts among 1,978 failed (0.9%. No pneumotorax, no major bleeding, and no nerve puncture were reported; four cases (0.2% showed self-limiting hematomas. The mean lifespan of CVC was 189.7 +/- 18.6 days (range 7-701. Symptomatic deep-vein thrombosis of the upper limbs developed in 48 patients (2.42%. Catheter-related infections occurred in 197 (9.96% of the catheters inserted. They were successfully treated with antibiotics and only in 48 (2.9% patients definitive CVC removal was required for infection and/or thrombosis or malfunctioning. Conclusions This study represents the largest published series of consecutive patients with cancer undergoing CVC insertion under US guidance; this procedure allowed the completion of the therapeutic program for 1,930/1,978 (97.6% of the catheters inserted. The absence of pneumotorax and other major complications indicates that US guidance should be mandatory for CVC insertion in patients with cancer.

  20. Pooled comparison of regadenoson versus adenosine for measuring fractional flow reserve and coronary flow in the catheterization laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Stolker, Joshua M., E-mail: jstolker@yahoo.com [Mercy Heart and Vascular, 901 Patients First Drive, Washington, MO 63090 (United States); Saint Louis University, 3635 Vista Ave, St. Louis, MO 63110 (United States); Lim, Michael J., E-mail: limmj@slu.edu [Saint Louis University, 3635 Vista Ave, St. Louis, MO 63110 (United States); Shavelle, David M., E-mail: david.shavelle@med.usc.edu [University of Southern California, 1510 San Pablo St, Suite 322, Los Angeles, CA 90033 (United States); Morris, D. Lynn, E-mail: morrisdl@einstein.edu [Albert Einstein Medical Center, 5501 Old York Rd, Philadelphia, PA 19141 (United States); Angiolillo, Dominick J., E-mail: dominick.angiolillo@jax.ufl.edu [University of Florida Health-Jacksonville, 655 West 8th St, Jacksonville, FL 32209 (United States); Guzman, Luis A., E-mail: luis.guzman@jax.ufl.edu [University of Florida Health-Jacksonville, 655 West 8th St, Jacksonville, FL 32209 (United States); Kennedy, Kevin F., E-mail: kfkennedy@saint-lukes.org [Saint Luke' s Mid America Heart Institute, 4401 Wornall Road, Kansas City, MO 64111 (United States); Weber, Elizabeth, E-mail: eweber1@slu.edu [Saint Louis University, 3635 Vista Ave, St. Louis, MO 63110 (United States); Zareh, Meena, E-mail: meena.zareh@med.usc.edu [University of Southern California, 1510 San Pablo St, Suite 322, Los Angeles, CA 90033 (United States); Neumayr, Robert H., E-mail: robneumayr@gmail.com [Mercy Heart and Vascular, 901 Patients First Drive, Washington, MO 63090 (United States); Saint Louis University, 3635 Vista Ave, St. Louis, MO 63110 (United States); Zenni, Martin M., E-mail: martin.zenni@jax.ufl.edu [University of Florida Health-Jacksonville, 655 West 8th St, Jacksonville, FL 32209 (United States)

    2015-07-15

    Background: Adenosine is the gold standard for augmenting coronary flow during fractional flow reserve (FFR) testing of intermediate coronary stenoses. However, intravenous infusion is time-consuming and intracoronary injection is subject to variability. Regadenoson is a newer adenosine alternative administered as a single intravenous bolus during nuclear stress testing, but its efficacy and safety during FFR testing have been evaluated only in small, single-center studies. Methods: We pooled data from 5 academic hospitals, in which patients undergoing clinically-indicated FFR prospectively underwent comparison of intravenous adenosine infusion (140–175 mcg/kg/min) versus regadenoson bolus (400 mcg). Hemodynamics and symptoms with adenosine were recorded until maximal hyperemia occurred, and after returning to baseline hemodynamics, regadenoson was administered and monitoring was repeated. In a subset of patients with coronary flow data, average peak velocity (APV) at the distal flow sensor was recorded. Results: Of 149 patients enrolled, mean age was 59 ± 9 years, 76% were male, and 54% underwent testing of the left anterior descending artery. Mean adenosine-FFR and regadenoson-FFR were identical (0.82 ± 0.10) with excellent correlation of individual values (r = 0.96, p < 0.001) and no difference in patient-reported symptoms. Four patients (2.6%) had discrepancies between the 2 drugs for the clinical decision-making cutoff of FFR ≤ 0.80. Coronary flow responses to adenosine and regadenoson were similar (APV at maximal hyperemia 36 cm/s for both, p = 0.81). Conclusions: Regadenoson single-bolus administration has comparable FFR, symptoms, and coronary flow augmentation when compared with standard intravenous adenosine infusion. With its greater ease of administration, regadenoson may be a more “user-friendly” option for invasive ischemic testing.

  1. A new design of a lead-acrylic shield for staff dose reduction in radial and femoral access coronary catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Eder, H. [Deptartment of Radiation Protection (Germany); Seidenbusch, M.C.; Treitl, M. [Muenchen Univ. Clinical Center (Germany). Inst. for Clinical Radiology; Gilligan, P. [Mater Private Hospital, Dublin (Ireland). Medical Physics

    2015-10-15

    Today's standard radiation protection during coronary angiography and percutaneous coronary interventions is the combined use of lead acrylic shields and table-mounted lower body protection. Ambient dose measurements, however, have shown that these protection devices need improvement. Using an anthropomorphic physical phantom, various scenarios were investigated with respect to personnel exposure: (a) enlarging the shield (b) adding a flexible protective curtain to the bottom side of the shield, and (c) application of radioprotective patient drapes. For visualization of the dose reduction effect, Monte Carlo simulations were performed. The flexible curtain in contact with the patient's body reduces the ambient dose rate at the operator's position by up to (87.5 % ± 7.1) compared to the situation with the bare shield. The use of both the flexible curtain and the patient drape reduces the ambient dose rate by up to (90.8 % ± 7). Similar results were achieved for the assisting personnel when they were positioned next to the operator. In addition, the enlarged shield provides better protection of the head region of tall operators. Adding a flexible protective curtain to the bottom side of the shield can protect operators from high doses, especially for body parts which are not protected by lead aprons, e.g. head, and eye lenses. This may be important with respect to lower dose limits for eye lenses in future. The protective effect in real-life working conditions is still being evaluated in an ongoing clinical study.

  2. Perceptions of advantages and barriers to radial-access percutaneous coronary intervention in VA cardiac catheterization laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Helfrich, Christian D., E-mail: Christian.Helfrich@va.gov [VA Puget Sound Health Services Research and Development Center of Innovation, US Department of Veterans Affairs, Seattle, WA (United States); Department of Health Services, University of Washington School of Public Health, Seattle, WA (United States); Tsai, Thomas T. [VA Eastern Colorado Health Care System, Denver, CO (United States); Department of Medicine and the Division of Cardiology, University of Colorado School of Medicine, Aurora, CO (United States); Rao, Sunil V. [Cardiac Catheterization Laboratories, Durham VA Medical Center, Durham, NC (United States); Duke Clinical Research Institute, Durham, NC (United States); Lemon, Jaclyn M.; Eugenio, Evercita C. [VA Puget Sound Health Services Research and Development Center of Innovation, US Department of Veterans Affairs, Seattle, WA (United States); Vidovich, Mladen I.; Shroff, Adhir R. [Department of Cardiology, Jesse Brown VA Medical Center, Chicago, IL (United States); Department of Internal Medicine, Section of Interventional Cardiology, University of Illinois at Chicago, Chicago, IL (United States); Speiser, Bernadette S. [Department of Cardiology, Jesse Brown VA Medical Center, Chicago, IL (United States); Bryson, Chris L. [VA Puget Sound Health Services Research and Development Center of Innovation, US Department of Veterans Affairs, Seattle, WA (United States); Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA (United States)

    2014-09-15

    Background/Purpose: Compared with trans-femoral percutaneous coronary intervention (TFI), trans-radial PCI (TRI) has a lower risk of bleeding, access site complications and hospital costs, and is preferred by patients. However, TRI accounts for a minority of PCIs in the US, and there is currently little research that explores why. Methods/Material: We conducted a national survey in February 2013 to assess perceptions of TRI vs. TFI, and barriers to TRI adoption and implementation among interventional cardiologists employed by the US Veterans Health Administration (VHA), and linked these data to site-level TRI annual rates for 2013. Results: We received 78 completed surveys (32% response rate). Respondents at sites that perform few or no TRIs identified increased radiation exposure as the greatest barrier while at sites that perform a high percentage of TRIs respondents identified the steep learning curve as the greatest barrier. Majorities of survey respondents at all sites rated TRI as superior on 5 of 7 criteria, including patient comfort and bleeding complications, but rated TFI as superior on procedure time and procedure success. Conclusions: Even interventional cardiologists at sites that perform few or any TRIs recognized the superiority of TRI for patient comfort and safety, but rated it inferior to TFI on procedure time and technical results. Interventional cardiologists at high-TRI labs rated TRI as equivalent on procedure time and technical results. Efforts to increase TRI adoption and implementation may be more successful if they emphasize that procedure times and technical results depend on achieving proficiency. - Highlights: • Sites with few TRIs identified increased radiation exposure as the greatest barrier. • Sites with many TRIs identified the steep learning curve as the greatest barrier. • TFI was rated superior on procedure time and procedure success. • TRI was rated superior on all other criteria.

  3. Complexity of cardiac signals for predicting changes in alpha-waves after stress in patients undergoing cardiac catheterization

    Science.gov (United States)

    Chiu, Hung-Chih; Lin, Yen-Hung; Lo, Men-Tzung; Tang, Sung-Chun; Wang, Tzung-Dau; Lu, Hung-Chun; Ho, Yi-Lwun; Ma, Hsi-Pin; Peng, Chung-Kang

    2015-08-01

    The hierarchical interaction between electrical signals of the brain and heart is not fully understood. We hypothesized that the complexity of cardiac electrical activity can be used to predict changes in encephalic electricity after stress. Most methods for analyzing the interaction between the heart rate variability (HRV) and electroencephalography (EEG) require a computation-intensive mathematical model. To overcome these limitations and increase the predictive accuracy of human relaxing states, we developed a method to test our hypothesis. In addition to routine linear analysis, multiscale entropy and detrended fluctuation analysis of the HRV were used to quantify nonstationary and nonlinear dynamic changes in the heart rate time series. Short-time Fourier transform was applied to quantify the power of EEG. The clinical, HRV, and EEG parameters of postcatheterization EEG alpha waves were analyzed using change-score analysis and generalized additive models. In conclusion, the complexity of cardiac electrical signals can be used to predict EEG changes after stress.

  4. Suspected Pulmonary Embolism during Hickman Catheterization in a Child: What Else Should Be Considered besides Pulmonary Embolism?

    Directory of Open Access Journals (Sweden)

    Haemi Lee

    2016-02-01

    Full Text Available A 16-month-old girl with acute lymphoblastic leukemia expired during Hickman catheter insertion. She had undergone chemoport insertion of the left subclavian vein six months earlier and received five cycles of chemotherapy. Due to malfunction of the chemoport and the consideration of hematopoietic stem cell transplantation, insertion of a Hickmann catheter on the right side and removal of the malfunctioning chemoport were planned under general anesthesia. The surgery was uneventful during catheter insertion, but the patient experienced the sudden onset of pulseless electrical activity just after saline was flushed through the newly inserted catheter. Cardiopulmonary resuscitation was commenced aggressively, but the patient was refractory. Migration of a thrombus generated by the previous central catheter to the pulmonary circulation was suspected, resulting in a pulmonary embolism.

  5. Direct aneurysm sac catheterization and embolization of an enlarging internal iliac aneurysm using cone-beam CT

    Science.gov (United States)

    Merchant, Monish; Shah, Rohan; Resnick, Scott

    2015-01-01

    Since cone-beam computed tomography (CT) has been adapted for use with a C-arm system it has brought volumetric CT capabilities in the interventional suite. Although cone-beam CT image resolution is far inferior to that generated by traditional CT scanners, the system offers the ability to place an access needle into position under tomographic guidance and use the access to immediately begin a fluoroscopic procedure without moving the patient. We describe a case of a “jailed” enlarging internal iliac artery aneurysm secondary to abdominal aortic aneurysm repair, in which direct percutaneous puncture of the internal iliac artery aneurysm sac was performed under cone-beam CT guidance. PMID:25858522

  6. Examination of nanoparticles as a drug carrier on blood flow through catheterized composite stenosed artery with permeable walls.

    Science.gov (United States)

    Ijaz, S; Nadeem, S

    2016-09-01

    In this paper, we have discussed the influence of copper nanoparticles on a blood flow through composite stenosed artery with permeable walls. The nature of blood is discussed mathematically by considering it as viscous nanofluid. The study is carried out for a blood vessel under mild stenosis approximations and expressions of the temperature, velocity, resistance impedance to flow, wall shear stress and the pressure gradient is obtained by using corresponding boundary conditions. Results for the effects of permeability on blood flow through composite stenosis have been discussed graphically. The considered analysis also summarizes that the drug copper nanoparticles are efficient to reduce hemodynamics of stenosis and could be helpful to predict important uses for biomedical applications. Results indicate that nanoparticles are helpful as drug carriers to minimize the effects of resistance impedance to blood flow or coagulation factors due to stenosis.

  7. Post-operative corticosterone levels in plasma and feces of mice subjected to permanent catheterization and automated blood sampling.

    Science.gov (United States)

    Sundbom, Renée; Jacobsen, Kirsten R; Kalliokoski, Otto; Hau, Jann; Abelson, Klas S P

    2011-01-01

    This study investigated the effects of surgical placement of permanent arterial catheters on plasma corticosterone levels, fecal corticosterone excretion and body weight in male BALB/c/Sca mice. In addition, the effects of voluntarily ingested buprenorphine in doses of 0.5 and 1.0 mg/kg body weight on these parameters were studied. A catheter was placed in the carotid artery during isoflurane anesthesia. Immediately after surgery, the mice were connected to an AccuSampler® μ and blood samples for plasma corticosterone quantification were collected automatically during the first 24 h postoperatively. All fecal boli produced 24 h before and 24 h after surgery were collected for fecal corticosterone excretion measures and the pre- and post-operative body weights were registered. Plasma corticosterone levels were in the range of 150-300 ng/ml after the surgical procedure and the body weight was significantly lower 24 h after surgery compared to its pre-operative value. Contrary to what was expected, the total fecal corticosterone excretion was significantly reduced 24 h after surgery, as was the defecation. Buprenorphine treatment significantly lowered the plasma corticosterone levels, but had no effect on fecal corticosterone excretion or body weight change. It was concluded that surgical placement of an arterial catheter induces a significant stress response, as judged by its effect on plasma corticosterone and body weight. Voluntary ingestion of buprenorphine improved postoperative recovery by lowering plasma corticosterone concentrations. Neither fecal corticosterone excretion nor body weight change seems suitable for postoperative stress assessment in mice in the present experimental setup.

  8. Validation of the use of photogrammetry to register pre-procedure MR images to intra-procedure patient position for image-guided cardiac catheterization procedures

    Science.gov (United States)

    Gao, Gang; Tarte, Segolene; King, Andy; Ma, Yingliang; Chinchapatnam, Phani; Schaeffter, Tobias; Razavi, Reza; Hawkes, Dave; Hill, Derek; Rhode, Kawal

    2008-03-01

    A hybrid X-ray and magnetic resonance imaging system (XMR) has been proposed as an interventional guidance for cardiovascular catheterisation procedure. However, very few hospitals can benefit from the XMR system because of its limited availability. In this paper we describe a new guidance strategy for cardiovascular catheterisation procedure. In our technique, intra-operative patient position is estimated by using a chest surface reconstructed from a photogrammetry system. The chest surface is then registered with the same surface derived from pre-procedure magnetic resonance (MR) images. The catheterisation procedure can therefore be guided by a roadmap derived from the MR images. Patients were required to hold the breath at end expiration during MRI acquisition. The surface matching accuracy is improved by using a robust trimmed iterative closest point (ICP) matching algorithm, which is especially designed for incomplete surface matching. Compared to the XMR system, the proposed guidance strategy is low cost and easy to set up. Experimental data were acquired from 6 volunteers and 1 patient. The patient data were collected during an electrophysiology procedure. In 6 out of 7 subjects, the experimental results show our method is accurate in term of reciprocal residual error (range from 1.66m to 3.75mm) and constant (closed-loop TREs range from 1.49mm to 3.55mm). For one subject, trimmed ICP failed to find the optimal transform matrix (residual = 4.89, TRE = 9.32) due to the poor quality of the photogrammetry-reconstructed surface. More studies are being carried on in clinical trials.

  9. The role of the ECG in diagnosis, risk estimation, and catheterization laboratory activation in patients with acute coronary syndromes: a consensus document.

    Science.gov (United States)

    Birnbaum, Yochai; Nikus, Kjell; Kligfield, Paul; Fiol, Miguel; Barrabés, Jose Antonio; Sionis, Alessandro; Pahlm, Olle; Niebla, J Garcia; de Luna, Antonio Bayès

    2014-09-01

    The electrocardiogram (ECG) is the most widely used imaging tool helping in diagnosis and initial management of patients presenting with symptoms compatible with acute coronary syndrome. Acute ischemia affects the configuration of the QRS complexes, the ST segments and the T waves. The ECG should be read along with the clinical assessment of the patient. ST segment elevation (and ST depression in leads V1 -V3 ) in patients with active symptoms usually indicates acute occlusion of an epicardial artery with ongoing transmural ischemia. These patients should be triaged for emergent reperfusion therapy per current guidelines. However, many patients have ST segment elevation secondary to nonischemic causes. ST depression in leads other than V1 -V3 usually are indicative of subendocardial ischemia secondary to subocclusion of the epicardial artery, distal embolization to small arteries or spasm supply/demand mismatch. ST depression may also be secondary to nonischemic etiologies, such as left ventricular hypertrophy, cardiomyopathies, etc. Knowing the clinical scenario, comparison to previous ECG and subsequent ECGs (in cases that there are changes in the quality or severity of symptoms) may add in the diagnosis and interpretation in difficult cases. This review addresses the different ECG patterns, typically seen in patients with active symptoms, after resolution of symptoms and the significance of such changes when seen in asymptomatic patients.

  10. Introducing ultrasound-guided vein catheterization into clinical practice: A step-by-step guide for organizing a hands-on training program with inexpensive handmade models.

    Science.gov (United States)

    Di Domenico, S; Licausi, M; Porcile, E; Piaggio, F; Troilo, B; Centanaro, M; Valente, U

    2008-12-01

    Sommario INTRODUZIONE: Il catetererismo venoso centrale (CVC) riveste un ruolo fondamentale nella gestione del paziente ospedalizzato. La tecnica eco-guidata è la metodica che assicura una più elevata percentuale di successo e permette un più sicuro e rapido posizionamento di CVC rispetto alla tecnica tradizionale. Tuttavia, la diffusione di tale metodica è ostacolata dall'assenza di uno specifico training durante i corsi di specializzazione in anestesia e chirurgia. Al fine di introdurre la tecnica eco-guidata, abbiamo organizzato un training producendo e utilizzando modelli in agar. METODI: Sono stati costruiti tre differenti modelli utilizzando contenitori per alimenti, segmenti di laccio emostatico, tubo in silicone e gelatina a base di agar. RISULTATI: Un training specifico per la puntura ecoguidata è stato effettuato utilizzando i modelli prodotti. Il training ha consentito una rapida acquisizione delle basi tecniche per effettuare il posizionamento di CVC eco-guidato. Il costo medio di ogni modello è risultato inferiore a 5 euro. DISCUSSIONE: I modelli prodotti in agar si sono rivelati un utile strumento per acquisire la coordinazione di base necessaria per la puntura eco-guidata. Il loro basso costo ne può permettere una ampia diffusione e può incentivare la realizzazione di nuovi percorsi educativi al fine di introdurre tale tecnica nella pratica clinica.

  11. Study on Application of Painless Urethral Catheterization for Prostatic Hyperplasia Patients%前列腺增生患者无痛导尿术的探索

    Institute of Scientific and Technical Information of China (English)

    刘俊雅

    2009-01-01

    前列腺增生症是老年男性常见疾病,前列腺增生可使后尿道受压变形弯曲,使尿道阻力增加,引起尿道梗阻,常需要导尿治疗。在导尿过程中由于患者紧张、疼痛,且前列腺增生引起尿道受压变形导致插管困难,这些刺激可引起患者强烈的应激反应,导致血流动力学改变。为了减轻患者痛苦,提高导尿一次成功率,并观察导尿前20min与导尿插管时患者血压、心率变化,

  12. Referral of patients with ST-segment elevation acute myocardial infarction directly to the catheterization suite based on prehospital teletransmission of 12-lead electrocardiogram

    DEFF Research Database (Denmark)

    Sillesen, Martin; Sejersten, Maria; Strange, Søren;

    2008-01-01

    BACKGROUND: Time from symptom onset to reperfusion is essential in patients with ST-segment elevation acute myocardial infarction. Prior studies have indicated that prehospital 12-lead electrocardiogram (ECG) transmission can reduce time to reperfusion. PURPOSE: Determine 12-lead ECG transmission...

  13. Emergent Median Sternotomy for Mediastinal Hematoma: A Rare Complication following Internal Jugular Vein Catheterization for Chemoport Insertion—A Case Report and Review of Relevant Literature

    Directory of Open Access Journals (Sweden)

    Saptarshi Biswas

    2014-01-01

    Full Text Available Mediastinal hematoma is a rare complication following insertion of a central venous catheter with only few cases reported in the English literature. We report a case of a 71-year-old female who was admitted for elective chemoport placement. USG guided right internal jugular access was attempted using the Seldinger technique. Resistance was met while threading the guidewire. USG showed a chronic clot burden in the RIJ. A microvascular access was established under fluoroscopic guidance. Rest of the procedure was completed without any further issues. Following extubation, the patient complained of right-sided chest pain radiating to the back. Chest X-ray revealed a contained white out in the right upper lung field. She became hemodynamically unstable. Repeated X-ray showed progression of the hematoma. Median Sternotomy showed posterior mediastinal hematoma tracking into right pleural cavity. Active bleeding from the puncture site at RIJ-SCL junction was repaired. Patient had an uneventful recovery. Injury to the central venous system is the result of either penetrating trauma or iatrogenic causes as in our case. A possible explanation of our complication may be attributed to the forced manipulation of the dilator or guidewire against resistance. Clavicle and sternum offer bony protection to the underlying vital venous structures and injuries often need sternotomy with or without neck extension. Division of the clavicle and disarticulation of the sternoclavicular joint may be required for optimum exposure. Meticulous surgical technique, knowledge of the possible complications, and close monitoring in the postprocedural period are of utmost importance. Chest X-ray showed to be routinely done to detect any complication early.

  14. Acesso venoso central guiado por ultrassom: qual a evidência? Ultrasound-guided central venous catheterization: what is the evidence?

    Directory of Open Access Journals (Sweden)

    Felippe Leopoldo Dexheimer Neto

    2011-06-01

    Full Text Available Recentemente, órgãos internacionais de qualidade em saúde passaram a recomendar o uso de orientação ultrassonográfica para punções venosas centrais. O objetivo deste artigo foi revisar as evidências fundamentando tais recomendações. Foi revisada a literatura no MEDLINE, PubMed e SCIELO com os seguintes termos (MeSH: acesso venoso central, ultrassom e adultos. A pesquisa realizada em 24/09/2010, com seleção de metanálises, ensaios clínicos randomizados e revisões, encontrou 291 artigos. Os 21 artigos mais importantes foram utilizados para a confecção desta revisão. A veia jugular interna é o local mais estudado para punções guiadas por ultrassonografia, com metanálises demonstrando menor risco relativo de falha e de complicações. Além disso, o maior ensaio clínico randomizado disponível também demonstrou redução na incidência de infecções de corrente sanguínea associadas aos cateteres venosos centrais. Poucos estudos existem com relação à punção da veia subclávia, porém o uso do ultrassom mostrou-se benéfico em duas metanálises (mas com um número pouco expressivo de pacientes. Quanto ao sítio venoso femoral, há apenas um ensaio clínico randomizado (20 pacientes, o qual obteve resultados positivos. Em uma avaliação britânica de custo-efetividade, houve economia de recursos com o auxílio do ultrassom na realização das punções venosas nos diferentes sítios. Fortes evidências demonstram benefício com o auxílio ultrassonográfico para punção jugular interna. Embora o método pareça atraente para os demais sítios, ainda não há estudos suficientes que sustentem alguma recomendação.In recent years, international health quality assurance organizations have been recommending ultrasound guidance for central venous punctures. This article reviews the evidence behind these recommendations. The MEDLINE, PubMed and SCIELO databases were searched for the following MeSH terms: central venous access, ultrasonography, and adults. The search was conducted on September 24, 2010, and selected meta-analyses, randomized clinical trials and reviews, retrieving 291 papers. The 21 most important papers were analyzed in this review. The internal jugular vein is the most studied ultrasound-guided puncture site, with meta-analysis showing lower relative risks of failure and complications. In addition, the largest available randomized clinical trial demonstrated a reduced central venous catheter-associated blood stream infection rate. There are few studies involving subclavian vein puncture; however, ultrasound was shown to be beneficial in two meta-analyses (however, with small numbers of patients. Regarding the femoral venous site, only one randomized clinical trial (20 patients was identified, showing positive findings. In a British cost-effectiveness study, ultrasound use lead to resource savings for different sites of venous puncture. There is strong evidence for ultrasound benefit for internal jugular vein puncture. Although the method appears attractive for the other sites, the data are not sufficient to support any recommendation.

  15. 床边Seldinger导管法心包置管的临床护理%Clinical Nursing on Pericardial Catheter Ingress by Bedside Seldinger Catheterization

    Institute of Scientific and Technical Information of China (English)

    尚喜艳; 李转珍; 郭瑞贤

    2005-01-01

    心包积液是一种临床常见病。其诊治过程常需做心包穿刺术,以往心包穿刺术致命性并发症高达11.4%-20%。我科自2000年2月-2003年6月对34例病人在床边采用Seldinger导管法,置管引流心包积液。并留置导管进行药物治疗。避免了反复心包穿刺的高危状况。心包置管术操作简单、安全、受到病人欢迎。

  16. The acute metabolic response to breads with contrasting content and composition of arabinoxylans and ß-glucan - metabolomics analysis of plasma from porto-arterial catheterized pigs

    DEFF Research Database (Denmark)

    Nielsen, Kirstine Lykke; Hedemann, Mette Skou; Lærke, Helle Nygaard

    2014-01-01

    A liquid chromatography–MS (LC-MS) metabolomics analysis of plasma from portal–arterial catheterised pigs fed breads prepared with whole-grain rye or wheat flour with added concentrated arabinoxylan (AX) or β-glucan (BG) was conducted. Comparison of the effects of concentrated fibres with whole...... amino acids in plasma correlated with the protein contents in the breads and leucine uptake significantly affected insulin secretion in the mesenteric artery...

  17. Association of Roadway Proximity with Fasting Plasma Glucose and Metabolic Risk Factors for Cardiovascular Disease in a Cross-Sectional Study of Cardiac Catheterization Patients

    Science.gov (United States)

    Background: The relationship between traffic-related air pollution (TRAP) and risk factors for cardiovascular disease needs to be better understood in order to address the adverse impact o.f air pollution on human health.Objective: We examined associations between roadway proximi...

  18. 6 Sigma法在降低留置导尿感染风险中的应用%Application of Six Sigma in Reducing the Infection Risk of Indwelling Urethral Catheterization

    Institute of Scientific and Technical Information of China (English)

    戴慧珊; 施雁; 毛雅芬

    2007-01-01

    目的 规范留置导尿及其护理过程,降低留置导尿感染率.方法 将73例留置导尿患者按住院号单、双分为对照组(38例)和观察组(35例),对照组按无菌操作原则置尿管,置管后以常规方法进行护理;观察组应用6 Sigma改进模式及失效模式测量、分析留置导尿管感染主要原因,改进置管及置管后护理操作流程.结果 留置导尿的第5、7天,观察组尿道口有菌率显著低于对照组(P<0.05,P<0.01);两组中段尿、导尿管和集尿袋接口处有菌率比较,差异无显著性意义(均P>0.05).结论 应用6 Sigma方法系统分析留置导尿感染原因准确,采取的控制感染措施能有效降低留置导尿感染风险.

  19. Pathogenic Bacteria Distribution and Drug Resistance in the Urinary Tract Infection Caused by Urethral Catheterization%留置尿管相关性尿路感染的病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    张晓红; 周云; 陶云珍

    2012-01-01

    Objective To investigate the bacterial spectrum of the CAtlTI and the Bnti-microbial resistance of commonly used antimicrobial agents,and to provide scientific basis for clinical rational use of antibiotics. Methods 427 cases of detaining ure-thral catheter children from July 2009 to July 2011 in Children' s Hospital of Soochow University were collected, urine culture was done in the day before drawing tube,bacteriological culture was performed among any positive,drug sensitive test was conducted to the separated pathogen by Kir-Bauer AGAR diffusion method. Results Among 427 cases of detaining urethra) catheter urine samples of children,53 slrains( 12.4% ) of pathogenic bacteria were separated ,with gram-positive bacteria 31 cases,gram-negative bacteria 20 cases, candida albicans in 2 cases. Gram-positive cocci were highly resistant to rifampin( >77.8% ) ,and had a certain resistance to aminoglycosides, but were sensitive to the linezolid and vancomycin. Enterocoecus faecalis' s resistance to penicillin and levofloxacin were significantly lower than Enterococcus faecium.but almost all of them were resistant to dalfopris-lin. All of the Enterococcus faecium were resistant to penicillin,also had a very high resistance to levofloxacin( >87.5% ). Cram-negative bacteria had a high drug-resistant rate to 1 -3 generations and penicillins (about 75% ) ,were lowly resistant to imipen-em,amikaein, piperacillin-tazobactam, and cefoxitin( <30%). Conclusion Gram-positive enterocoecua and escherichia coli were primarily in urinary catheter related urinary tract infections,and showed multiple resistance;to different pathogens,sensitive drugs were quite different. Drug resistance should be tested before treatment.%目的 了解留置尿管相关性尿路感染(CAUTIU)的细菌谱及其对常用抗菌药物的耐药性,为临床合理使用抗菌药物提供参考.方法 收集苏州大学附属儿童医院小儿泌尿外科2009年7月-2011年7月住院期间留置导尿管患儿427例,在拔管前一天做尿培养,阳性者再行细菌学培养,分离的病原菌以Kir by-Bauer琼脂扩散法行药敏试验.结果 留置导尿管患儿427例尿液标本分离的病原菌53株(12.4%),其中革兰阳性细菌31例,革兰阴性细菌20例,白色念珠菌2例.革兰阳性球菌对利福平耐药率较高(>77.8%),对氨基糖苷类也有一定耐药,但对利奈唑胺和万古霉素都敏感.粪肠球菌对青霉素美及左氧氟沙星的耐药性显著低于屎肠球菌,而对达福普汀几乎全部耐药.屎肠球菌对青霉素全部耐药,对左氧氟沙星也有相当高的耐药性(>87.5%).革兰阴性杆菌对青霉素类及1~3代头孢菌素的耐药率均较高(75%左右),时亚胺培南、阿米卡星、哌拉西林他唑巴坦及头孢西丁的耐药率较低(<30%).结论 留置尿管相关性尿路感染以革兰阳性肠球菌及大肠埃希菌为主,出现多重耐药,不同病原菌敏感药物存在较大差异,建议用药前进行药物敏感试验,抗生素应交叉使用,必要时联合应用.

  20. Ultrasound-guided deep venous catheterization in vascular access for hemodialysis%超声引导下深静脉穿刺置管术建立血管通路在血液透析中的应用

    Institute of Scientific and Technical Information of China (English)

    李绍华; 卓燕; 袁茜; 谢攀; 尹娜; 孙岩; 彭侃夫; 朱俊萍

    2016-01-01

    目的 评价超声引导下行深静脉穿刺置管术建立血管通路在血液透析中的应用价值.方法 选择本院肾科2015年透析患者200例,按就诊序号2∶1比例分为超声定位组(A组)132例和体表解剖标志定位组(B组)68例,观察两组置管成功率、第1针穿刺成功率、穿刺时间、并发症(置管后2周内感染情况、血肿、误穿动脉).采用SPSS 16.0统计软件进行分析.结果 两组置管成功率均是100%,差异无统计学意义(P>0.05);A组颈内静脉和股静脉第1针穿刺成功率分别为96.0%和93.3%,高于B组70.0%和62.5%;A组颈内静脉和股静脉穿刺平均时间分别为(7.15 ±2.59) min和(7.43 ±3.29) min,与B组的(11.24 ±6.49)min和(12.80±5.78) min比较,A组明显少于B组(P<0.05);并发症(血肿)A组1例(0.7%),明显少于B组并发症(血肿、误穿动脉)4例(5.8%);置管2周内感染率A组3例(2.2%)低于B组5例(7.3%).结论 在超声引导下行深静脉穿刺置管术可以提高第一针穿刺成功率,减少穿刺操作时间,减少并发症,值得在血液透析深静脉置管术中推广应用.

  1. Prevalência de estenose das artérias renais em 1.656 pacientes que realizaram cateterismo cardíaco Prevalence of renal artery stenosis in 1,656 patients who have undergone cardiac catheterization

    Directory of Open Access Journals (Sweden)

    Rogério Tadeu Tumelero

    2006-09-01

    Full Text Available OBJETIVO: Determinar a prevalência de estenose da artéria renal (EAR em pacientes submetidos a cineangiocoronariografia. MÉTODOS: Estudo prospectivo, considerando 1.656 cinean-giocoronariografias seguidas de aortografia, entre janeiro/2002 e fevereiro/2004, de pacientes encaminhados à cineangiocoronariografia diagnóstica com história ou não de hipertensão arterial sistêmica (HAS. RESULTADOS: Dos 1.656 pacientes, a idade média foi de 61,6 ± 11,8 anos, 53,8% eram do sexo masculino, 10,2% eram diabéticos, 63,8% apresentavam coronariopatia obstrutiva. A presença de EAR maior que 50% foi observada em 228 (13,8% pacientes, e em 25 (1,5% destes, ocorreu bilateralmente. A coronariopatia obstrutiva foi definida como estenose que causa redução do lúmen do vaso em 50% ou mais, em um, dois ou três vasos principais, denominados uniarterial, biarterial ou triarterial, respectivamente.A quantificação era realizada através da análise visual da angiografia. Comparando os grupos com e sem EAR > 50%, observou-se diferença estatisticamente significativa quanto a gênero, idade, ocorrência de diabete melito, PA e função ventricular esquerda. Não houve diferença significativa, no entanto, quanto à ocorrência de obstrução coronariana > 50%. Quando, porém, a EAR considerada é > 70%, observa-se diferença significativa quanto a PA, associação à obstrução coronariana > 50% e à disfunção ventricular esquerda, maiores no grupo com EAR. CONCLUSÃO: A prevalência de EAR neste estudo foi comparável àquela das grandes casuísticas da literatura e, em razão de sua importância pela associação com HAS e doença renal terminal (DRT e suas seqüelas, devemos estar atentos para seu diagnóstico angiográfico.OBJECTIVE: To determine the prevalence of renal artery stenosis (RAS in patients who have undergone cineangiocoronariography. METHODS: Prospective study of cineangiocoronariography and aortography examinations conducted between January 2002 and February 2004 on 1,656 hypertensive and normotensive patients who underwent the examinations to confirm the diagnosis of obstructive coronary artery disease or valve disease. RESULTS: The average age of the 1,656 patients was 61.6 ± 11.8 years. Eight hundred and ninety-one (53.8% were male, 169 (10.2% were diabetic and 1,054 (63.8% presented obstructive coronary artery disease. Renal stenosis greater than 50% was observed in 228 (13.8% patients, and 25 (1.5% had bilateral stenosis. Obstructive coronary artery disease was defined as stenosis greater than or equal to 50% of the vessel lumen, in one, two or three main arteries, classified as single, double or triple vessels, respectively. Quantification was conducted using visual analysis of the angiography. Comparison of the groups with and without renal artery obstruction > 50%, revealed significant statistical differences in relation to gender, age, diabetes mellitus, blood pressure and left ventricular function. However, no statistical difference was noted in relation to the occurrence of coronary artery obstructions > 50%. Nevertheless, renal artery obstructions > 70%, revealed significant differences in relation to blood pressure, coronary artery obstructions > 50% and left ventricular function, which were all higher in the renal artery obstruction group. CONCLUSION: The prevalence of RAS found in our study was comparable to that reported by major medical literature case studies. RAS is associated with systemic hypertension (SH, end-stage renal disease (ESRD and its sequelae, emphasizing how important it is that we are aware of possible candidates for angiographic diagnosis of this disease.

  2. 中心静脉导管代替胸腔穿刺引流治疗胸腔积液的临床应用%Clinical Application of Central Venous Catheterization Instead of Thoracocentesis for Treating Pleural Fluid

    Institute of Scientific and Technical Information of China (English)

    刘本刚; 郭茜

    2010-01-01

    目的:评价中心静脉导管在胸腔积液治疗中的疗效.方法:选择147例经胸片、胸部CT证实胸腔积液患者,经胸部彩超定位后胸腔中心静脉导管引流.结果:中心静脉导管胸腔置入引流术病人并发症少,痛苦轻,综合费用降低,可代替传统胸腔穿刺或胸腔闭式引流术.结论:中心静脉导管胸腔引流在胸腔积液治疗中有较高的临床应用价值.

  3. Herzkathetereingriffe in Österreich im Jahr 2015 (mit Audit bis 2016 // Austrian National CathLab Registry (ANCALAR: Cardiac Catheterization, Coronary Angiography (CA and PCI in Austria during the Year 2015 (Registry Data with Audit including 2016

    Directory of Open Access Journals (Sweden)

    Mühlberger V

    2017-01-01

    Full Text Available Our independent, purely academic activity is located in the area of health services research, and has also the option to generate benchmarks for individual centres. Participation in our surveys is voluntary but no centre was missing. Since 1992, every year, without interruption 90–100 para meters are applicable. The questionnaire will be optimized and adapted to current conditions. This is done in cooperation with the participating centres. To provide comparability we make only minimal and absolutely most necessary modifications. The data are collected and summarized at the end of the year by each centre itself. During the year the centres are visited to perform audits and to keep personal contact to them.br iHere are the results:/ibr Concerning international comparison for the year 2015/2014, Austria (A/AU/AUT is situated under the top nations in Europe with 6306/6534 Diagnostic Coronary Angiographies (CA, 2591/ 2686 Percutaneous Coronary Interventions (PCI, 381/379 Electrophysiologic Ablations and 77/70 Transarterial Aortic Valve Implantations (TAVI per one million inhabitants.br Numbers concerning non-coronary diagnoses and therapy further increased, coronary procedures decreased both (CA and PCI by –2.2% each, especially when related to the increasing numbers of inhabitants in Austria. Another reason in PCI reduction is the increasing number of intracoronary (i. c. diagnostics without i. c. therapy, i. e. in n = 22 reporting centres 13.1% of PCI were pure i.c. diagnostics during 2015.br A higher mortality of 25.6% in PCI-patients due to pre-existing shock in ST-Segment-elevation- myocardial infarction (STEMI is the main contributor to the constant all over mortality of PCI of 0.91% during 2015. Some centres do not report their mortality numbers at all, the rest of them reports 2.72%/0.32% mortality in their PCI for acute/non-acute cases. 24 hours/7 days on duty were 10 centres in 2015, starting with one to two in 2004 to 2009.br Innovations within the Cath Labs in Austria increased again in 2014/2015, e.g. the leadless pacemaker with n = 32/64, other “new devices” of the foregoing years decreased: bioresorbable vascular scaffolds (BVS; “BioStent” decreased by 37.5% from 7.4% of PCI in 2014 to 4.7% in 2015 (n =1058 cases. Percutaneous Renal Denervation suffered the expected downslope 2014 and 2015. On the other hand it takes years until scientific knowledge – downgraded as class II– III indications in the guidelines – really decreases. This is evident 2015 again concerning intraarterial balloon pump (n = 208 cases in 2010 and n = 69 cases in 2015.br Further on it is still observed, that scientific knowledge, recommended as class I indications in the guidelines, takes several years to establish itself nationwide, or in a special case concerning antithrombotic management in the CathLab, direct thrombin inhibitors already decrease from1,406 (6.8% of PCI in 2014 – reporting centres only to n = 858 (4.5% of PCI in 2015 – reporting centres only before they are established.br The continuous increase in PCI-cases using non-femoral (mostly radial puncture techniques showed increasing 31%/40%/43% of PCI during the years 2013–2015. A sometimes necessary switch to femoral techniques during PCI in 8.8%/8.6% of PCI was documented 2014/2015! 50% of cases in pure diagnostic CA were started using non-femoral (mostly radial techniques, but, at the same time, PCI during diagnostic study (ad hoc decreased from n = 18.597 (80.7% to n = 16.652 (73.9% from 2014 to 2015; so patients are dismissed to perform PCI for a femoral approach later.br Left main and bifurcational stents (for large side branches, n = 1454 increased both from 2.0%/6.7% in 2011 to 2.5%/9.2% of PCI in 2015 (reporting centres only. Additional increasing numbers in multi-vessel-PCI (reporting centres = 19.2% of PCI in 2015, in multiple-stent-PCI (reporting centres = 40.3% of stent cases in 2015 and in chronic total occlusion- (CTO- PCI (n = 790 until 2015 reveal more complex interventions compared to the years before.br Reintervention (REDO – due to restenosis – reporting centres observed rather an increase than a reduction during 2010–2015 from 4.6% to 4.7% in such cases (4.2% in 2014 – reporting centres only. Since 2010 (15.2% to 2015 (15.4% the relative percentage of late, chronic stent thromboses stayed constant in those REDO cases. So neither REDOs nor late, chronic stent thromboses could really be improved from 2010 to 2015 in spite of the use of dual antiplatelet therapy (DAPT.br The data for 2015 are presented in Vienna (November 18th–19th, 2016 at the autumn meeting of the working group “Interventional Cardiology of the Austrian Society of Cardiology” (ÖKG, as a basis for discussion. The presentation will also be placed under the website a href="http://iik.i-med.ac.at"http://iik.i-med.ac.at/a bKurzfassung:/b Im internationalen Vergleich für das Jahr 2015/2014 liegt Österreich (A/AU/AUT mit 6306/6534 diagnostischen Koronarangiographien (CA, 2591/2686 perkutanen Koronarinterventionen (PCI, 381/379 elektrophysiologischen Ablationen und 77/70 transarteriellen Aortenklappenimplantationen (TAVI bezogen auf eine Million Einwohner weiterhin im europäischen Spitzenfeld.br Die Eingriffe an den Herzklappen und an der Reizleitung nehmen weiterhin zu, Eingriffe wie CA und PCI – insbesondere nach Bezug auf die zunehmende Bevölkerungszahl – nehmen ab, jeweils –2,2 %. Teilursache des Rückgangs bei PCI ist die zunehmende intrakoronare (i. c. Diagnostik mit Devices ohne daraus folgende PCI. Bei n = 22 meldenden Zentren im Jahr 2015 war es 13,1 % reine (i. c. Diagnostik bezogen auf die Anzahl der therapeutischen PCI.br Die erhöhte Mortalität von 25,6 % bei Patienten mit PCI wegen ST-Hebungsinfarkten (STEMI und konsekutivem Schock ist hauptverantwortlich für die konstante Gesamtmortalität nach PCI von 0,91 %. Nicht alle Zentren melden Todesfälle. Jene Zentren, die Todesfälle für akute/nichtakute PCI melden, lassen eine Mortalität von 2,72/0,32 % berechnen. Die 24-Stunden-Teamanwesenheit in den Zentren steigt deutlich (2004–2009 meldeten 1–2 Labore und 2016 waren es 10 Labore.br Der BioStent – eine Innovation des Jahres 2011 – nimmt wieder drastisch um 37,5 % auf n = 1058 Fälle im Jahr 2015 (4,7 % der PCI gegenüber 2014 (7,4 % der PCI ab.br Die intrakoronare Druckmessung (FFR = „fractional flow reserve“ nimmt zu (14,0 % aller PCI im Jahr 2015 und die Anwendung ohne Adenosin (eine Innovation des Jahres 2014 – „wavefree“ – „instantaneous flow reserve“ – iFR steigt auf n = 64 Fälle im Jahr 2015 an.br Der Anteil der PCI-Fälle, welche 2013/2014/ 2015 mittels nicht-femoraler (meist radialer Punktion begonnen wurden, zeigten eine anhaltende Steigerung (31/40/43 % der PCI. Jener Anteil von Fällen, welche unmittelbar einen Wechsel auf femoral erforderten, blieb bei den meldenden Zentren 2014/2015 konstant (8,8/ 8,6 %. Der Anteil der CA-Fälle, welche 2015 mittels nicht-femoraler Punktion begonnen wurden, betrug 50 % der CA. Eine CA plus die PCI „in einem Akt“ nimmt bei diesen Zentren gleichzeitig ab von n = 18.596 auf 16.652 Fälle (80,7 % auf 73,9 %: teilweise wird nach CA neu einbestellt, um dann transfemoral zu therapieren.br Hauptstammstents (2,0 vs. 2,5 % der PCI der meldenden Zentren; 2011 vs. 2015 und Bifurkationstents sehr großer Seitenäste nahmen zuletzt von n = 830 Fällen im Jahr 2011 auf n = 1454 Fälle im Jahr 2015 zu ( 6,7 vs. 9,2 % der PCI der meldenden Zentren; 2011 vs. 2015. Weitere Zunahmen bei Mehrgefäß-PCI (meldende Zentren = 19,2 % der PCI; 2015, multiplen Stents (meldende Zentren = 40,3 % der Stents; 2015 und bei chronisch totaler Okklusions- (CTO- PCI (n = 790 bis 2015 belegen, dass komplexer interveniert wird als in den Vorjahren.br Bei Auswertung nur der meldenden Zentren nehmen Eingriffe wegen Restenosen eher zu als ab, auf 4,7 % im Jahr 2015 (4,2 % im Jahr 2014, aber 4,6 % im Jahr 2010, und es bleibt der relative Anteil der späten, chronischen Stentthrombosen seither konstant (15,4 % im Jahr 2015 gegenüber 15,2 % im Jahr 2010. Somit gingen weder die späten, chronischen Stentthrombosen noch die Reeingriffe unter dualer oraler Antikoagulantion (DOAK zwischen 2010 und 2015 wirklich zurück.br 2014/2015 kam es zu einer Innovation im Katheterlabor, dem „Leadless Pacemaker“, mit einer Zunahme auf n = 32/64 Fälle. Den erwarteten starken Rückgang 2014 und 2015 erlebte die renale Denervation.br Weiterhin besteht das Phänomen, dass wissenschaftliche Erkenntnisse, die ihrerseits als Klasse-I-Indikationen in den Richtlinien empfohlen werden, mehrere Jahre benötigen, um sich flächendeckend zu etablieren bzw. nimmt z. B. die Meldung direkter Thrombininhibitoren bei PCI 2014/2015 sogar ab (n = 1406/858 auf 3,8 % (Werte wie vor dem Jahr 2011 bei gepoolter Auswertung, bei meldenden Zentren ein Rückgang von 6,8% auf 4,5 %.br Die Daten für 2015 dienen in Wien (18./19.11.2016 im Rahmen der Herbsttagung der Arbeitsgruppe „Interventionelle Kardiologie” der „Österreichischen Kardiologischen Gesellschaft“ (ÖKG unter anderem als Diskussionsgrundlage. Die Präsentation 2015 ist unter a href="http://iik.i-med.ac.at"http://iik.i-med.ac.at/a ersichtlich.

  4. The clinical analysis of persistently pleural drainage with central venous catheterization to treat tuberculous pleuritis%胸腔置管持续引流治疗结核性胸膜炎206例临床分析

    Institute of Scientific and Technical Information of China (English)

    陈欲晓; 孙根辉

    2006-01-01

    目的:探讨胸腔置入中心静脉导管持续引流治疗结核性胸膜炎的临床疗效.方法:将392例结核性胸膜炎患者分为2组:治疗组206例,采用中心静脉导管置入胸腔持续引流胸水;对照组186例,采用常规胸腔穿刺抽胸水.比较2组患者治疗后胸水消失时间及3、7、14 d后胸水吸收率.结果:治疗组胸水消失时间(7±5) d,对照组(17±9) d,有明显差异;治疗组3、7、14 d胸水吸收率均显著高于对照组,差异有统计学意义(P<0.05).结论:胸腔置管持续引流治疗结核性胸膜炎疗效确切,操作简便,值得推广.

  5. The clinical analysis of persistently pleural drainage with catheterization to treat tuberculosis pleuritis in 126 cases%胸腔置管引流治疗结核性胸膜炎126例临床分析

    Institute of Scientific and Technical Information of China (English)

    朴范洙; 金善姬; 尹龙德; 金京爱

    2011-01-01

    目的:探讨和评价胸腔置管引流及胸腔内给药治疗结核性胸膜炎的疗效和价值.方法:在全身抗结核治疗基础上,治疗组126例结核性渗出性胸膜炎患者,采用胸腔内置管持续引流及胸腔内给药方法,对照组120例结核性渗出性胸膜炎患者,每次B超定位后胸腔穿刺,每周1~2次,每次抽尽胸腔积液后胸腔内注入药物.结果:治疗组完全好转98例,占77.78%,有效率为98.41%,对照组完全好转71例,占59.17%,有效率为90%.结论:胸腔置管引流及胸腔内给药治疗结核性胸膜炎操作简单、安全,有效率高,值得临床广泛推广应用.

  6. 探讨心脏介入性治疗中并发心脏压塞的原因及诊断治疗%Investigate the Cause and Diagnosis of Cardiac Catheterization in the Treatment of Cardiac Interventional Therapy

    Institute of Scientific and Technical Information of China (English)

    牛思泉

    2015-01-01

    Objective:To investigate the reasons,diagnosis and treatment methods of cardiac tamponade in treatment of cardiac interventional therapy. Method:The clinical data of 487 patients with cardiac interventional therapy in hospital the were selected from January 2010 to November 2014,the cardiac tamponade was diagnosed by clinical manifestations, echocardiography and X-ray examination.Once found patients with cardiac tamponade,immediately stop cardiac interventional therapy,they were given pericardiocentesis drainage,pericardial incision and drainage in the treatment of surgery,coronary artery bypass surgery and repair of coronary artery.Result:487 patients in our hospital with cardiac interventional therapy occurred in 3 cases of cardiac tamponade complications,the incidence was 0.62%. The incidence of reason:atrial septal mistaken puncture into the left atrial wall,left atrial wall damage,coronary artery rupture and pericardial tamponade.2 patients had disease by X-ray examination confirmed,another 1 cases of patients with X-ray examination normal,after echocardiography confirmed the disease.1 cass underwent pericardial puncture treatment,1 patiens underwent pericardial incision and drainage treatment, the other 1 patient underwent coronary artery bypass surgery and coronary perforation repair.After the treatment,3 patients with no adverse reaction,hemodynamic indexes in normal condition to restore stability ,good condition and prognosis. Conclusion:Cardiac tamponade in cardiac interventional therapy is an extremely rare and more dangerous complications.The timely discovery, quickly identify the cause and appropriate treatment is the guaranteed for patients with a good prognosis.%目的:探讨分析心脏介入性治疗中并发心脏压塞的原因、诊断及治疗方法。方法:分析该院2010年1月-2014年11月间收治的487例心脏介入性治疗患者的临床资料,根据患者的临床表现、超声心动图检查以及X线检查诊断心脏压塞。一旦发现患者出现心脏压塞的症状,立即停止心脏介入性治疗,采取心包穿刺术引流、心包切开引流术、冠状动脉搭桥术和冠状动脉修补术等治疗。结果:本院收治的487例心脏介入性治疗患者中发生心脏压塞并发症患者为3例,发生率为0.62%。发病原因为:房间隔穿刺时误穿左心房壁、左心房壁受损,冠状动脉破裂及心包压塞。2例患者病情经X线片检查得以证实,另外1例患者X线片检查无异样,后经超声心动图检查证实病情。1例患者行心包穿刺术治疗,1例患者行心包切开引流术治疗,另1例患者行冠状动脉搭桥术和破裂冠状动脉修补术,治疗后3例患者均未出现不良反应,血流动力学指标正常,病情恢复稳定,预后状况良好。结论:心脏压塞是心脏介入性治疗中一种极为少见并且较为危险的并发症,及时发现、快速认清病因并进行恰当处理,是患者有良好预后的保证。

  7. 10 Cases of Nursing Experience of Dexamethasone Injection Treatment of Venous Catheterization Skin Allergy%地塞米松注射液治疗静脉置管皮肤过敏10例护理体会

    Institute of Scientific and Technical Information of China (English)

    高凌云

    2014-01-01

    Objective:To explore the deep venous catheter in PICC or al ergic reaction to the skin care ef ect of dexamethasone injection. Methods: from 2012 October to 2013 September in our hospital in 10 cases of local skin al ergy patients using dexamethasone injection coated and strengthen. The papula, blister patients: general y do not use alcohol wipe can be used for the first time, saline local sebum clean, with 0.5% iodophor disinfectant to be dried, coated with dexamethasone injection, to avoid the at ention of bubble film, IV3000 film can be pruned, increase the bandage times, general 2-3 day. Results: the use of dexamethasone, patients with a local al ergic skin, obviously relieve among papules, erythema, cure. No cases of lead to extubation due to local skin al ergic reaction. Conclusion: Dexamethasone Injection in the treatment of catheter after the skin has a good curative ef ect, is worth the clinical promotion.%目的:探讨地塞米松注射液在PICC或深静脉置管局部皮肤过敏护理效果。方法选取2012年10月~2013年9月我院对10例置管局部皮肤过敏患者使用地塞米松注射液外涂并加强换药。对丘疹、水疱患者:一般不使用酒精首次擦拭,可选用生理盐水进行局部皮脂清洁,再用0.5%碘伏常规消毒待干,外涂地塞米松注射液,贴膜时注意避开水泡,可修剪IV3000贴膜,增加换药次数,一般1次/2~3d。结果使用地塞米松后,患者局部过敏皮肤风疹团、丘疹明显缓解,红斑消退,达到治愈。无1例因局部皮肤过敏反应导致拔管。结论地塞米松注射液治疗置管后皮肤过敏有较好的疗效,值得临床推广。

  8. Application of evidence-based nursing on urine release for catheterization after cesarean section.%循证护理在剖宫产术后导尿放尿方法中的应用

    Institute of Scientific and Technical Information of China (English)

    杨红梅; 何丽娜

    2010-01-01

    目的:探讨循证护理在剖宫产术后导尿不同放尿方法的护理中的应用.方法:将剖宫产产妇117例随机分为对照组57例和实验组60例,对照组采用持续放尿法;实验组提出问题,并进行文献检索,对查出的相关文献进行分析、探讨,选出最佳论据,指导护理实践.结果:对照组与实验组放尿方法比较,一次排尿成功率有显著性差异(P<0.01),拔管后自行排尿时间比较,差异有高度统计学意义(P<0.01),两组均未发生子宫复旧不良和产后出血.结论:循证护理提高了护理实践的科学性,有利于护理人员主动学习和密切医护患关系,推动护理科研的开展.

  9. 脑卒中患者心脏导管术后再发急性脑血管意外分析%Cerebral vascular accidents after cardiac catheterization in patients with anamnesis of stroke

    Institute of Scientific and Technical Information of China (English)

    张华; 张茁

    2007-01-01

    探讨既往患有脑卒中的患者行心脏导管术(CC)后再发脑血管病的特点以及相关因素分析.方法 对892例实施了CC术的既往患有脑卒中的患者进行回顾性分析,通过对患者的一般状况、心脏血管病变数量、分布、治疗情况以及出现再发脑卒中的情况和相关因素进行分析.结果 术中和术后24 h内101例患者出现脑卒中,占11.32%,33例出现短暂脑缺血发作(TIA),64例发生了急性脑梗死(CI),4例并发脑出血(CH).Logistic回归分析显示脑血管患者CC术后再次出现急性脑血管意外的危险因素包括:男性、饮酒,高脂血症、患有外周血管病、心脏血管病变的数量以及治疗方法有关.结论 脑血管患者CC术后再次出现急性脑卒中的危险因素包括:男性、饮酒,高脂血症、患有外周血管病、心脏血管病变的数量以及治疗方法.

  10. Modified Seldinger Catheterization Technique for Pericardial Indwelling Catheter Drainage Large Refractory Pericardial Effusion%改良Seldinger介入置管法治疗顽固性大量心包积液

    Institute of Scientific and Technical Information of China (English)

    赵费敏; 谢波; 韦凡平; 袁高辉

    2004-01-01

    目的:探求治疗顽固性大量心包积液(RLPE)安全、有效、简便的置管引流方法.方法:选用美国ARROW公司生产的中心静脉置管装置,在心超引导下,对12例RLPE采用Seldinger's经皮穿刺心包留置导管,进行全封闭适度负压持续引流.结果:不仅装置简便、操作简化、定位准确,而且置管可靠、引流彻底、疗效确切,无不良反应及损伤.结论:该介入置管法是对传统置管方法的改进,是目前RLPE科学和实用的引流治疗方法.

  11. 经动脉导管脾栓塞术致上消化道出血1例%A case of upper digestive tract hemorrhage caused by transarterial catheterization splenic thrombosis

    Institute of Scientific and Technical Information of China (English)

    徐淑红; 樊红伟; 王旭东; 刘莉; 刘梅

    2001-01-01

    @@1 临床资料 男性,48岁,两年前患者经常低热、乏力、食欲不振,易发创伤性皮下瘀血,症状加重1m而入院。查体:全身多处陈旧及新发皮下瘀血、脾肿大、下界在左肋也3.0cm、双下肢轻度浮肿。检查:血色素111g/L,血细胞总数:3.0×109L,血小板102×109L,肝肾功能正常,复部B超:肝硬化、脾大。骨髓穿刺涂片:细胞增生改变。诊断:"肝硬化、脾肿大、脾功能亢进"。

  12. Impacto de la implantación de recordatorios para disminuir eventos adversos en pacientes con accesos venosos periféricos Impact of implementation of reminders to reduce adverse effects in patients with peripheral venous catheterizations

    Directory of Open Access Journals (Sweden)

    T. Sebastian-Viana

    2012-12-01

    Full Text Available Fundamento. Medir el impacto clínico de la implantación de un sistema de recordatorios, que avise de los pacientes que tienen riesgo de presentar un evento adverso (EA relacionado con los catéteres venosos periféricos. Métodos. A partir de los registros que se utilizan para seguimiento de los catéteres intravenosos se desarrolló una consulta automatizada que elabora un listado de los pacientes ingresados que incluye fecha de ingreso, fecha colocación, vía y tipo de vía. Se actualiza por turno en los ordenadores de la unidad. Se implantó en enero de 2010. Se ha realizado un estudio cuasiexperimental midiendo la incidencia acumulada de flebitis, extravasaciones y obstrucciones en los pacientes dados de a en 2009 y en 2010. Se ha evaluado la asociación entre variables cualitativas con el test de Chi cuadrado, se ha estimado riesgo relativo (RR y el número necesario de pacientes a tratar (NNT. Resultados. En el año 2009 fueron dados de a en las unidades de estudio 9.263 pacientes y en 2010, 9.220 pacientes. Los resultados encontrados han sido: Pacientes que desarrollan flebitis 2010/2009: RR: 0,827 (pBackground. The main purpose of this paper is to measure the clinical impact of the implementation of a reminder system that would warn of patients who are at risk of presenting an adverse event (AE related to the peripheral venous catheter. Method. On the basis of the registers used for monitoring intravenous catheters, an automated consultation was realized that elaborated a list of the patients admitted, including: date of admission, date of the insertion of the venous access device, and type of device. It was implanted in January 2010 and updated three times a day with the computers of the unit. A quasi-experimental study has measured the cumulative incidence of phlebitis, extravasation and obstructions in the patients registered in 2009 and 2010. The association between qualitative variables was evaluated with the Chi-squared test, and relative risk (RR and Number Needed to Treat (NNT were estimated. Results. Nine thousand two hundred and sixty-three patients were registered in the studied units in the year 2009, and 9,220 patients in 2010. The results were the following: Patients with phlebitis 2010/2009: RR: 0.827 (p < 0.001. Patients with extravasations 2010/2009: RR: 0.804 (p < 0.001. Patients with obstructions 2010/2009: RR: 0.954 (p < 0.554. Conclusion. With the help of a reminder list (which includes the patients with vascular access and the date, there has been a decrease in the number of phlebitis and extravasations but not in the number of obstructions.

  13. Using and Nursing Care of Deep Vein Catheterization in The Emergency Treatment of Hypovolemic Shock%深静脉置管在低血容量休克抢救中的运用及护理

    Institute of Scientific and Technical Information of China (English)

    罗瑛

    2010-01-01

    目的:探讨深静脉置管在低血容量休克抢救中的运用及护理体会.方法:选择不同病因的低血容量休克患者66例,在抢救过程中使用深静脉置管术.术后导管的维持主要依靠精心的护理及并发症的预防与积极处理.结果:66例患者在滴注中,1例发生导管源性感染,2例发生导管堵塞,经试通无效被迫拔管,均发生在深静脉置管的初期阶段,无血栓栓塞事件发生.结论:深静脉置管可以为成功抢救低血容量休克赢得时间.只有充分认识深静脉置管术的特点,并根据术后不同阶段的病理生理特点采取适当的护理策略,才能尽最大可能减少术后的并发症,达到最理想的治疗目的.

  14. 预见性护理对胸心外科患者中心静脉置管并发症的影响%Nursing intervention on prevention complications of central venous catheterization of cardiothoracic surgery patients

    Institute of Scientific and Technical Information of China (English)

    叶京英; 彭慧娟

    2014-01-01

    Objective:To explore the application of central venous catheter in cardiothoracic surgery patients and complications observation and nursing. Meth-ods:182 cases of deep venous catheter were randomly divided into observation group (n=86) and control group(n=96). The control group received routine care of central venous catheter. The observation group were given conventional central venous catheter care and implementation of nursing intervention. Results:The incidence of complications in observation group was lower than that of control group (P<0. 05). Conclusion:Patients with central venous catheter to per-form nursing interventions can effectively reduce the incidence of central venous catheter complications.%目的:探讨预见性护理对胸心外科患者中心静脉置管并发症的影响。方法:选择我科2013年1~8月182例深静脉置管患者为研究对象,随机分为观察组86例和对照组96例。对照组给予中心静脉置管常规护理,观察组在对照组基础上实施预见性护理。结果:观察组患者并发症发生少于对照组,两组比较差异有统计学意义(P<0.05)。结论:对中心静脉置管患者进行预见性护理,能有效降低中心静脉置管并发症的发生。

  15. 直肠超声下前列腺囊肿置管硬化治疗探讨%Catheterization for sclerosis therapy of prostate cyst guided By transrectal ultrasonography

    Institute of Scientific and Technical Information of China (English)

    王树松; 颜翠兰

    2002-01-01

    目的探讨直肠超声引导穿刺并置管在前列腺囊肿硬化治疗中的应用. 方法在直肠超声引导下,对前列腺囊肿进行穿刺置管,抽尽囊液、冲洗囊腔、注入无水酒精. 结果 21例均成功置管并进行硬化治疗.随访6月~18个月,21例囊肿均消失. 结论直肠超声引导穿刺前列腺囊肿准确可靠,置管硬化治疗方便、安全、有效.

  16. A case of right renal infarction and subcapsular hematoma that simultaneously developed after cardiac angiography.

    Science.gov (United States)

    Kwon, S H; Cho, H C; Lee, S W; Kim, D Y; Joo, W C; Lee, W H; Song, J H; Kim, M-J

    2009-01-01

    Of the several complications known to develop after cardiac catheterization, simultaneous acute renal infarction and renal subcapsular hematoma is rare. Here, the authors report a case of acute renal infarction with subcapsular hematoma that developed 4 hours after cardiac catheterization.

  17. Urinary incontinence - what to ask your doctor

    Science.gov (United States)

    ... to help with my urinary incontinence? What are Kegel exercises? What can I do when I want ... tape Urinary incontinence - vaginal sling procedures Patient Instructions Kegel exercises - self-care Self catheterization - female Self catheterization - ...

  18. Arrhythmias (For Parents)

    Science.gov (United States)

    ... Child If Your Child Has a Heart Defect Coarctation of the Aorta Cardiac Catheterization Mitral Valve Prolapse ... Atrial Septal Defect Arrhythmias Cardiac Catheterization EKG (Video) Coarctation of the Aorta Atrial Septal Defect Ventricular Septal ...

  19. Percutaneous microcrystalline chitosan application for sealing arterial puncture sites

    NARCIS (Netherlands)

    Hoekstra, A; Struszczyk, H; Kivekas, O

    1998-01-01

    Arterial catheterization is one of the most frequently performed inpatient diagnostic and therapeutic procedures in the development countries. Complications may occur after any catheterization from inadequate hemostasis, particularly in the setting of aggressive anticoagulation. This study suggests

  20. Clinical effect of peripherally inserted central catheters based on modified seldinger technique under guidance of vascular ultrasound

    Science.gov (United States)

    Wang, Qingguo; Wang, Ni; Sun, Yuzhen

    2016-01-01

    Objective: To observe and analyze the application effect of ultrasound-guided modified Seldinger technique (MST) in Peripherally Inserted Central Catheter (PICC) catheterization. Methods: Two hundred patients treated with PICC catheterization from January 2013 to December 2015 were selected and randomly divided into two groups, namely, observation group and control group. The observation group adopted ultrasound-guided MST for catheterization while the control group applied traditional puncture technique for catheterization. Then efficacy of catheterization, success rate of catheterization and incidence rates of complications were compared between two groups. Results: Various indicators of catheterization effects of the observation group were better than those of the control group, and the differences were statistically significant (Psatisfaction and comfort level of patients. PMID:27882017

  1. Duration and Adverse Events of Non-cuffed Catheter in Patients With Hemodialysis

    Science.gov (United States)

    2014-10-09

    Renal Failure Chronic Requiring Hemodialysis; Central Venous Catheterization; Inadequate Hemodialysis Blood Flow; Venous Stenosis; Venous Thrombosis; Infection Due to Central Venous Catheter; Central Venous Catheter Thrombosis

  2. Percutaneous interventions in Fontan circulation

    Directory of Open Access Journals (Sweden)

    Eduardo Franco

    2015-09-01

    Conclusions: Interventional catheterization procedures are often necessary to reach and maintain the fragile Fontan circulation, mainly in patients with right morphology systemic ventricles and fenestrated Fontan conduits.

  3. 留置导尿对全麻单侧膝关节置换术患者尿路刺激症状的影响%Effects of retention catheterization on urinary irritation symptoms in patients received general anesthesia unilateral knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    张捷; 徐梅; 王英丽; 赵晶

    2016-01-01

    目的:探讨全麻单侧膝关节置换术( TKA)患者术中是否留置导尿对患者术后发生尿路刺激症状的影响。方法2015年12月—2016年2月将95例拟行初次单膝TKA手术患者随机分为术前非留置导尿管( NIC)组和术前留置导尿管( IC)组。 IC组( n=48)全麻后留置尿管,于术后24 h内拔除导尿管;NIC组患者( n=47)术中不进行导尿。比较两组术后24 h内尿潴留、尿路刺激征等症状及主观感受。结果 NIC组患者术后出现尿潴留3例,尿路刺激0例,IC组术后出现尿潴留1例、尿路刺激5例,两组尿潴留、尿路刺激发生率比较,差异无统计学意义( P>0.05);两组均无尿路感染发生。术后NIC组患者镇静程度评估量表评分为(3.89±0.31)分,IC 组为(4.06±0.24)分,两组比较差异有统计学意义(t=-2.941,P0.05) . No urinary tract infection cases in two groups. The score of sedative degree of patients in the NIC group was (3.89±0.31), and was (4.06±0.24) in the IC group (t=-2.941,P<0.05).Conclusions The risk of urinary irritation was higher in IC group than in NIC group when received total anesthesia in TKA. Indwelling urinary catheter is not routinely needed in TKA, non-indwelling urinary catheter can contribute to increasing the comfort of surgery.

  4. 多磺酸粘多糖乳膏外用与湿热敷法预防肿瘤患者PICC置管后静脉炎的效果比较%Effect comparison of hirudoid cream and wet-hot compress on preventing phlebitis after PICC catheterization in cancer patients

    Institute of Scientific and Technical Information of China (English)

    张淑香; 李峥

    2014-01-01

    目的 探讨多磺酸粘多糖乳膏外用与湿热敷法两种干预措施对肿瘤患者PICC置管后静脉炎的效果.方法 选取首次进行PICC置管的患者396例,分为多磺酸粘多糖乳膏外用组196例和湿热敷组200例,给予两组患者相同的健康教育,比较两组患者静脉炎的发生率以及静脉炎的严重程度.结果 两组患者静脉炎发生率及严重程度比较差异均无统计学意义(P>0.05).结论 多磺酸粘多糖乳膏外用与湿热敷法均可用于预防肿瘤患者PICC置管后静脉炎,临床中可根据患者经济状况及舒适需求自主选择.

  5. Prognostic values of common definition of contrast-induced nephropathy after coronary catheterization in patients with normal serum creatinine%造影剂肾病常用定义对基线肌酐正常患者的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    吴登轩; 谭宁; 刘勇; 赵健斌; 刘远辉; 李华龙; 王岩

    2016-01-01

    Objective To evaluate the prognostic values of common definition compared to traditional definition of contrast-induced nephropathy (CIN) in patients with normal serum creatinine (SCr). Methods Patients undergoing percutaneous coronary angiology or intervention with normal baseline SCr were enrolled prospectively. Those who were diagnosed as CIN according to common definition were divided into two groups based on the peak increase from baseline in the SCr concentration within 48 ~ 72 hours after the procedure: ≥ 44.2 μmol/L (CIN44.2 group, in common with traditional definition), ≥25% of baseline to < 44.2 μmol/L (CIN25%-44.2 group, interval between the two definitions). Hospital stay and long-term outcomes were compared among CIN44.2, CIN25%-44.2, and non-CIN groups. Results Of all 3,044 patients enrolled, 302 (9.9%) patients developed CIN according to common definition including CIN44.2 occurred in 56 (1.8%) patients and CIN25%-44.2 in 246 (8.1%) patients. Patients in CIN44.2 group indicated significant longer hospital stay and long-term outcomes compared with non-CIN group (P < 0.05). However, patients in CIN25%-44.2 group had similar in-hospital mortality and long-term cumulative risk of major clinical adverse events (MACE) and death with non-CIN group (all, P = 1.00). Multivariate Cox proportional hazard analyses also demonstrated that CIN25%-44.2 did not associate with long-term MACE (HR 1.16, P = 0.645) and death (HR 0.98, P = 0.964) after adjusting for potential confounding factors. Conclusions For patients with normal baseline SCr, common definition based on traditional definition of CIN is unreasonable and overestimates the incidence of CIN, whose extension of traditional denifition proves no significant clinical value.%目的:评估造影剂肾病(CIN)常用定义与传统定义相比在基线血清肌酐(SCr)正常患者中的临床应用价值。方法:前瞻性入选行冠脉介入诊疗术且基线SCr正常的患者,根据术后48~72 h内SCr升高程度将常用定义CIN患者分为两组:CIN44.2组(同传统定义,≥44.2μmol/L)和CIN25%-44.2组(较传统定义扩充部分,<44.2μmol/L,但≥25%基线值),与非CIN患者比较住院及远期预后差异。结果:入选3044例患者,发生常用定义CIN 302例(9.9%),其中CIN44.2组56例(1.8%),CIN25%-44.2组246例(8.1%)。与非CIN组相比, CIN44.2组住院及远期随访合并主要临床不良事件(MACE)和死亡发生率均显著升高(P <0.05);CIN25%-44.2组住院死亡率及远期MACE和死亡累积发生风险与非CIN组相比差异均无统计学意义(均P =1.00)。多因素Cox回归仍表明CIN25%-44.2对患者MACE(HR 1.16,P =0.645)和死亡(HR 0.98,P =0.964)风险无显著影响。结论:对于基线SCr正常的患者,CIN常用定义高估CIN发生率,其较传统定义扩充部分无显著临床价值。

  6. Clinical observation on pericardial effusion in patients with lung cancer treated by intrapericardial catheterization and infusion of highly agglutinative staphylococcin and cisplatin%高聚生联合顺铂心包腔内灌注治疗肺癌致心包液的临床观察

    Institute of Scientific and Technical Information of China (English)

    江启安; 周毅得; 程桂娥

    2006-01-01

    Objective: To evaluate the therapeutic efficacy of injecting highly agglutinative staphylococcin (HASL) and cisplatin into pericardial cavity of lung cancer patients with pericardial effusion.Methods: 81 patients were randomized into two groups:45 in the experimental group (HASL and Cisplatin) and 36 in the control group (Cisplatin).At first pericardial effusion was drained out from a intrapericardial catheter and then different drugs were infused,respectively.24 h after perfusion the draining continued again until drainage quantity was less than 30 mL every day.The draining lasted 10-15 days.Results: The response rate was 91.1% for the experimental group and 80.6% for the control group.There was no significant difference between the two groups(P>0.05).The complete remission was 77.8% for the experimental group and 52.8% for the control group,which was statistically significant difference (P<0.05).The adverse effects were myelosuppression and nausea and vomiting,which were 35.6% and 40.0% in the experimental group and 72.2% and 66.7% in the control group,respectively (P<0.01,P<0.05).Conclusion: Injecting HASL and cisplatin into pericardial cavity may be a better way to control pericardial effusion of lung cancer.

  7. Clinical investigation of trans-jugular catheterization thrombolysis combined with trans-dorsalis pedis vein access in the treatment of compound deep venous thrombosis of the lower limbs%经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成

    Institute of Scientific and Technical Information of China (English)

    崔艳峰; 祖茂衡; 徐浩; 顾玉明; 李国均; 张庆桥; 魏宁; 许伟

    2010-01-01

    目的 探讨经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成的临床疗效.方法 回顾性分析78例混合型下肢深静脉血栓形成患者临床资料.放置下腔静脉滤器后,经颈静脉置管溶栓治疗,同时予以经患侧足背静脉溶栓治疗.观察术后患者的临床症状和体征变化,行彩超评价静脉通畅程度,患者出院后经门诊随访其近期疗效.结果 78例患者成功经右颈内静脉置管以及经患侧足背静脉溶栓.48例患者放置下腔静脉滤器,滤器放置成功率100%.术后患者的临床症状均明显缓解,彩超示下肢深静脉血流通畅.患者出院后随访1年,随访结果提示近期疗效满意.结论 采用经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成可以取得较好的临床疗效.

  8. Dolor a la inyección de propofol en sedación para colonoscopia: rol que desempeña el sitio de cateterización venosa Propofol injection pain during sedation for colonoscopy: the role of venous catheterization site

    Directory of Open Access Journals (Sweden)

    Roberto Rodríguez-Miranda

    2013-03-01

    Full Text Available Justificación: la mayor área de crecimiento en el uso de propofol ha sido para sedación en salas de operaciones y centros diagnósticos. El dolor a la inyección de propofol es un problema clínico común. Ha habido muchos intentos para reducir el dolor, sin embargo, la inhibición completa no se ha logrado. Métodos: se diseñó una fórmula para la recolección de datos, la cual se aplicó a los pacientes sedados para colonoscopia en la Sala de Endoscopia del Hospital San Juan de Dios. En la citada fórmula se incluyó la escala de dolor a la inyección de propofol, según lo establecido por McCrirrick, y se registraron las variables demográficas, localización y calibre del catéter venoso utilizado, así como los fármacos administrados concomitantemente. Los datos de la fórmula fueron completados por el médico anestesiólogo a cargo de la sedación, y revisados por el investigador. Resultados: un 58% de los pacientes no presentó dolor a la inyección de propofol; un 24,8% presentó dolor leve; un12,8%, dolor moderado, y un 1,7%, dolor intenso. Estadísticamente, el grupo de pacientes al que se le administró propofol en una vía colocada en fosa antecubital, presentó menos dolor que aquellos pacientes a los cuales se les colocó vía en dorso de mano, muñeca o cara anterior de antebrazo (p=0,006. Conclusión: la mejor forma de reducir el dolor a la inyección de propofol, consiste en utilizar una cánula venosa en la fosa antecubital para su administración.Background: The use of propofol has seen its greatest growth in the operating room and diagnostic centers. Pain associated with propofol injection is a common clinical issue. There have been many attempts to reduce pain, however, complete inhibition has not been achieved. Methods: Data was colected from patients sedated with propofol in the Endoscopy room at San Juan de Dios Hospital. The data obtained included the McCrirrick pain on propofol injection scale, demographic variables, caliber and location of venous catheters, as well as concomitant medications. The data was recorded by the treating anesthesiologist and reviewed by the researcher. Results: 58% of patients did not experience pain on propofol injection; 24,8% experienced mild pain, 12,8% moderate pain, and 1,7% severe pain. Statistically, the group of patients that received propofol through a venous catheter in the antecubital fossa, experienced less pain than those with a venous catheter placed in the hand, wrist, or anterior forearm. (p=0,006. Conclusion: The best way to reduce pain on propofol injection is to place the venous catheter in the antecubital fossa.

  9. Observation of the curative effect immediate technique of the catheterization of the superficial temporal artery for retrograde intra-artery chemotherapy on postoperative chemotherapy administration in patients with oral squamous cell carcinomas%即刻行颞浅动脉逆行置管化疗技术对口腔鳞癌患者术后化疗的疗效观察

    Institute of Scientific and Technical Information of China (English)

    倪鑫; 赵洪伟; 冯驰; 季平; 邱丽华; 李勇; 高翔; 刘平; 王涛

    2015-01-01

    目的:对口腔鳞癌患者采用不同化疗给药途径并观察奈达铂(nedaplatin,NDP)和5‐氟尿嘧啶(5‐fluorouracil,5‐Fu)的疗效和不良反应。方法将64例口腔鳞癌患者分为术后普通静脉化疗组(IV组,32例)和术中即刻行颞浅动脉逆行置管化疗组(IA组,32例),两组化疗方案都为DNP和5‐Fu,其中IA组剂量为IV组的1/3,观察疗效和不良反应。结果IA组疗效优于IV组(P<0.05),同时IA组在骨髓抑制、胃肠道反应及口腔黏膜炎等化疗后并发症较IV组轻,差异有统计学意义(P<0.05)。结论术中IA疗效明显,不良反应轻且安全,适合临床推广。%Objective Treat patients with oral squamous cell carcinomas with different chemotherapy administration route ,and observe the effects and adverse reaction of Nedaplatin (NDP) and 5‐Fluorouracil (5‐Fu) .Methods Sixty four patients with oral squamous cell carcinomas were randomly divided into two groups which included intravenous chemotherapy group (IV)(with 32 ca‐ses) and intra‐artery infusion via the superficial temporal artery group (IA)(with 32 cases) .Each group was treated with NDP and 5‐Fu .The dose of the IA group was one third of that of the IV group .Efficacy and side effect had been observed .Results Efficacy of the IA group was better than that of the IV group (P<0 .05) .Complications including bone marrow suppression ,gastrointestinal reactions and oral mucositis of the IA group was lighter than that of the IV group ,which was significantly different (P<0 .05) . Conclusion The retrograde intra‐arterial chemotherapy via the superficial temporal artery during the surgery is safe ,effective and useful ,and it is worth of further clinical application .

  10. The study on the application of remifentanil combined with propofol in general anesthesia using laryngeal mask airway during pediatric cardiac catheterization with radio frequency catheter ablation%瑞芬太尼复合异丙酚喉罩麻醉在小儿射频消融术中应用研究

    Institute of Scientific and Technical Information of China (English)

    沈书斌; 宋铁鹰; 王虹; 朱宇翔; 王姝媛; 王军

    2008-01-01

    目的 观察瑞芬太尼复合异丙酚喉罩全麻用于小儿经导管心内射频消融术中可行性和临床效果.方法 选择ASAⅠ~Ⅱ级,介入治疗的经导管心内射频消融患儿48例,随机分为2组,每组24例,经快速诱导后分别插入喉罩(A组)和气管导管(B组).观测并比较2组患儿血流动力学变化及与通气情况,并观测术中不良反应.结果 B组平均动脉压(MBP)、心率(HR)与气管插管前比较有统计学意义(P<0.05),2组间置入喉罩与气管插管后MBP、HR、血氧饱和度(SpO2)比较有统计学意义(P<0.05).B组MBP、HR与拔除气管插管前比较有统计学意义(P<0.05),2组间拔除喉罩与气管插管后MBP、HR、SpO2比较有统计学意义(P<0.05).结论 患儿对喉罩插入的耐受性较好,反应小,对心脏传导系统无影响.瑞芬太尼复合异丙酚喉罩麻醉用于儿童射频消融术可行且安全有效.

  11. Effects of Dexmedetomidine on the Appearance of Agitation after Cardiac Catheterization in General Anesthesia on Children with Congenital Heart Disease%右美托咪定对先心病患儿心导管术后苏醒期躁动的影响

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    [目的]探讨右美托咪定对先心病患儿心导管术后苏醒期躁动的影响.[方法]93例拟行心导管介入手术的先心病患儿随机分成三组.给予七氟烷面罩吸入诱导,静脉注射舒芬太尼0.1 μg/kg和罗库溴铵0.6 mg/kg,气管插管后行定压型模式通气.术中A组患儿以吸入七氟烷维持,B组患儿以吸入七氟烷复合静脉持续输注瑞芬太尼0.25 μg/(kg·min)维持,C组患儿以吸入七氟烷复合静脉持续输注右关托咪定0.5μg/(kg·h)维持.记录患儿苏醒期情况,并采用改良Aldrete评分、PAEDS评分和CHEOPS评分对患儿复苏、苏醒期躁动和术后疼痛进行评估.[结果]三组患儿苏醒期各时间段躁动发生率:A组>B组>C组(P<0.05),C组麻醉后恢复室(PACU)停留时间较A组和B组延长(P<0.01).三组患儿改良Aldrete评分比较无统计学差异.入PACU后C组前3个时间点的PAEDS评分均低于A组和B组(P<0.05),且第15min和第30 min C组PAEDS评分明显低于A组(P<0.01).第30 min和第45 min C组CHEOPS评分低于A组和B组(P<0.05).[结论]右美托咪定有助于预防先心病患儿心导管手术麻醉苏醒期躁动的发生,提高患儿苏醒质量.

  12. Aspectos técnicos da cateterização do seio coronariano baseada no componente atrial do eletrograma intracavitário e anatomia radiológica durante o procedimento de implante de marcapasso biventricular Technical aspects of coronary sinus catheterization based on the atrial component of the intracavitary electrogram and radiological anatomy during the implantation procedure of a biventricular pacemaker

    OpenAIRE

    Fernando Sérgio Oliva de Souza; Nicola Luciano Mortati; Domingo Marcolino Braile; Reinaldo Wilson Vieira; Salomon Ordinola Rojas; Alessandre Caputo Rabelo; Januário Manuel de Souza; Sérgio Almeida de Oliveira

    2006-01-01

    OBJETIVO: Apresentar uma proposição técnica baseada na experiência de 130 implantes utilizando técnica simplificada para cateterização do seio coronariano, baseada no componente atrial do eletrograma intracavi-tário e anatomia radiológica. MÉTODOS: De outubro de 2001 a outubro de 2004 foram realiza-dos 130 implantes de marcapasso biventricular, utilizando-se anatomia radiológica e observação de eletrograma intracavitário, com prioridade ao componente atrial. RESULTADOS: O implante do sistema,...

  13. The Effects of Students' Learning Anxiety and Motivation on the Learning Achievement in the Activity Theory Based Gamified Learning Environment

    Science.gov (United States)

    Su, Chung-Ho

    2017-01-01

    The advancement of mobile game-based learning has encouraged many related studies, which has enabled students to learn more and faster. To enhance the clinical path of cardiac catheterization learning, this paper has developed a mobile 3D-CCGBLS (3D Cardiac Catheterization Game-Based Learning System) with a learning assessment for cardiac…

  14. Best practices in urinary catheter care.

    Science.gov (United States)

    Herter, Rebecca; Kazer, Meredith Wallace

    2010-06-01

    Urinary catheterization is a common healthcare intervention used to manage urinary dysfunction that poses serious associated risks and complications. This article discusses methods of urinary catheterization and their indications, catheter-associated complications, and assessment and management strategies that home healthcare practitioners can employ to ensure best patient outcomes and minimize complications.

  15. Cylothorax developing due to thrombosis in the subclavian vein: A case report

    OpenAIRE

    Isik, Yasemin; Goktas, Ugur; Bınıcı, orhan; Kati, Ismail

    2015-01-01

    Chylothorax, which is a rare complication of central venous catheterization, is an accumulation of lymphatic fluid in the pleural space as a result of impairment of the integrity of ductus thoracicus. In this case report, we will look over chylothorax related to thrombus developing following subclavian vein catheterization.

  16. Cardiac tamponade in an infant during contrast infusion through central venous catheter for chest computed tomography; Tamponamento cardiaco durante infusao de contraste em acesso venoso central para realizacao de tomografia computadorizada do torax em lactente

    Energy Technology Data Exchange (ETDEWEB)

    Daud, Danilo Felix; Campos, Marcos Menezes Freitas de; Fleury Neto, Augusto de Padua [Hospital Geral de Palmas, TO (Brazil)

    2013-11-15

    Complications from central venous catheterization include infectious conditions, pneumothorax, hemothorax and venous thrombosis. Pericardial effusion with cardiac tamponade hardly occurs, and in infants is generally caused by umbilical catheterization. The authors describe the case of cardiac tamponade occurred in an infant during chest computed tomography with contrast infusion through a central venous catheter inserted into the right internal jugular vein. (author)

  17. Irving Independent School District, Petitioner v. Henri Tatro, et Ux., Individually and as Next Friend of Amber Tatro, a Minor. On Writ of Certiorari to the United States Court of Appeals for the Fifth Circiut. No. 83-558.

    Science.gov (United States)

    Supreme Court of the U. S., Washington, DC.

    A Supreme Court ruling is presented regarding the provision of clean intermittent catheterization as part of related services mandated under P.L. 94-142, the Education for All Handicapped Children Act. The case argued focused on the needs of a young girl with spina bifida for intermittent catheterization to remove urine from her bladder. The court…

  18. Arteriogram

    Science.gov (United States)

    ... eds. Rutherford's Vascular Surgery . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 102. Goldstein LB. Approach to ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 406. Kern M. Catheterization and ...

  19. Left ventricle function in patients with ischemic cardiopathy: determination of the expulsion fraction of the left ventricle with gated-SPECT. Experience in the CMN 20 de Noviembre ISSSTE; Funcion ventricular izquierda en pacientes con cardiopatia isquemica: determinacion de la fraccion de expulsion del ventriculo izquierdo con gated-SPECT. Experiencia en el CMN 20 de Noviembre ISSSTE

    Energy Technology Data Exchange (ETDEWEB)

    Mendoza, L.; Puente, A.; Hernandez, T.; Jimenez, L. [Departamento de Medicina Nuclear y Cardiologia, Hospital CMN 20 de Noviembre, ISSSTE, 03000 Mexico D.F. (Mexico)

    2007-07-01

    The objective of this work is to correlate the expulsion fraction of the left ventricle (FEVI) obtained by means of g-SPECT and other diagnostic methods: ECO 2D and ventriculography for heart catheterization (CTT). (Author)

  20. Urinary incontinence - vaginal sling procedures

    Science.gov (United States)

    ... your doctor will have you try bladder retraining, Kegel exercises, medicines, or other options. If you tried ... Urinary incontinence - tension-free vaginal tape Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  1. Urinary incontinence - tension-free vaginal tape

    Science.gov (United States)

    ... your doctor will have you try bladder retraining, Kegel exercises, medicines, or other options. If you tried ... suspension Urinary incontinence - vaginal sling procedures Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  2. When you have urinary incontinence

    Science.gov (United States)

    ... Pelvic Floor Muscle Strengthening Your provider may recommend Kegel exercises . These are exercises in which you tighten ... vaginal sling procedures Patient Instructions Indwelling catheter care Kegel exercises - self-care Multiple sclerosis - discharge Self catheterization - ...

  3. Anterior vaginal wall repair

    Science.gov (United States)

    ... may have you: Learn pelvic floor muscle exercises ( Kegel exercises ) Use estrogen cream in your vagina Try ... Urinary incontinence - vaginal sling procedures Vagina Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  4. Lipolysis in human adipose tissue during exercise

    DEFF Research Database (Denmark)

    Lange, Kai Henrik Wiborg; Lorentsen, Jeanne; Isaksson, Fredrik;

    2002-01-01

    Subcutaneous adipose tissue lipolysis was studied in vivo by Fick's arteriovenous (a-v) principle using either calculated (microdialysis) or directly measured (catheterization) adipose tissue venous glycerol concentration. We compared results during steady-state (rest and prolonged continuous...

  5. Bladder Management

    Science.gov (United States)

    ... Catheterization • Urinary Tract Infections: Indwelling (Foley) Catheter Bladder Management [ Download this pamphlet: "Bladder Management" - (PDF, 499KB) ] The ... and medication or surgery may be helpful. Bladder Management Foley or Suprapubic Catheter A tube is inserted ...

  6. The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals

    DEFF Research Database (Denmark)

    Wolsk, Emil; Bakkestrøm, Rine; Thomsen, Jacob H

    2017-01-01

    . Participants had hemodynamic parameters measured using right heart catheterization during rest, passive leg raise, and incremental exercise. RESULTS: During rest, all hemodynamic parameters were similar between age groups, apart from blood pressure. During leg raise and incremental exercise...

  7. Pediatric sciatic neuropathies due to unusual vascular causes

    NARCIS (Netherlands)

    Srinivasan, Jayashri; Escolar, Diane; Ryan, Monique; Darras, Basil; Jones, H. Royden

    2008-01-01

    Four cases of pediatric sciatic neuropathies due to unusual vascular mechanisms are reported. Pediatric sciatic neuropathies were seen after umbilical artery catheterization, embolization of arteriovenous malformation, meningococcemia, and hypereosinophilic vasculitis. Electrophysiologic studies dem

  8. Chronic Pericarditis

    Science.gov (United States)

    ... caused by severe pressure on the heart ( cardiac tamponade ) may not develop. However, if fluid accumulates rapidly, ... sufficiently, the heart can become compressed and cardiac tamponade may occur. Diagnosis Echocardiography Cardiac catheterization or imaging ...

  9. Atrial Septal Defect (For Teens)

    Science.gov (United States)

    ... septal defect (pronounced: AY-tree-ul SEP-tul DEE-fekt), or ASD for short, is sometimes referred ... can be treated with cardiac catheterization (pronounced: CAR-dee-ack cath-uh-turr-ih-ZAY-shun), in ...

  10. Ventricular Septal Defect (For Parents)

    Science.gov (United States)

    ... Electrocardiogram) Anesthesia - What to Expect Tetralogy of Fallot Coarctation of the Aorta Patent Ductus Arteriosus (PDA) Getting ... Murmurs Atrial Septal Defect Cardiac Catheterization EKG (Video) Coarctation of the Aorta Atrial Septal Defect Ventricular Septal ...

  11. Coronary vasodilatory action after a single dose of nicorandil

    NARCIS (Netherlands)

    H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick); P.J. de Feyter (Pim); P.D. Verdouw (Pieter); P.G. Hugenholtz (Paul)

    1988-01-01

    textabstractCoronary hemodynamics and vasodilatory effects on major epicardial arteries were investigated after a single dose of nicorandil in 22 patients undergoing cardiac catheterization for suspected coronary artery disease. Nicorandil, 20 mg, was administered sublingually to 11 consecutive pati

  12. Percutaneous transsplenic embolization of esophageal varices in a 5-year-old child

    Energy Technology Data Exchange (ETDEWEB)

    Rasinska, G.; Wermenski, K.; Rajszys, P.

    A five-year-old girl with portal vein thrombosis and severe gastrointestinal hemorrhage recurring after repeated endoscopic sclerotherapy was successfully embolized via an ultrasonically guided transsplenic catheterization of the splenic vein.

  13. Central venous catheter-related blood stream infection rate in critical care units in a tertiary care, teaching hospital in Mumbai

    Directory of Open Access Journals (Sweden)

    K Chopdekar

    2011-01-01

    Full Text Available Blood stream infections related to central venous catheterization are one of the major device-associated infections reported. Patients admitted in critical care units requiring central venous catheterization and presenting with signs of septicemia during catheterization period were investigated for catheter-related blood stream infections (CRBSI. The CRBSI rate was 9.26 per 1000 catheter days in general with highest rate in neonatal intensive care unit (27.02/1000 days. Site of insertion of catheter and duration of catheterization did not show the influence on the CRBSI rate. Coagulase-negative Staphylococci were the predominant cause. Mortality of 33% was observed in patients with CRBSI. Since central venous catheters are increasingly being used in the critical care, regular surveillance for infection associated them are essential.

  14. Bladder Control and Nerve Disease

    Science.gov (United States)

    ... procedure at regular intervals, a practice called clean intermittent catheterization. Some patients cannot place their own catheters ... Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información de ...

  15. Transient Presyncope Secondary to Posterior Descending Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Andrew D. Moffat

    2011-01-01

    Full Text Available We describe the case of a 64-year-old male initially presenting with presyncope and bradycardia, without any anginal symptoms or objective evidence of myocardial ischemia. A stress test induced no physical symptoms but revealed a left bundle branch block with multiple preventricular contractions on electrocardiogram. Subsequent catheterization revealed severe obstructive disease throughout the coronary arteries. He was treated percutaneously on two separate heart catheterizations. The presyncope and bradycardia resolved after reperfusion of the posterior descending artery.

  16. From arteritis to mycotic aneurysm: visualization of the progression of mycotic aneurysm development following femoral arterial line insertion in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Beck-Razi, Nira [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Rambam Medical Center, Department of Medical Imaging, Haifa (Israel); Bar-Joseph, Gad [Israel Institute of Technology, Pediatric Critical Care Unit, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Ofer, Amos; Gaitini, Diana [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Hoffman, Aharon [Israel Institute of Technology, Department of Vascular Surgery, Rambam Health Care Center, The Rappaport Faculty of Medicine, Technion, Haifa (Israel)

    2010-12-15

    Although uncommon, mycotic aneurysms in infants can be lethal because of the high risk of rapid expansion and rupture. Most catheter-associated mycotic aneurysms reported in the first year of life develop following umbilical artery catheterizations. We describe the sonographic detection of an early stage mycotic aneurysm in a 4-month-old following femoral artery catheterization complicated by methicillin-resistant Staphylococcus aureus (MRSA) septicemia. We also describe the sonographic and radiographic progression of this mycotic aneurysm before surgery. (orig.)

  17. Severe stenosis of a long tracheal segment, with agenesis of the right lung and left pulmonary arterial sling.

    Science.gov (United States)

    Munro, Hamish M; Sorbello, Andrea M C; Nykanen, David G

    2006-02-01

    A baby presented at term with respiratory distress was managed with extracorporeal membrane oxygenation. Bronchoscopy revealed tracheal hypoplasia, complete tracheal rings, and agenesis of the right main bronchus. Echocardiography showed a left pulmonary arterial sling arising from the proximal part of the right pulmonary artery. Cardiac catheterization demonstrated abnormal pulmonary vasculature in the left lung which would have prevented survival, even after surgical repair. Diagnostic catheterization was important in delineating the anatomy, and aided in the decision not to proceed with surgical repair.

  18. A clever technique for placement of a urinary catheter over a wire

    Directory of Open Access Journals (Sweden)

    Joel E Abbott

    2015-01-01

    Conclusion: Placing urinary catheters over a wire is standard practice for urologists, however, use of this technique gives the freedom of performing wire-guided catheterization in more situations than a council-tip allows. This technique facilitates successful transurethral catheterization over wire in the setting of DUC for all catheter types and styles aiding in urologic management of patients at a cost benefit to the health care system.

  19. Prevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Andersen, Kasper Hasseriis; Iversen, Martin; Kjaergaard, Jesper;

    2012-01-01

    The prevalence, prognostic importance, and factors that predict the presence and degree of pulmonary hypertension (PH) diagnosed with right heart catheterization (RHC) in patients with end-stage chronic obstructive pulmonary disease (COPD) remain unclear.......The prevalence, prognostic importance, and factors that predict the presence and degree of pulmonary hypertension (PH) diagnosed with right heart catheterization (RHC) in patients with end-stage chronic obstructive pulmonary disease (COPD) remain unclear....

  20. Impact of catheter on uroflow rate in pressure-flow study

    Institute of Scientific and Technical Information of China (English)

    张鹏; 武治津; 高居忠

    2004-01-01

    @@ The importance of a pressure-flow study in the diagnostic work-up of patients suffering from benign prostatic hyperplasia (BPH) has been recognized. However, there is still uncertainty regarding the role the catheter might play in affecting uroflow rate during a pressure-flow study. In this present study, we retrospectively analyzed voiding data from pressure-flow studies taken before and after catheterization in 44 patients suffering from BPH to investigate whether catheterization has an effect on uroflow rate.

  1. MISPLACEMENTS OF CENTRAL VENOUS CATHETERS: INTERNAL JUGULAR VERSUS SUBCLAVIAN ACCESS IN CRITICAL CARE PATIENTS

    OpenAIRE

    2007-01-01

    Aim; In central venous catheterization (CVC), misplacement is not a rare complication since this is a blinded procedure. The aim of this study was to compare the misplacement risks of the access of internal jugular vein with that of subclavian vein catheterizations. Methods;The records of a total of 1092 patients in whom central venous catheters were placed between 2002 and 2006 in Anesthesiology Intensive Care Unit and the location of the tips was confirmed radiologically were retrospe...

  2. DELAYED BILATERAL HYDROTHORAX AFTER CENTRAL VENOUS CATHERIZATION: A CASE REPORT

    OpenAIRE

    Arpana; Moses Charles D; Kutappa; Deepa

    2014-01-01

    : Central venous catheterization is a common procedure in anesthetic management of patients undergoing major surgery or care of critically ill patients. Delayed complication such as hydrothorax, hydromediastinum or cardiac tamponade is extremely rare with a few case reports. We report a case of bilateral hydrothorax due to migration of the tip of the central venous catheter from within the vein into the mediastinum following subclavian vein catheterization.

  3. Radiographic mislead: apparent arterial placement of subclavian central venous catheter due to mediastinal shift

    OpenAIRE

    Shaji Mathew; Kush Goyal; Souvik Chaudhuri; Arun Kumar(University of Delhi, Delhi, India); Amjad Abdulsamad

    2014-01-01

    Optimal placement of central venous catheters (CVC) is essential for accurate monitoring of central venous pressure (CVP) in major surgeries and ensuring long-term use of the catheter for managing the critically ill patient. Accidental subclavian artery catheterization is one of the most serious complications of the procedure. Radiography is commonly used to ensure optimal placement of CVC tip and rule out subclavian artery catheterization in the absence of Doppler ultrasound and a pressure t...

  4. Diagnostica microbiologica delle infezioni associate all’utilizzo di cateteri venosi centrali (CVC): considerazioni generali e studio in pazienti immunocompromessi

    OpenAIRE

    Giancarlo Basaglia; Sandro Stocco Calzavara; Antonella Pancino; Paola Sperandio; Maria Luisa Tomasini; Paolo Paoli

    2006-01-01

    Central venous catheterization today is essential for the intensive management of both medical and surgical patients (for the administration of iv fluids, medications, blood products and parenteral nutrition fluids, to monitor hemodynamic status and to provide hemodialysis). CVC infection is a serious complication of catheterization and a common type of nosocomial infection. This complication is particularly serious in oncologic, haematologic and AIDS, frequently immunocompromised, patients. ...

  5. Proteus mirabilis biofilm - Qualitative and quantitative colorimetric methods-based evaluation

    OpenAIRE

    2014-01-01

    Proteus mirabilis strains ability to form biofilm is a current topic of a number of research worldwide. In this study the biofilm formation of P. mirabilis strains derived from urine of the catheterized and non-catheterized patients has been investigated. A total number of 39 P. mirabilis strains isolated from the urine samples of the patients of dr Antoni Jurasz University Hospital No. 1 in Bydgoszcz clinics between 2011 and 2012 was used. Biofilm formation was evaluated using two independen...

  6. Central venous catheter-related thrombosis in senile male patients: New risk factors and predictors.

    Science.gov (United States)

    Liu, Gao; Fu, Zhi-Qing; Zhu, Ping; Li, Shi-Jun

    2015-06-01

    Central venous catheterization (CVC)-related venous thrombosis is a common but serious clinical complication, thus prevention and treatment on this problem should be extensively investigated. In this research, we aimed to investigate the incidence rate of CVC-related venous thrombosis in senile patients and give a further discussion on the related risk factors and predictors. A total of 324 hospitalized senile male patients subjected to CVC were selected. Retrospective investigation and analysis were conducted on age, underlying diseases, clinical medications, catheterization position and side, catheter retention time, and incidence of CVC-related venous thrombosis complications. Basic laboratory test results during catheterization and thrombogenesis were also collected and analyzed. Among the 324 patients, 20 cases (6.17%) of CVC-related venous thrombosis were diagnoseds. The incidence rate of CVC-related venous thrombosis in subclavian vein catheterization was significantly lower than that in femoral vein catheterization (Pvenous thrombosis history (Prisk factors or predictors of CVC-related venous thrombosis in senile male patients. Subclavian vein catheterization was the most appropriate choice among senile patients to decrease the incidence of CVC-related venous thrombosis. Previous venous thrombosis history, high lactate dehydrogenase level, low HDL level, and low albumin level were important risk factors in predicting CVC-related venous thrombosis.

  7. Treatment of severe pulmonary hypertension in the setting of the large patent ductus arteriosus.

    Science.gov (United States)

    Niu, Mary C; Mallory, George B; Justino, Henri; Ruiz, Fadel E; Petit, Christopher J

    2013-05-01

    Treatment of the large patent ductus arteriosus (PDA) in the setting of pulmonary hypertension (PH) is challenging. Left patent, the large PDA can result in irreversible pulmonary vascular disease. Occlusion, however, may lead to right ventricular failure for certain patients with severe PH. Our center has adopted a staged management strategy using medical management, noninvasive imaging, and invasive cardiac catheterization to treat PH in the presence of a large PDA. This approach determines the safety of ductal closure but also leverages medical therapy to create an opportunity for safe PDA occlusion. We reviewed our experience with this approach. Patients with both severe PH and PDAs were studied. PH treatment history and hemodynamic data obtained during catheterizations were reviewed. Repeat catheterizations, echocardiograms, and clinical status at latest follow-up were also reviewed. Seven patients had both PH and large, unrestrictive PDAs. At baseline, all patients had near-systemic right ventricular pressures. Nine catheterizations were performed. Two patients underwent 2 catheterizations each due to poor initial response to balloon test occlusion. Six of 7 patients exhibited subsystemic pulmonary pressures during test occlusion and underwent successful PDA occlusion. One patient did not undergo PDA occlusion. In follow-up, 2 additional catheterizations were performed after successful PDA occlusion for subsequent hemodynamic assessment. At the latest follow-up, the 6 patients who underwent PDA occlusion are well, with continued improvement in PH. Five patients remain on PH treatment. A staged approach to PDA closure for patients with severe PH is an effective treatment paradigm. Aggressive treatment of PH creates a window of opportunity for PDA occlusion, echocardiography assists in identifying the timing for closure, and balloon test occlusion during cardiac catheterization is critical in determining safety of closure. By safely eliminating the large PDA

  8. Intramuscular Administration of Drotaverine Hydrochloride Decreases Both Incidence of Urinary Retention and Time to Micturition in Orthopedic Patients under Spinal Anesthesia: A Single Blinded Randomized Study

    Directory of Open Access Journals (Sweden)

    Dariusz Tomaszewski

    2015-01-01

    Full Text Available Purpose. Postoperative urinary retention (POUR increases the duration of hospitalization and frequency and risk of urinary bladder catheterization. The objective of this study was to analyze the efficacy of intramuscularly administered drotaverine hydrochloride in the prevention of POUR in orthopedic patients. Methods. Two hundred and thirty patients 17–40 years of age undergoing lower limb orthopedic procedures under spinal anesthesia were enrolled in the study. The study group received 40 mg of drotaverine hydrochloride intramuscularly; the second group was the control. The main outcome measure was (1 the time to micturition and (2 the incidence of urinary bladder catheterization and time to catheterization. Results. Two hundred and one patients of 230 enrolled participants completed the study. Compared to the control group, the male patients in study group exhibited a shorter time to spontaneous micturition (441 versus 563 minutes, 95% CI of the difference of means between 39 and 205 minutes and a lower incidence of urinary bladder catheterization (4/75 versus 10/54 (RR 0.29, 95% CI: 0.1–0.87; P=0.0175. Conclusions. Intramuscular administration of drotaverine hydrochloride decreased the time to spontaneous micturition and decreased the incidence of urinary bladder catheterization in male patients who underwent orthopedic surgery under spinal anesthesia. This trial is registered with NCT02026427.

  9. Acquired urethral diverticulum in a man with paraplegia presenting with a scrotal mass: a case report

    Directory of Open Access Journals (Sweden)

    El Ammari Jalal Eddine

    2012-11-01

    Full Text Available Abstract Introduction Male urethral diverticula are rare. Patients with paraplegia may present with acquired diverticula as a result of prolonged catheterization. Diverticula may be asymptomatic or lead to lower urinary tract symptoms. Rarely, the diverticulum may initially present as a scrotal mass. Case presentation We report the case of a male 45-year-old Arab with paraplegia who presented with a mass in the peno-scrotal junction. He had in his medical history iterative prolonged urethral catheterizations associated with urine leakage through the urethral meatus upon applying compression. Diagnosis confirmation of urethral diverticula is obtained by retrograde urethrography. The patient underwent a diverticulectomy with urethroplasty. Conclusion Male acquired urethral diverticula can be found in patients who have a spinal cord injury because of prolonged urethral catheterization. Clinical presentations are different and sometimes can be misleading. Retrograde urethrography is the key to diagnosis and open surgery is the treatment of reference.

  10. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines1

    Science.gov (United States)

    Andrade, Vera Lúcia Fonseca; Fernandes, Filipa Alexandra Veludo

    2016-01-01

    Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice. PMID:27027676

  11. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Fonseca Andrade

    2016-01-01

    Full Text Available Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r, Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r, Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.

  12. Anatomical variations of the clavicle and main vascular structures in two pediatric patients: subclavicular vein cannulation with supraclavicular approach

    Directory of Open Access Journals (Sweden)

    Oksuz H

    2009-05-01

    Full Text Available Central venous catheterization is a routine application in the management of patients in critical condition. However, the placement of central venous catheters is not without risk. The standard technique for central venous cannulation includes the use of anatomical landmarks. However, an ultrasound-guided method is recommended for catheterization in high-risk patients. In this report, we present two pediatric cases which had anatomical variations of the clavicles and main vascular structures due to cerebral palsy and were treated with mechanical ventilation because of pneumonia. The subclavian vein cannulation was performed using a supraclavicular approach under ultrasound guidance in both cases. We conclude that central venous catheterization of critical patients who have anatomical variations must be performed under ultrasound guidance as it provides greater safety and a higher success rate.

  13. Immediate complications of percutaneous central venous cannulation in children

    Science.gov (United States)

    Dheer, Geetika; Chaudhry, Gurmeet Kaur; Singh, Tejinder

    2011-01-01

    Objective: To study the incidence of immediate complications associated with percutaneous central venous catheterization. Materials and Methods: A total of 103 central venous catheters were inserted in 70 children over a period of 18 months, governed by a uniform protocol. Sixty-three percent of the catheters were inserted in neonates, 23.3% in infants and 13.6% in children between 1 and 12 years of age. Statistical Analysis Used: Software SPSS version 15. Results: There were a total of 41 insertion-related immediate complications, of which 75.6% were in neonates. Neonatal age, hemodynamic instability and more number of attempts to catheterize the vein had a higher risk of insertion-related problems. There was no mortality directly as a result of the procedure. Conclusion: In our practice, it was observed that complications were fewer with increasing familiarity with the procedure. Hence, percutaneous central venous catheterization is a safe procedure when performed in experienced hands. PMID:22121313

  14. Immediate complications of percutaneous central venous cannulation in children

    Directory of Open Access Journals (Sweden)

    Geetika Dheer

    2011-01-01

    Full Text Available Objective: To study the incidence of immediate complications associated with percutaneous central venous catheterization. Materials and Methods: A total of 103 central venous catheters were inserted in 70 children over a period of 18 months, governed by a uniform protocol. Sixty-three percent of the catheters were inserted in neonates, 23.3% in infants and 13.6% in children between 1 and 12 years of age. Statistical Analysis Used: Software SPSS version 15. Results: There were a total of 41 insertion-related immediate complications, of which 75.6% were in neonates. Neonatal age, hemodynamic instability and more number of attempts to catheterize the vein had a higher risk of insertion-related problems. There was no mortality directly as a result of the procedure. Conclusion: In our practice, it was observed that complications were fewer with increasing familiarity with the procedure. Hence, percutaneous central venous catheterization is a safe procedure when performed in experienced hands.

  15. Percutaneous microcrystalline chitosan application for sealing arterial puncture sites.

    Science.gov (United States)

    Hoekstra, A; Struszczyk, H; Kivekäs, O

    1998-08-01

    Arterial catheterization is one of the most frequently performed inpatient diagnostic and therapeutic procedures in the development countries. Complications may occur after any catheterization from inadequate hemostasis, particularly in the setting of aggressive anticoagulation. This study suggests that microcrystalline chitosan (MCCh) sealant installation via an arterial sheath at the completion of catheterization may improve hemostasis. Results using MCCh in eight heparinized dogs documented significant reductions in manual compression time (P = 0.016) of the artery after withdrawal of both the sheath introducer and catheter. Comparative results were found in rats, wherein a created wound in the aorta could be sealed relatively quickly and easily. The biodegradability, optimalization, and a better pharmaceutical formulation of this potential hemostatic agent require further studies.

  16. Utility of electrocardiogram in the assessment and monitoring of pulmonary hypertension (idiopathic or secondary to pulmonary developmental abnormalities) in patients≤18 years of age.

    Science.gov (United States)

    Lau, Kelvin C; Frank, David B; Hanna, Brian D; Patel, Akash R

    2014-07-15

    Electrocardiograms have utility in disease stratification and monitoring in adult pulmonary arterial hypertension (PAH). We examined the electrocardiographic findings that are common in pediatric PAH and assessed for correlation with disease severity and progression. We retrospectively identified patients aged≤18 years followed at a single institution from January 2001 to June 2012 with catheterization-confirmed diagnosis of idiopathic PAH and PAH secondary to pulmonary developmental abnormalities. Patients with an electrocardiography performed within 60 days of catheterization were included. Primary and secondary outcomes are the prevalence of abnormal electrocardiographic findings at the time of catheterization and the association between electrocardiographic and hemodynamic findings and electrocardiographic changes with disease progression on follow-up catheterization, respectively. Of the 100 electrocardiography-catheterization pairs derived from the 46 patients identified, 93% had an electrocardiographic abnormality: 78% had right ventricular hypertrophy (RVH) and 52% had right axis deviation (RAD) for age. In patients with idiopathic PAH, the presence of RVH and RAD correlated with pulmonary vascular resistance and transpulmonary gradient. RAD and RVH on baseline electrocardiogram was associated with an increased risk of disease progression on subsequent catheterization (odds ratio 11.0, 95% confidence interval 1.3 to 96.2, p=0.03) after adjusting for PAH subgroup. The sensitivity, specificity, and positive and negative predictive values of RAD and RVH on baseline electrocardiogram for disease progression were 92%, 48%, 33%, and 95%, respectively. In conclusion, electrocardiographic abnormalities are common in pediatric PAH. RAD and RVH on electrocardiogram were associated with worse hemodynamics, whereas their absence is suggestive of a lack of disease progression.

  17. Occurrence of catheter-associated urinary tract infection in critical care units

    Directory of Open Access Journals (Sweden)

    Chanda R Vyawahare

    2015-01-01

    Full Text Available Background: Catheter-associated urinary tract infection (CAUTI is the most common nosocomial infection. The etiological agents of which may be varied. Advancing age, debilitation, diabetes mellitus, duration of catheterization are the risk factors. Complications include prostatitis, epididymitis, cystitis, pyelonephritis and septicemia in high-risk patients, adding to hospitalization and morbidity. With this background the present study was undertaken Objectives: (1 To identify microbial pathogens associated with urinary tract infection (UTI in catheterized patients from Intensive Care Units (ICU (2 to determine the susceptibility pattern of these isolates to antimicrobial agents (3 to determine the effect of days of catheterization and UTI. Materials and Methods: Consecutive urine samples of 345 catheterized patients admitted in ICUs were included in the study. They were processed by standard microbiological procedures. Isolated organisms were speciated, and antibiotic susceptibility performed as per standard guidelines. Results: From the 345 urine samples of catheterized patients, 205 showed no growth and were found to be sterile. Bacterial growth was seen in 69 patients and fungal growth in 50 patients. Among the bacterial isolates, Escherichia coli were isolated in 39, followed by Klebsiella spp. 14. The other isolates included Pseudomonas spp., Group D streptococci and methicillin-resistant Staphylococcus aureus. In the fungal isolates, Candida glabrata was the most common isolate. High resistance was seen among Klebsiella isolates (nalidixic acid-86% and cefotaxime-86%. Conclusion: Development of CAUTI is common in critically ill patients. Emphasis should be placed on good catheter management and reducing the duration of catheterization rather than prophylaxis in order to reduce the incidence of catheter-related UTI. Culture and susceptibility testing play a vital role in the management if UTI occurs.

  18. The Hyponatremic Hypertensive Syndrome in a Preterm Infant: A Case of Severe Hyponatremia with Neurological Sequels

    Directory of Open Access Journals (Sweden)

    Vera van Tellingen

    2011-01-01

    Full Text Available Objective. To report the irreversible severe neurological symptoms following the hyponatremic hypertensive syndrome (HHS in an infant after umbilical arterial catheterization. Design. Case report with review of the literature. Setting. Neonatal intensive care unit at a tertiary care children's hospital. Patient. A three-week-old preterm infant. Conclusions. In evaluating a neonate with hyponatremia and hypertension, HHS should be considered, especially in case of umbilical arterial catheterization. In case of diagnostic delay, there is a risk of severe irreversible neurological damage.

  19. [Case of spinal epidural abscess after continuous epidural block to manage the pain of herpes zoster].

    Science.gov (United States)

    Miyamoto, Tatsuhito; Nakatani, Toshihiko; Narai, Yasuhiro; Sakakibara, Manabu; Hashimoto, Tatsuya; Saito, Youji

    2014-03-01

    A woman in her 90's received continuous epidural block for the pain of herpes zoster. Four days after epidural catheterization, she was found with cellutitis. Fourteen days after epidural catheterization, spinal epidural abscess was pointed out on MRI. Since there were no neurological symptoms, we performed conservative medical management with antibiotics. She recovered without sequela When the symptoms of cellutitis appeared after epidural block (even if there are neither neurological symptoms nor infectious signs), there is a possibility of progressing into spinal epidural abscess.

  20. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  1. A Simple Technique to Facilitate Treatment of Urethral Strictures with Optical Internal Urethrotomy

    Directory of Open Access Journals (Sweden)

    Konstantinos Stamatiou

    2014-01-01

    Full Text Available Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization, urethroplasty, endoscopic internal urethrotomy, and dilation. Optical internal urethrotomy offers faster recovery, minimal scarring, and less risk of infection, although recurrence is possible. However, technical difficulties associated with poor visualization of the stenosis or of the urethral lumen may increase procedural time and substantially increase the failure rates of internal urethrotomy. In this report we describe a technique for urethral catheterization via a suprapubic, percutaneous approach through the urinary bladder in order to facilitate endoscopic internal urethrotomy.

  2. Penile Erosion in a Paraplegic Man With Indwelling Urinary Catheter and Scrotal Edema.

    Science.gov (United States)

    Young, Ashley; Mitacek, Ryan

    2017-05-01

    The chronic use of urinary indwelling catheters is a common practice in the setting of long-term patient care and is associated with numerous complications. More awareness about urogenital trauma from urinary catheterization is needed, as it is as common as symptomatic urinary tract infections. There are a number of preventable measures that can be taken to decrease the risk of mechanical trauma to the urethra and glans penis caused by chronic catheterization. We present a case of a 27-year old paraplegic male needing a chronic indwelling catheter that acquired ventral penile erosion while being cared for in the ICU setting.

  3. The Reten-World survey of the management of acute urinary retention: preliminary results.

    Science.gov (United States)

    Emberton, Mark; Fitzpatrick, John M

    2008-03-01

    Acute urinary retention (AUR) is a urological emergency characterized by a sudden and painful inability to pass urine. It represents a significant worldwide public health issue, as mortality within the year following an AUR episode appears much higher than in the general population, especially in younger patients. Management of AUR involves immediate bladder catheterization usually followed, until recently, by prostatic surgery. The greater morbidity and mortality associated with emergency surgery (within a few days after AUR), and the potential morbidity associated with prolonged catheterization (bacteriuria, fever, urosepsis) has led to an increasing use of a trial without catheter (TWOC). TWOC involves catheter removal after 1-3 days, allowing 23-40% of patients to void successfully, so that surgery can be performed at a later stage, if needed. Use of an alpha(1)-blocker before a TWOC may also be of help, as it has been demonstrated that it increases the chances of successful voiding after catheter removal. In the UK, this TWOC policy has resulted in a progressive decrease in the number of surgical procedures following a first episode of AUR, with the detriment of a slight increase in the AUR recurrence rate. Currently, there is no consensus on the optimal management of AUR in terms of type of catheterization, duration of catheterization and management following catheterization. The Reten-World survey is aimed at assessing current practice in the management of AUR in France, Asia, Latin America, North Africa and the Middle East. Interim results based on 3785 men with AUR associated with benign prostatic hyperplasia show that a urethral catheter is inserted in most cases (87%). Following this initial step, a TWOC after a median of 3 days' catheterization has become standard practice worldwide, with only a minority of men (6%) undergoing immediate surgery. Treatment with an alpha(1)-blocker before a TWOC improves the chances of success, regardless of the duration

  4. The internal mammary vein: an alternate route for central venous access with an implantable port.

    Science.gov (United States)

    Jaime-Solis, E; Anaya-Ortega, M; Moctezuma-Espinosa, J

    1994-10-01

    Central venous catheterization in pediatric patients has, among other risks, flebitis and thrombosis, and finally occlusion of the superior and inferior venae cavae, making long-term catheterization and multiple venous cutdown more difficult. Use of the internal mammary vein might be an alternative procedure to provide sure and easy access to the central venous circulation. The authors report on a patient with multiple venous cutdown and thrombosis of the inferior vena cava, in whom the internal mammary vein was used for placement of a vascular device. The procedure is technically easy, and no special positioning of the patient is required.

  5. [Inadvertent thoracic duct puncture during right axially central venous cannulation].

    Science.gov (United States)

    Kawashima, Shingo; Itagaki, Taiga; Adachi, Yushi; Ishii, Yasuhiro; Taniguchi, Midzuki; Doi, Matsuyuki; Sato, Shigehito

    2010-10-01

    A case of inadvertent thoracic duct puncture during right axially central venous cannulation is reported. The catheterization was performed under the real time ultrasound guidance technique and the coronal view image was continuously displayed. After confirming the feelings of venous puncture, clear yellow fluid was aspired into the connected syringe to the needle. Initially, an accidental thoracic puncture with subsequent pleural fluid aspiration was suspected;however, no finding of pleural effusion was observed with ultrasound imaging and computed tomography. Thus, an accidental thoracic duct puncture and the subsequent lymph fluid aspiration were suspected. Even in a right side approach for central venous catheterization, thoracic duct injury might ensure.

  6. Fifty-one cases of urinary retention treated by warm needle moxibustion and massage%温针灸配合按摩治疗尿潴留51例

    Institute of Scientific and Technical Information of China (English)

    阎翠兰

    2011-01-01

    @@ Urinary retention is a common urological emergency.Sometimes multi-line tube catheterization is used to treat this urological emergency condition.In this instance, multi-line tube catheterization is considered to be a fast and helpful method, yet it does not treat the root cause.In addition, acupuncture therapy is another unique way used to treat this medical condition, but it is less helpful than the method of thermal acupuncture and massage therapy.therefore, the author used warm needle moxibustion and massage to treat urinary retention-urological emergency, and the report is as follows.

  7. Digestive Endoscopy in Morocco: What Future Perspectives?

    Directory of Open Access Journals (Sweden)

    Professor Adil Ibrahimi

    2016-12-01

    Full Text Available Interventional endoscopy has evolved in parallel with diagnostic endoscopy and throughout the years, the performance of interventional endoscopy has proved to be efficient in improving morbidity and mortality in many diseases: biliopancreatic catheterism, dilatations of most stenosis in different parts of the digestive tube, haemostatic treatment, prosthetic fitting and installation, as well as benign and malignant tumors removal (polypectomy, mucosectomy....

  8. An Echodensity in the Sinus of Valsalva

    NARCIS (Netherlands)

    Amir, Rabia; Yeh, Lu; Matyal, Robina; Mahmood, Feroze

    2016-01-01

    A 60-YEAR-OLD woman was referred to the authors’ institution for surgical treatment of severe aortic valve stenosis with progressive exertional dyspnea. A few months before the current admission, she had been treated in an outside hospital for congestive heart failure. Cardiac catheterization confir

  9. Disseminated Intravascular Coagulation as a Possible Cause of Acute Coronary Stent Thrombosis: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Syed Amer

    2012-01-01

    Full Text Available Disseminated intravascular coagulation (DIC, as a cause of acute coronary stent thrombosis, has not yet been reported to our knowledge. We report a case of 64-year-old male, who presented with non-ST-segment elevation myocardial infarction (NSTEMI. Coronary angiography revealed right coronary artery (RCA stenosis and a drug eluting stent was deployed. Fifteen hours following the intervention, the patient developed an inferior wall ST elevation myocardial infarction. Repeat cardiac catheterization showed an acute in-stent thrombosis. Following thrombectomy, another stent was placed. The patient noted to have an acute drop in platelet count following the second intervention. Two hours following repeat intervention, the patient again developed chest pain and EKG showed recurrent ST-segment elevations in leads II, III, and aVF. Prior to repeat cardiac catheterization, the patient became unresponsive and developed cardiogenic shock. The patient was resuscitated and intubated, and repeat catheterization showed complete stent thrombosis. Intracoronary tissue plasminogen activator (tPA was given. The platelet count further dropped. Additional studies confirmed the diagnosis of DIC. No further cardiac catheterization was done at this point. The patient then later had a cardiac arrest and unfortunately cardiopulmonary resuscitation could not revive him. Amongst the etiologies of acute stent thrombosis, DIC was deemed a possible cause.

  10. A low cost DICOM review station for cardiac surgery

    NARCIS (Netherlands)

    Gerritsen, MG; Dijk, WA; Waterbolk, TW; Mook, PH; van der Velde, W; van der Putten, N; Dassen, WRM; Baljon, MH; Murray, A; Swiryn, S

    1998-01-01

    A low-cost PC based DICOM multi modality review station for cardiac surgery has been developed for use during Minimally Invasive Coronary Surgery. This system is a Windows 95 networked PC for review of DICOM coronary catheterization, ultrasound and MRI cine's stored at a departmental image server. F

  11. Insulin action in human thighs after one-legged immobilization

    DEFF Research Database (Denmark)

    Richter, Erik; Kiens, Bente; Mizuno, M.;

    1989-01-01

    -acyl-CoA-dehydrogenase in the vastus lateralis muscle by 9 and 14%, respectively, and thigh volume by 5%. After 7 days of immobilization, a two-step euglycemic hyperinsulinemic clamp procedure combined with arterial and bilateral femoral venous catheterization was performed. Insulin action on glucose uptake and tyrosine release...

  12. Intraosseous Erythropoietin for Acute Tissue Protection in Battlefield Casualties Suffering Hypovolemic Shock

    Science.gov (United States)

    2013-11-01

    picting the intraosseous access for drug delivery into the left tibia; vascular catheterization to monitor left ventricular pressure, aortic pressure...Resuscitation]; (d) [Myocardial Protection During Cardiac Arrest]; (e) [Chain of Survival: Community Involvement and Access to Emergency Services]; (f...Algunas Sugerencias para hacer Investigación en Medicina Intensiva, Sodium-Hydrogen Exchanger Inhibition: A Potencial New Treatment for Cardiac

  13. Novel Approach to Repeated Arterial Blood Sampling in Small Animal PET : Application in a Test-Retest Study with the Adenosine A1 Receptor Ligand [C-11]MPDX

    NARCIS (Netherlands)

    Sijbesma, Jürgen W A; Zhou, Xiaoyun; Vállez García, David; Houwertjes, Martin C; Doorduin, Janine; Kwizera, Chantal; Maas, Bram; Meerlo, Peter; Dierckx, Rudi A; Slart, Riemer H J A; Elsinga, Philip H; van Waarde, Aren

    2016-01-01

    Small animal positron emission tomography (PET) can be used to detect small changes in neuroreceptor availability. This often requires rapid arterial blood sampling. However, current catheterization procedures do not allow repeated blood sampling. We have developed a procedure which allows arterial

  14. Health Care Procedure Considerations and Individualized Health Care Plans

    Science.gov (United States)

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

    Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

  15. Adrenocorticotrophic hormone (ACTH) stimulation of sheep fetal adrenal cortex can occur without increased expression of ACTH receptor (ACTH-R) mRNA

    DEFF Research Database (Denmark)

    Carter, A M; Petersen, Y M; Towstoless, M;

    2002-01-01

    In the present study, it was hypothesized that the adrenocorticotrophin hormone receptor (ACTH-R) would be up-regulated in the adrenal gland of the sheep fetus following infusion of physiological amounts of ACTH, as shown for adrenal cortical cells in culture. In chronically catheterized sheep, a...

  16. Epidemiology of biofilm formation by gram-negative bacilli in patients with urinary tract infection in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Jasmin Halim Hussain

    2017-01-01

    CONCLUSION: The present study shows that urinary catheterization is a major environmental factor that facilitates biofilm formation by uropathogenic Gram-negative bacilli. As biofilm-producing organisms are difficult to treat, proper measures should be taken to prevent its formation.

  17. Safety and efficacy of femoral artery closure with the FemoSeal(R) device after coronary angiography using a 7 French sheath.

    Science.gov (United States)

    Wanitschek, M M; Suessenbacher, A; Dörler, J; Pachinger, O; Moes, N; Alber, H F

    2011-09-01

    Post-cardiac catheterization femoral artery hemostasis can be accomplished with several mechanisms, including the FemoSeal® hemostasis device which has been designed and approved for closure of 6 French (F) arterial puncture sites. The aim of this study was to investigate whether the FemoSeal® vascular closure device can effectively and safely seal 7F arterial puncture sites after diagnostic and interventional cardiac catheterizations. Femoral artery puncture sites of 50 consecutive patients undergoing cardiac catheterization were closed with the FemoSeal® vascular closure device, according to the manufacturer's instructions. Efficacy endpoints were time to hemostasis and successful ambulation. Safety endpoints included bleeding complications, vessel occlusion and pseudoaneurysms. Mean time to hemostasis was 57.8±26.3 seconds (0-125 seconds). Hemostasis was achieved in 100 percent of the 50 patients. One patient suffered minor bleeding the next day, i.e. local hematoma. This clinical study demonstrates that the FemoSeal® vascular closure device, initially approved for closure of 6F arterial puncture sites, shows promising efficacy and safety to seal a larger (7F) femoral arterial puncture sites after diagnostic and interventional cardiac catheterizations.

  18. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan, E-mail: akhano@tr.net; Akkaya, Selçuk, E-mail: selcuk.akkaya85@gmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Dağoğlu, Merve Gülbiz, E-mail: drmgkartal@gmail.com [Istanbul University, Department of Radiology, Istanbul School of Medicine (Turkey); Akpınar, Burcu, E-mail: burcu-akpinar@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Erbahçeci, Aysun, E-mail: aysunerbahceci@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Department of Radiology (Turkey); Çiftçi, Türkmen, E-mail: turkmenciftci@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Köroğlu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology (Turkey); Akıncı, Devrim, E-mail: akincid@hotmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey)

    2016-03-15

    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

  19. Massive Bleeding from Guidewire Perforation of an External Iliac Artery: Treatment with Hand-made Stent-Graft Placement

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, Vimal, E-mail: drvimalmehta@yahoo.co.in; Pandit, Bhagya Narayan; Mehra, Pratishtha; Nigam, Arima; Vyas, Aniruddha; Yusuf, Jamal; Mukhopadhyay, Saibal; Trehan, Vijay [G.B. Pant Institute of Postgraduate Medical Education and Research (India)

    2016-01-15

    We report life-threatening bleeding from an external iliac artery perforation following guidewire manipulation in a patient with atherosclerotic iliac artery disease. This complication was successfully managed by indigenous hand-made stent-graft made from two peripheral stents in the catheterization laboratory.

  20. Aras Ui Dhomhnaill Nursing Home, Loughnakey, Milford, Donegal.

    LENUS (Irish Health Repository)

    Thomas, Arun Z

    2009-10-01

    To examine the magnitude of potentially avoidable iatrogenic complications of male urethral catheterization (UC) within a tertiary-care supra-regional teaching hospital, and to evaluate risk factors and subjective feeling of interns in our institution on the adequacy of training on UC.

  1. Evaluation and Control of Occupational Exposure to Ethylene Oxide in Health Care Facilities.

    Science.gov (United States)

    1985-08-01

    as corneal and organ transplants, cardiac catheterization, and prosthesis implantation would be extremely difficult, if not impossible, to perform...of empirical and semiempirical equations. In a study of nine such equations, it was concluded that the Hirschfelder, Bird , and Spotz equation agreed

  2. The clinical characteristics of systemic sclerosis-related pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    王辉

    2014-01-01

    Objective To study the clinical,cardiopulmonary functional and hemodynamic profiles of systemic sclerosis patients with pulmonary hypertension(SSc-PAH)compared with those of idiopathic pulmonary hypertension(IPAH).Methods Patients diagnosed with SSc-PAH or IPAH by right heart catheterization were consecutively enrolled into the study between 2011 and 2013 in Peking

  3. Patient management after noninvasive cardiac imaging results from SPARC (Study of myocardial perfusion and coronary anatomy imaging roles in coronary artery disease).

    NARCIS (Netherlands)

    Hachamovitch, R.; Nutter, B.; Hlatky, M.A.; Shaw, L.J.; Ridner, M.L.; Dorbala, S.; Beanlands, R.S.; Chow, B.J.; Branscomb, E.; Chareonthaitawee, P.; Weigold, W.G.; Voros, S.; Abbara, S.; Yasuda, T.; Jacobs, J.E.; Lesser, J.; Berman, D.S.; Thomson, L.E.; Raman, S.; Heller, G.V.; Schussheim, A.; Brunken, R.; Williams, K.A.; Farkas, S.; Delbeke, D.; Schoepf, U.J.; Reichek, N.; Rabinowitz, S.; Sigman, S.R.; Patterson, R.; Corn, C.R.; White, R.; Kazerooni, E.; Corbett, J.; Bokhari, S.; Machac, J.; Guarneri, E.; Borges-Neto, S.; Millstine, J.W.; Caldwell, J.; Arrighi, J.; Hoffmann, U.; Budoff, M.; Lima, J.; Johnson, J.R.; Johnson, B.; Gaber, M.; Williams, J.A.; Foster, C.; Hainer, J.; Carli, M.F. Di

    2012-01-01

    OBJECTIVES: This study examined short-term cardiac catheterization rates and medication changes after cardiac imaging. BACKGROUND: Noninvasive cardiac imaging is widely used in coronary artery disease, but its effects on subsequent patient management are unclear. METHODS: We assessed the 90-day post

  4. Respiratoir falen soms toch door cardiale oorzaak

    NARCIS (Netherlands)

    van den Tol, D C; van der Werf, T S; Hamer, J P; Tulleken, J E; Ligtenberg, J J; Zijlstra, J G

    1998-01-01

    In two women aged 65 and 49 years and a man aged 64 years, severe respiratory failure developed and a pulmonary disease was suspected. They also had a minor systolic murmur. At further investigation no pulmonary cause for the disease could be established. Pulmonary artery catheterization revealed in

  5. Hepatocellular Carcinoma Fed by the Hepatic Artery Arising from the Superior Mesenteric Artery: Angiographic Analysis and Interventional Treatment

    Institute of Scientific and Technical Information of China (English)

    MUWei; LIQiang; YOUJian; CHENJie

    2003-01-01

    Objective: To investigate the angiographic characteristics and the interventional catheterization techniques of hepatocellular carcinoma (HCC) fed by aberrant hepatic arteries arising from the superior mesenteric artery (SMA), namely SMA type. Methods: Digital subtraction angiography (DSA) manifes-tations and the data from interventional treatment in 41 cases of SMA type HCCs were retrospectively reviewed. The frequency of the aberrant arteries was summed up statistically and their anatomic charac-teristics (such as origin, course, branches and distribution) and the relationship with catheterization were described and analyzed. Results: Of 350 HCC cases, SMA type HCCs were found in 41 cases (11.9%),including accessory right hepatic artery (15 cases, 36.5%), replaced right hepatic artery (16 cases, 39.0%),common hepatic artery (8 cases, 19.5%) and celiac artery arising from SMA (2 cases, 5.0%). Of the 31 cases with accessory or replaced right hepatic arteries, right hepatic arteries were small or absent on celiac angiograph in 29 cases (94.0%), and there was an avascular zone on the right liver. Superselective catheter-ization was successfully performed in 25 cases (61%) by using RH catheter, but the rest acquired successful superselective catheterization by using Cobra, Simmon catheters and microcatheters. Conclusion: SMA type is a commonly seen variation of hepatic arterial blood supply. A knowledge of this is very important in transcatheter arterial chemoembolization for HCC.

  6. Nursing experience of central venous catheter for constant drainage in 56 patients with malignant pleural effusion%中心静脉导管在56例恶性胸腔积液患者持续引流中的护理体会

    Institute of Scientific and Technical Information of China (English)

    丁海平; 王元兰

    2013-01-01

    目的 探讨中心静脉导管应用于恶性胸腔积液患者的护理.方法 选择56例胸腔积液患者置入中心静脉导管.结果 有7例患者置管处疼痛后拔管,其余患者均达到治疗周期,未发生其他置管并发症.结论 恶性胸腔积液患者胸腔置入中心静脉导管后,实施有效的护理措施能够保证治疗顺利进行,并减少多次胸腔穿刺的痛苦.%Objective To explore the nursing of central venous catheter in the treatment of patients with malignant pleural effusion. Methods 56 patients with pleural effusion underwent central venous catheterization. Results 7 patients had extubation because of pain in catheterization region; the rest of the patients completed the entire treatment, and no one had other complications of catheterization. Conclusion After central venous catheterization for the patients with malignant pleural effusion, the effective nursing measures should be implemented to ensure the smooth process of treatment and reduce the suffering caused by repeated thoracocentesis.

  7. Study of incidence and risk factors of urinary tract infection in catheterised patients admitted at tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Jayasukhbhai D. Mangukiya

    2015-12-01

    Conclusions: It is must to implement following strategy for reducing the risk of infection due to indwelling catheters: 1. reducing the duration of catheterization 2. Use antibacterial substance coated catheter 3. Strict infection control measures. [Int J Res Med Sci 2015; 3(12.000: 3808-3811

  8. Dual anterior descending coronary artery associated with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Siqueira Luciane da L. V.

    2003-01-01

    Full Text Available The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation.

  9. CATETERISMO VESICAL FEMININO EM POSIÇÃO DE CONFORTO

    Directory of Open Access Journals (Sweden)

    Nair Matsuko Myamoto

    1981-01-01

    Full Text Available It is an avaluation of the dorsal position with the legs stretched and separated, far away one from another, in the execution of thé feminine vesical catheterism.The informations that we have got show the facility of the execution, a lower danger of contamination, better physical and psychical comfort for the patient, besides a better stability.

  10. Application of PTCA steerable guide wire for abdominal and peripheral interventional angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kuribayashi, Sachio; Ootaki, Makoto; Iwata, Yoshirou; Harada, Tsumio; Tsuji, Makoto; Matsuyama, Seiya

    1988-06-01

    Steerable guide wire used in PTCA was applied for various abdominal and peripheral interventional angiographies in eight patients. In embolization procedures, this wire was used with coaxial catheter system. The steerable wire facilitated superselective catheterization of distal branches in mesenteric, renal and hepatic artery embolizations. This wire was also useful for traversing severe stenoses in renal and peripheral angioplasties.

  11. Imaging of aortopulmonary collateral arteries with high-resolution multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Greil, Gerald F.; Hofbeck, Michael; Sieverding, Ludger [University of Tuebingen, Department of Pediatric Cardiology, Children' s Hospital, Tuebingen (Germany); Schoebinger, Max; Meinzer, Hans-Peter [German Cancer Research Center, Division of Medical and Biological Informatics, Heidelberg (Germany); Kuettner, Axel; Schaefer, Juergen F.; Dammann, Florian; Claussen, Claus D. [University of Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany)

    2006-06-15

    Precise visualization of the pulmonary vasculature is mandatory for adequate treatment of patients with pulmonary atresia and ventricular septal defect (PA-VSD). Aortopulmonary collateral arteries (APCs) can be visualized by selective injections of contrast agent in the catheterization laboratory. To evaluate multidetector CT (MDCT) and different image postprocessing methods for analysis of complex pulmonary blood supply in patients with PA-VSD. Eight patients (6 weeks to 27.8 years of age) with PA-VSD and APCs underwent MDCT and cardiac catheterization. Using multiplanar reformatting, volume rendering and semiautomatic segmentation algorithms, the aorta, pulmonary arteries and APCs were displayed. MDCT and cardiac catheterization were analyzed by two independent observers. MDCT accurately imaged central pulmonary arteries (n=8), aortopulmonary shunts (n=2), right ventricular to pulmonary artery conduits (n=2) and origin, course and intrapulmonary connections of APCs (n=25), compared to X-ray angiography. A high correlation was found between the MDCT vessel diameter measurements by two independent observers (n=70, r=0.96, P<0.01) and between MDCT and angiographic vessel diameter measurements (n=68, r=0.96, P<0.01). Using three-dimensional imaging software, a complex pulmonary blood supply can be non-invasively and accurately imaged with high-resolution MDCT. This technique may help to reduce the number of cardiac catheterizations or guide interventional or surgical therapy. (orig.)

  12. Effect of volume expansion on systemic hemodynamics and central and arterial blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Bendtsen, F; Henriksen, Jens Henrik Sahl

    1995-01-01

    and in controls. METHODS: Thirty-nine patients with cirrhosis (12 patients with Child-Turcotte class A, 14 with class B, and 13 with class C) and 6 controls were studied. During hepatic vein catheterization, cardiac output, systemic vascular resistance, central and arterial blood volume, noncentral blood volume...

  13. Hepatic venous oxygen content in alcoholic cirrhosis and non-cirrhotic alcoholic liver disease

    DEFF Research Database (Denmark)

    Bendtsen, F; Henriksen, Jens Henrik Sahl; Widding, A

    1987-01-01

    Blood gas analyses and hepatic blood flow were determined during hepatic vein catheterization in order to establish a possible hypoxic component in alcoholic liver disease. Fifty-six patients (9 non-cirrhotic liver disease, 14 cirrhosis Child-Turcotte class A, 23 class B, 10 class C) and 10 control...

  14. Hepatic-intestinal disposal of endogenous human alpha atrial natriuretic factor99-126 in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Bendtsen, Flemming; Schütten, H J

    1990-01-01

    Hepatic-intestinal disposal of endogenous human alpha atrial natriuretic factor99-126 (ANF) was assessed in 13 patients with cirrhosis (six Child-Turcotte class A, five class B, and two class C) and eight control subjects. The Fick principle was applied during hepatic vein catheterization. Arterial...

  15. Pediatric Urinary Tract Infection

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and ... To protect the kidneys from damage – By preventing urinary tract infections (UTI) – By identifying and treating vesicoureteral remux (VUR). ...

  16. Necessity is the Mother of Invention.

    Science.gov (United States)

    Sinha, Ramanand Prasad; Kothari, Shivani Rakesh; Thakkar, Ashok Suryakant

    2016-02-01

    A well executed transseptal puncture is crucial for successful percutaneous transvenous mitral balloon valvotomy. We report a case of accidentally damaged Mullins sheath dilator. Due to immediate unavailability of another dilator at cardiac catheterization laboratory, angioplasty guidewire and balloon was used as an additional assisting armamentarium for successful percutaneous transvenous mitral balloon valvotomy.

  17. Healthcare for Women

    Science.gov (United States)

    ... not good for the kidneys and a catheterization program may be warranted. Is orgasm possible? The vagina and sex organs can also be affected by Spina Bilda. Sexual arousal may not always induce vaginal lubrication. Thus, it is important to have a lubricant ...

  18. Embolization of a deep orbital varix through endovascular route

    Directory of Open Access Journals (Sweden)

    R Ravi Kumar

    2015-01-01

    Full Text Available We report a case of the primary deep orbital venous varix treated by endovascular coil embolization procedure by transfemoral catheterization. This method of treatment has the advantage of image-guided localization of the pathology, real-time management and confirmation of the success of the procedure in the sitting.

  19. Serial CSF sampling over a period of 30 h via an indwelling spinal catheter in healthy volunteers : headache, back pain, tolerability and measured acetylcholine profile

    NARCIS (Netherlands)

    den Daas, Izaak; Wemer, Johan; Abou Farha, Khalid; Tamminga, Wim; de Boer, Theo; Spanjersberg, Rob; Struys, Michel M. R. F.; Absalom, Anthony R.

    2013-01-01

    Timed interval cerebrospinal fluid (CSF) sampling by indwelling catheterization can be a valuable corroborative tool for the pharmacokinetic and pharmacodynamic assessment of drugs. CSF sampling in studies on drug candidates for Alzheimer's disease have been conducted in evaluations of the biomarker

  20. Fluid dynamics of coarctation of the aorta: analytical solution, in vitro validation and in vivo evaluation

    Science.gov (United States)

    Keshavarz-Motamed, Zahra

    2015-11-01

    Coarctation of the aorta (COA) is a congenital heart disease corresponding to a narrowing in the aorta. Cardiac catheterization is considered to be the reference standard for definitive evaluation of COA severity, based on the peak-to-peak trans-coarctation pressure gradient (PtoP TCPG) and instantaneous systolic value of trans-COA pressure gradient (TCPG). However, invasive cardiac catheterization may carry high risks given that undergoing multiple follow-up cardiac catheterizations in patients with COA is common. The objective of this study is to present an analytical description of the COA that estimates PtoP TCPG and TCPG without a need for high risk invasive data collection. Coupled Navier-Stokes and elastic deformation equations were solved analytically to estimate TCPG and PtoP TCPG. The results were validated against data measured in vitro (e.g., 90% COA: TCPG: root mean squared error (RMSE) = 3.93 mmHg; PtoP TCPG: RMSE = 7.9 mmHg). Moreover, the estimated PtoP TCPG resulted from the suggested analytical description was validated using clinical data in twenty patients with COA (maximum RMSE: 8.3 mmHg). Very good correlation and concordance were found between TCPG and PtoP TCPG obtained from the analytical formulation and in vitro and in vivo data. The suggested methodology can be considered as an alternative to cardiac catheterization and can help preventing its risks.

  1. Biventricular Takotsubo cardiomyopathy in Graves hyperthyroidism.

    Science.gov (United States)

    Perkins, Matthew J; Schachter, David T

    2014-03-01

    Graves hyperthyroidism is commonly seen in clinical practice and Takotsubo stress cardiomyopathy is an increasingly recognized cardiac complication of physical or emotional stress. We report the rare case of a patient with Graves hyperthyroidism that was complicated by severe biventricular takotsubo cardiomyopathy, which was demonstrated on heart catheterization. After appropriate pharmacologic treatment of her hyperthyroidism, she had complete resolution of her cardiomyopathy.

  2. Accidental placement of central venous catheter in lung parenchyma causing hydrothorax

    Directory of Open Access Journals (Sweden)

    Vivek Badada

    2014-01-01

    Full Text Available Central venous catheterization is associated with its share of complications. Most of these complications can be avoided and treated by appropriate patient selection, careful insertion technique and vigilance following catheter insertion. We report a patient presenting with unilateral hydrothorax due malposition of central venous catheter in lung parenchyma. Prompt recognition of complication and its treatment remedied the situation.

  3. Diagnosis of a missed central line guidewire using critical care ultrasound

    Directory of Open Access Journals (Sweden)

    Ali Al Bshabshe

    2016-01-01

    Full Text Available Central venous catheterization, though an imperative tool in the management of critically ill patient, is associated with a variety of complications and some of which can be life-threatening. Here, we report an index case in the field of critical care of detecting a missed guidewire primarily using a bedside critical care ultrasound.

  4. Blood Gases Test

    Science.gov (United States)

    ... prevent any bleeding from the site. Sometimes mixed venous blood taken from a central line is used in particular situations, such as in cardiac catheterization labs and by transplant services. Careful interpretation of the results is required. Peripheral venous blood, such as that taken from a vein ...

  5. Catheter malposition following supraclavicular approach for subclavian vein catheterisation--case reports.

    Science.gov (United States)

    Singh, Prem K; Ali, Zulfiquar; Rath, Girija P; Prabhakar, Hemanshu

    2008-10-01

    The supraclavicular approach of subclavian vein catheterization is associated with the lowest incidence of malposition. We report two cases of unusual malpositions seen during central venous cathelerization of subclavian vein via supraclavicular approach. Literature search did not reveal such malpositions. The possible cause for the malposition and method to prevent it is discussed.

  6. Malpostion of subclavin central venous cannulation into ipsilateral jugular vein -An unusal case report

    Directory of Open Access Journals (Sweden)

    Vishal

    2013-11-01

    Full Text Available ABSTRACT: Central venous catheterization (CVC via infraclavicular subclavian approach in neurosurgical pat ients is very common practice. Malpositioning of central venous catheter inserted into subclavian vein is a known and dreaded complication. Malpositioning of catheter tip into ipsilateral jugular vein is an unusual occurrence. We hereby describe a case whe re a subclavian central venous catheter malpositioned into ipsilateral jugular vein

  7. Malpostion of subclavin central venous cannulation into ipsilateral jugular vein -An unusal case report

    OpenAIRE

    Vishal; Sumantra; Rajnikant; Dilpreet; Shweta

    2013-01-01

    ABSTRACT: Central venous catheterization (CVC) via infraclavicular subclavian approach in neurosurgical pat ients is very common practice. Malpositioning of central venous catheter inserted into subclavian vein is a known and dreaded complication. Malpositioning of catheter tip into ipsilateral jugular vein is an unusual occurrence. We hereby describe a case whe re a subclavian central venous catheter malpositioned into ipsilateral jugular vein

  8. Aortic thrombus formation during a Seldinger aortography

    Energy Technology Data Exchange (ETDEWEB)

    Kiermayer, H.

    1984-12-01

    Acute aortic thrombosis is a rarely described complication of angiography with the technique of arterial catheterization. In the presented case record, a sudden therapy-resistant rise in blood pressure was accompanied by paraplegia of the lower limbs. The activation of the coagulation system caused by the heterogeneous material brought into the aorta, combined with severe arteriosclerosis, is discussed as a possible cause.

  9. Infektioner relateret til centralvenekatetre

    DEFF Research Database (Denmark)

    Nielsen, J; Kolmos, H J; Espersen, F

    1996-01-01

    by S. aureus. Some patients develop metastatic suppurative complications. Risk factors include prolonged catheterization, localization of catheter to the groin, the number of times the system is entered, use for parenteral nutrition and for dialysis, immunosuppresion and loss of skin integrity...

  10. Pulse Densitometer Indocyanine Green Dilution Curves : A Simple Applicable and Accurate Method for Determination of Cardiac Shunts

    NARCIS (Netherlands)

    Bergstra, Arend; Hoendermis, Elke S.; Talsma, Melle D.; Mook, Gerrit A.; Zijlstra, Willem G.; Berger, Rolf M. F.

    2009-01-01

    Objective. Adequate hemodynamic evaluation is crucial in the management of patients with congenital heart disease. Although non-invasive diagnostic tools have reduced the need for invasive procedures, cardiac catheterization is still mandatory for absolute quantification of pressures, flows and vasc

  11. AngioVac extraction of intra-atrial hepatoma masquerading as PICC-associated thrombus

    Science.gov (United States)

    Abboud, Samir; Raparia, Kirtee; Ubago, Julianne M.; Resnick, Scott

    2016-01-01

    Thrombus associated with peripherally inserted central catheterization is not uncommon. Treatment is typically conservative; however, more aggressive therapies can be considered in patients with tenuous medical condition. The authors present a patient with metastatic hepatocellular carcinoma masquerading as peripherally inserted central catheter-associated intra-atrial thrombus, subsequently removed via vacuum-assisted mechanical thrombectomy. PMID:26509915

  12. Polypoid cystitis mimicking bladder tumor: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Pil Yeob; Kwon, Oh Jun; Kim, Jong Kuk [School of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2002-01-01

    Polypoid cystitis without a history of catheterization is rare. We report a case in which the condition occurred in a 16-year-old girl complaining of dysuria, urgency, frequency, and a residual urine sensation. Cystography revealed a large intravesical filling defect with bladder distension, while sonography and CT demonstrated a large, inhomogeneously enhancing solid mass in the urinary bladder.

  13. Proteus mirabilis biofilm - qualitative and quantitative colorimetric methods-based evaluation.

    Science.gov (United States)

    Kwiecinska-Piróg, Joanna; Bogiel, Tomasz; Skowron, Krzysztof; Wieckowska, Ewa; Gospodarek, Eugenia

    2014-01-01

    Proteus mirabilis strains ability to form biofilm is a current topic of a number of research worldwide. In this study the biofilm formation of P. mirabilis strains derived from urine of the catheterized and non-catheterized patients has been investigated. A total number of 39 P. mirabilis strains isolated from the urine samples of the patients of dr Antoni Jurasz University Hospital No. 1 in Bydgoszcz clinics between 2011 and 2012 was used. Biofilm formation was evaluated using two independent quantitative and qualitative methods with TTC (2,3,5-triphenyl-tetrazolium chloride) and CV (crystal violet) application. The obtained results confirmed biofilm formation by all the examined strains, except quantitative method with TTC, in which 7.7% of the strains did not have this ability. It was shown that P. mirabilis rods have the ability to form biofilm on the surfaces of both biomaterials applied, polystyrene and polyvinyl chloride (Nelaton catheters). The differences in ability to form biofilm observed between P. mirabilis strains derived from the urine of the catheterized and non-catheterized patients were not statistically significant.

  14. Proteus mirabilis biofilm - Qualitative and quantitative colorimetric methods-based evaluation

    Directory of Open Access Journals (Sweden)

    Joanna Kwiecinska-Piróg

    2014-12-01

    Full Text Available Proteus mirabilis strains ability to form biofilm is a current topic of a number of research worldwide. In this study the biofilm formation of P. mirabilis strains derived from urine of the catheterized and non-catheterized patients has been investigated. A total number of 39 P. mirabilis strains isolated from the urine samples of the patients of dr Antoni Jurasz University Hospital No. 1 in Bydgoszcz clinics between 2011 and 2012 was used. Biofilm formation was evaluated using two independent quantitative and qualitative methods with TTC (2,3,5-triphenyl-tetrazolium chloride and CV (crystal violet application. The obtained results confirmed biofilm formation by all the examined strains, except quantitative method with TTC, in which 7.7% of the strains did not have this ability. It was shown that P. mirabilis rods have the ability to form biofilm on the surfaces of both biomaterials applied, polystyrene and polyvinyl chloride (Nelaton catheters. The differences in ability to form biofilm observed between P. mirabilis strains derived from the urine of the catheterized and non-catheterized patients were not statistically significant.

  15. Pulmonary extraction of circulating noradrenaline in man

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Christensen, N J; Ring-Larsen, H

    1986-01-01

    Pulmonary plasma kinetics of endogenous noradrenaline (NA) and tritium labelled L-noradrenaline (3H-NA) was studied in fifteen subjects during pulmonary arterial catheterization. Plasma NA concentration in femoral artery ranged from 0.5 to 8.2 nmol l-1, mean 2.3 nmol l-1, which was not significan...

  16. Recovery after total intravenous general anaesthesia or spinal anaesthesia for total knee arthroplasty

    DEFF Research Database (Denmark)

    Harsten, A; Kehlet, H; Toksvig-Larsen, S

    2013-01-01

    . Secondary outcome parameters included actual time of discharge, postoperative pain, intraoperative blood loss, length of stay in the Post Anaesthesia Care Unit, dizziness, postoperative nausea and vomiting, need for urinary catheterization and subject satisfaction. RESULTS: /st>GA resulted in shorter LOS...

  17. Maintenance of increased coronary blood flow in excess of demand by nisoldipine administered as an intravenous infusion

    NARCIS (Netherlands)

    A.L. Soward; P.J. de Feyter (Pim); P.G. Hugenholtz (Paul); P.W.J.C. Serruys (Patrick)

    1986-01-01

    textabstractSystemic and hemodynamic effects of nisoldipine, administered as a 4.5-micrograms/kg intravenous bolus over 3 minutes followed immediately by an infusion of 0.2 microgram/kg/min over 30 minutes, were studied in 13 patients undergoing diagnostic catheterization for suspected coronary arte

  18. 深静脉穿刺置管在急诊中的应用%Application of Deep Venous Puncture in Emergency Department

    Institute of Scientific and Technical Information of China (English)

    熊伟

    2015-01-01

    目的分析探讨深静脉穿刺置管术在急诊临床工作中的应用价值。方法回顾性分析我院2012年10月~2014年10月52例行深静脉穿刺置管的患者进行分析。结果深静脉穿刺置管术成功率高,能迅速的帮助休克患者补液,抢救效果良好,且并发症少。结论深静脉穿刺置管术是一项效果明显的急救技术,在急诊抢救工作中有重要作用。%Objective To explore the application value of deep venous puncture and catheterization in emergency treatment.Methods Retrospective analysis of 52 patients with deep venous catheterization from October 2012 to October 2014 in our hospital.Results The success rate of deep venous catheterization was high,and it can help the patients with shock in a rapid rate of fluid infusion,the rescue ef ect is good,and the complications are few.Conclusion Deep venous catheterization is an ef ective emergency treatment technology,which plays an important role in the emergency rescue work.

  19. Pulmonary Hypertension in Scleroderma

    Science.gov (United States)

    ... is a reduced diffusing capacity (DL CO ) on pulmonary function tests (PFTs). The DL CO measures the ability of ... catheterization to measure the actual pressure in the pulmonary ... the PH; to assess the function of the left side of the heart; and ...

  20. Hyperglycemia suppresses the sympatho-adrenal response to hypoxia, but not to handling stress

    NARCIS (Netherlands)

    Benthem, L; Taborsky, G.J.

    1998-01-01

    We hypothesized that the ability of prior hyperglycemia to suppress the sympatho-adrenal response would depend on the type of stress. To test this hypothesis, hyperglycemia was induced in chronically catheterized rats, before submitting them to either hypoxia (7.5% O-2) or handling stress. Central v

  1. Safety of a New Compact Male Intermittent Catheter: Randomized, Cross-Over, Single-Blind Study in Healthy Male Volunteers

    DEFF Research Database (Denmark)

    Bagi, Per; Hannibalsen, Jane; Permild, Rikke

    2011-01-01

    Introduction: A new compact male intermittent catheter was compared with a regular intermittent male catheter in terms of safety and acceptability. Methods: In this randomized, single-blind, cross-over study, healthy male volunteers were catheterized twice with a compact catheter and twice with a...

  2. Hepatic cystic echinococcosis:Percutaneous treatment as an outpatient procedure

    Institute of Scientific and Technical Information of China (English)

    Mert Krolu; Okan Akhan; Bekir Erol; Cemil Grses; Bar Trkbey; Cem Yunus Ba; Ahmetkr Alparslan; Banu Kale Krolu; clal Erdem Toslak; Blenteki

    2014-01-01

    Objective:To demonstrate utility and safety of the puncture aspiration injection and reaspiration (PAIR) technique for outpatients.Methods:Percutaneous treatment withUS guidance was applied to33 patients for44 cysts.Patients treated with thePAIR technique, were outpatients. PAIR and catheterization technique were evaluated for efficacy and safety of procedure and complication rates.Results:Thirty-five of44 cysts were treated with thePAIR and9 of44 were treated with the catheterization technique.The success rate of the cystsGharbi type1(CE1) and type2(CE3a) treated with thePAIR technique was100%.In the follow up of9 cysts treated with the catheterization technique,2 of them(22%) developed cyst infection and1(11%) developed a biliary fistula.Conclusions:ThePAIR technique was found to be an effective and safe approach in order to treatGharbi type1 and type2 cysts percutaneously for outpatients.It has a very low complication rate in comparison with the catheterization technique.So every effort should be made to finish the treatment withPAIR technique.

  3. Meal-induced changes in splanchnic blood flow and oxygen uptake in middle-aged healthy humans

    DEFF Research Database (Denmark)

    Madsen, Jan L; Søndergaard, Susanne B; Møller, Søren

    2006-01-01

    healthy men (52-76 years). Splanchnic blood flow was measured during hepatic vein catheterization by indirect Fick principle with indocyanine green as the indicator. Splanchnic oxygen uptake was calculated from splanchnic blood flow and the arteriovenous oxygen difference. RESULTS: The meal induced...

  4. BNP and N-terminal proBNP are both extracted in the normal kidney

    DEFF Research Database (Denmark)

    Gøtze, Jens Peter; Jensen, Gorm Boje; Møller, Søren;

    2006-01-01

    with catheterization of the femoral artery and femoral and renal veins. Blood sampling from the catheters allowed determination of the arteriovenous extraction ratio of N-terminal proBNP and BNP. Results Neither the peripheral N-terminal proBNP (13, 11, 19 pmol L(-1), NS) nor the BNP plasma concentrations (4, 12, 9...

  5. The acid-labile subunit of human ternary insulin-like growth factor binding protein complex in serum

    DEFF Research Database (Denmark)

    Juul, A; Møller, S; Mosfeldt-Laursen, E;

    1998-01-01

    of ALS determination is not known. We therefore, determined the: 1) hepatosplanchnic release of ALS by liver vein catheterization (n=30); 2) 24-h diurnal variation of ALS (n=8); 3) normal age-related ranges of circulating ALS (n=1158); 4) diagnostic value of ALS in 108 patients with childhood-onset GH...

  6. Elevated circulating leptin levels in arterial hypertension: relationship to arteriovenous overflow and extraction of leptin

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Holst, J J; Møller, Søren;

    2000-01-01

    during catheterization with elective blood sampling from different vascular beds (artery, and renal, hepatic, iliac and cubital veins). Plasma leptin was determined by a radioimmunoassay. Patients with hypertension had significantly elevated levels of circulating leptin (12.8 ng/l, compared with 4.1 ng...

  7. [Percutaneous brachial access: a few simple considerations].

    Science.gov (United States)

    Marcy, P Y; Ianessi, A; Ben Taarit, I

    2009-01-01

    This letter is with regards to the recently published article by Vidal et al. in the Journal Français de Radiologie Médicale. A clarification of US and venographic techniques of brachial venous catheterization and related complications are presented. The main indications for PICC line and subcutaneous port placement are described.

  8. Validation of an Endoscopic Fibre-Optic Pressure Sensor for Noninvasive Measurement of Variceal Pressure

    Directory of Open Access Journals (Sweden)

    Bin Sun

    2016-01-01

    Full Text Available In this study, the authors have developed endoscopic fibre-optic pressure sensor to detect variceal pressure and presented the validation of in vivo and in vitro studies, because the HVPG requires catheterization of hepatic veins, which is invasive and inconvenient. Compared with HVPG, it is better to measure directly the variceal pressure without puncturing the varices in a noninvasive way.

  9. Apical Hypertrophic Cardiomyopathy in Association with PulmonaryArtery Hypertension

    Directory of Open Access Journals (Sweden)

    Mehdi Peighambari

    2012-09-01

    Full Text Available Apical Hypertrophic Cardiomyopathy is an uncommon condition constituting 1% -2% of the cases with Hypertrophic Cardiomyopathy (HCM diagnosis. We interestingly report two patients with apical hypertrophic cardiomyopathy in association with significant pulmonary artery hypertension without any other underlying reason for pulmonary hypertension. The patients were assessed by echocardiography, cardiac catheterization and pulmonary function parameters study.

  10. Markers of fibrinolytic potency and clotting activation in stable angina pectoris : Role of urokinase, assessment of atrioventricular differences and correlation with coronary patency

    NARCIS (Netherlands)

    Páramo, U.A.; Panizo, C.; Montes, R.; Orbe, J.; Alegría, E.; Martínez-Caro, D.; Dooijewaard, G.

    1999-01-01

    To characterize the extent of activation of the hemostatic system and to detect local alterations which may favour thrombus formation we obtained samples from the right atrium (RA) and left ventricle (LV) of 60 stable angina patients (mean age 59 years, M/F: 49/11) during the cardiac catheterization

  11. Propranolol and haemodynamic response in cirrhosis

    DEFF Research Database (Denmark)

    Bendtsen, F; Henriksen, Jens Henrik Sahl; Sørensen, T I

    1991-01-01

    In the present study, we compared cirrhotic patients who had a decrease in the hepatic venous pressure gradient after propranolol intake to patients without a decrease. Twenty patients with cirrhosis and oesophageal varices were investigated during hepatic vein catheterization before and 90 min...

  12. Prostaglandin E2 induces vascular relaxation by E-prostanoid 4 receptor-mediated activation of endothelial nitric oxide synthase

    DEFF Research Database (Denmark)

    Hristovska, Ana-Marija; Rasmussen, Lasse E; Hansen, Pernille B L;

    2007-01-01

    , calyculin (10(-8) mol/L), abolished the PGE(2)-mediated relaxation. In aortic rings, PGE(2) dephosphorylated eNOS at Thr(495). Chronically catheterized eNOS(-/-) mice were hypertensive (137+/-3.6 mm Hg, n=13, versus 101+/-3.9 mm Hg, n=9) and exhibited a lower sensitivity of blood pressure reduction...

  13. Left ventricular dysfunction in patients with suspected pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Francisca Gavilanes

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the role of right heart catheterization in the diagnosis of pulmonary arterial hypertension (PAH. METHODS: We evaluated clinical, functional, and hemodynamic data from all patients who underwent right heart catheterization because of diagnostic suspicion of PAH-in the absence of severe left ventricular dysfunction (LVD, significant changes in pulmonary function tests, and ventilation/perfusion lung scintigraphy findings consistent with chronic pulmonary thromboembolism-between 2008 and 2013 at our facility. RESULTS: During the study period, 384 patients underwent diagnostic cardiac catheterization at our facility. Pulmonary hypertension (PH was confirmed in 302 patients (78.6%. The mean age of those patients was 48.7 years. The patients without PH showed better hemodynamic profiles and lower levels of B-type natriuretic peptide. Nevertheless, 13.8% of the patients without PH were categorized as New York Heart Association functional class III or IV. Of the 218 patients who met the inclusion criteria, 40 (18.3% and 178 (81.7% were diagnosed with PH associated with LVD (PH-LVD and with PAH, respectively. The patients in the HP-LVD group were significantly older than were those in the PAH group (p < 0.0001. CONCLUSIONS: The proportional difference between the PAH and PH-LVD groups was quite significant, considering the absence of echocardiographic signs suggestive of severe LVD during the pre-catheterization investigation. Our results highlight the fundamental role of cardiac catheterization in the diagnosis of PAH, especially in older patients, in whom the prevalence of LVD that has gone undiagnosed by non-invasive tests is particularly relevant.

  14. Bedside ultrasound reliability in locating catheter and detecting complications

    Directory of Open Access Journals (Sweden)

    Payman Moharamzadeh

    2016-10-01

    Full Text Available Introduction: Central venous catheterization is one of the most common medical procedures and is associated with such complications as misplacement and pneumothorax. Chest X-ray is among good ways for evaluation of these complications. However, due to patient’s excessive exposure to radiation, time consumption and low diagnostic value in detecting pneumothorax in the supine patient, the present study intends to examine bedside ultrasound diagnostic value in locating tip of the catheter and pneumothorax. Materials and methods: In the present cross-sectional study, all referred patients requiring central venous catheterization were examined. Central venous catheterization was performed by a trained emergency medicine specialist, and the location of catheter and the presence of pneumothorax were examined and compared using two modalities of ultrasound and x-ray (as the reference standard. Sensitivity, specificity, and positive and negative predicting values were reported. Results: A total of 200 non-trauma patients were included in the study (58% men. Cohen’s Kappa consistency coefficients for catheterization and diagnosis of pneumothorax were found as 0.49 (95% CI: 0.43-0.55, 0.89 (P<0.001, (95% CI: 97.8-100, respectively. Also, ultrasound sensitivity and specificity in diagnosing pneumothorax were 75% (95% CI: 35.6-95.5, and 100% (95% CI: 97.6-100, respectively. Conclusion: The present study results showed low diagnostic value of ultrasound in determining catheter location and in detecting pneumothorax. With knowledge of previous studies, the search still on this field.   Keywords: Central venous catheterization; complications; bedside ultrasound; radiography;

  15. Transurethral bladder irrigation in male nursing intervention analysis of neurogenic bladder%经尿道膀胱冲洗对男性神经源性膀胱护理干预的分析

    Institute of Scientific and Technical Information of China (English)

    谢粟梅; 李艳芬; 陈中英; 文琪; 孙群

    2016-01-01

    Objective To explore the transurethral bladder irrigation in male neurogenic bladder nursing intervention ef-fect and application value.Methods From September 2014 to June 2015,60 patients neurogenic bladder caused by spinal cord injury in our hospital were selected and randomly divided into control group (clean intermittent catheteriza-tion) and observation group (transurethral plasmakentic vaporization of bladder irrigation) based on clean intermittent catheterization,record the 1st,3rd,6th months average daily number of urethral catheterization in both groups,the average amount of urethral catheterization,bladder residual urine volume;Record fever,blood in urine,urinary tract infection and other adverse events;Compared two groups of bladder washing and complication treatment total cost.Results The 3rd,6th months average daily number of urethral catheterization,the average amount of urethral catheterization,bladder residual urine volume in the observation group compared with before intervention,with the siginificant difference (P﹤0.05);Com-pared with the control group and observation group,fewer daily urethral catheterization on average amount of urethral catheterization,bladder residual urine volume,with the siginificant difference(P﹤0.05).Observation group bladder washout and complication treatment combined cost less than that of control group;The complication rate of observation group was lower than those of control group (P﹤0.05).Conclusion Transurethral bladder irrigation can promote the urethral catheterization,reduce bladder residual urine volume and complications.It can be used widely in clinic.%目的:探讨经尿道膀胱冲洗在男性神经源性膀胱护理干预中的实施效果及应用价值。方法选取2014年9月~2015年6月本院门诊处收集的脊髓损伤导致的神经源性膀胱患者60例,随机分为对照组(清洁间歇性导尿)和观察组(清洁间歇性导尿基础上行经尿道膀胱冲洗),记录第1、3、6个

  16. Screening for aortic aneurysm after treatment of coarctation.

    Science.gov (United States)

    Hoffman, James L; Gray, Robert G; LuAnn Minich, L; Wilkinson, Stephen E; Heywood, Mason; Edwards, Reggie; Weng, Hsin Ti; Su, Jason T

    2014-01-01

    Isolated coarctation of the aorta (CoA) occurs in 6-8 % of patients with congenital heart disease. After successful relief of obstruction, patients remain at risk for aortic aneurysm formation at the site of the repair. We sought to determine the diagnostic utility of echocardiography compared with advanced arch imaging (AAI) in diagnosing aortic aneurysms in pediatric patients after CoA repair. The Congenital Heart Databases from 1996 and 2009 were reviewed. All patients treated for CoA who had AAI defined by cardiac magnetic resonance imaging (MRI), computed tomography (CT), or catheterization were identified. Data collected included the following: type, timing, and number of interventions, presence and time to aneurysm diagnosis, and mortality. Patients were subdivided into surgical and catheterization groups for analysis. Seven hundred and fifty-nine patients underwent treatment for CoA during the study period. Three hundred and ninety-nine patients had at least one AAI. Aneurysms were diagnosed by AAI in 28 of 399 patients at a mean of 10 ± 8.4 years after treatment. Echocardiography reports were available for 380 of 399 patients with AAI. The sensitivity of echocardiography for detecting aneurysms was 24 %. The prevalence of aneurysms was significantly greater in the catheterization group (p Aneurysm was also diagnosed earlier in the catheterization group compared with the surgery group (p = 0.02). Multivariate analysis showed a significantly increased risk of aneurysm diagnosis in patients in the catheterization subgroup and in patients requiring more than three procedures. Aortic aneurysms continue to be an important complication after CoA repair. Although serial echocardiograms are the test of choice for following-up most congenital cardiac lesions in pediatrics, our data show that echocardiography is inadequate for the detection of aneurysms after CoA repair. Because the time to aneurysm diagnosis was shorter and the risk greater in the

  17. Bladder management methods and urological complications in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Roop Singh

    2011-01-01

    Full Text Available Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI and other urological complications in spinal cord injury patients (SCI, and to compare the incidence of these complications with different bladder management subgroups. Materials and Methods: 545 patients (386 males and 159 females of traumatic spinal cord injury with the mean age of 35.4±16.2 years (range, 18 - 73 years were included in the study. The data regarding demography, bladder type, method of bladder management, and urological complications, were recorded. Bladder management methods included indwelling catheterization in 224 cases, clean intermittent catheterization (CIC in 180 cases, condom drainage in 45 cases, suprapubic cystostomy in 24 cases, reflex voiding in 32 cases, and normal voiding in 40 cases. We assessed the incidence of UTI and bacteriuria as the number of episodes per hundred person-days, and other urological complications as percentages. Results: The overall incidence of bacteriuria was 1.70 / hundred person-days. The overall incidenceof urinary tract infection was 0.64 / hundered person-days. The incidence of UTI per 100 person-days was 2.68 for indwelling catheterization, 0.34 for CIC, 0.34 for condom drainage, 0.56 for suprapubic cystostomy, 0.34 for reflex voiding, and 0.32 for normal voiding. Other urological complications recorded were urethral stricture (n=66, 12.1%, urethritis (n=78, 14.3%, periurethral abscess (n=45, 8.2%, epididymorchitis (n=44, 8.07%, urethral false passage (n=22, 4.03%, urethral fistula (n=11, 2%, lithiasis (n=23, 4.2%, hematuria (n=44, 8.07%, stress incontinence (n=60, 11%, and pyelonephritis (n=6, 1.1%. Clean intermittent catheterization was associated with lower incidence of urological complications, in comparison to indwelling catheterization. Conclusions

  18. Low Diagnostic Yield of Elective Coronary Angiography

    Science.gov (United States)

    Patel, Manesh R.; Peterson, Eric D.; Dai, David; Brennan, J. Matthew; Redberg, Rita F.; Anderson, H. Vernon; Brindis, Ralph G.; Douglas, Pamela S.

    2014-01-01

    Background Guidelines for triaging patients for cardiac catheterization recommend a risk assessment and noninvasive testing. We determined patterns of noninvasive testing and the diagnostic yield of catheterization among patients with suspected coronary artery disease in a contemporary national sample. Methods From January 2004 through April 2008, at 663 hospitals in the American College of Cardiology National Cardiovascular Data Registry, we identified patients without known coronary artery disease who were undergoing elective catheterization. The patients’ demographic characteristics, risk factors, and symptoms and the results of noninvasive testing were correlated with the presence of obstructive coronary artery disease, which was defined as stenosis of 50% or more of the diameter of the left main coronary artery or stenosis of 70% or more of the diameter of a major epicardial vessel. Results A total of 398,978 patients were included in the study. The median age was 61 years; 52.7% of the patients were men, 26.0% had diabetes, and 69.6% had hypertension. Noninvasive testing was performed in 83.9% of the patients. At catheterization, 149,739 patients (37.6%) had obstructive coronary artery disease. No coronary artery disease (defined as <20% stenosis in all vessels) was reported in 39.2% of the patients. Independent predictors of obstructive coronary artery disease included male sex (odds ratio, 2.70; 95% confidence interval [CI], 2.64 to 2.76), older age (odds ratio per 5-year increment, 1.29; 95% CI, 1.28 to 1.30), presence of insulin-dependent diabetes (odds ratio, 2.14; 95% CI, 2.07 to 2.21), and presence of dyslipidemia (odds ratio, 1.62; 95% CI, 1.57 to 1.67). Patients with a positive result on a noninvasive test were moderately more likely to have obstructive coronary artery disease than those who did not undergo any testing (41.0% vs. 35.0%; P<0.001; adjusted odds ratio, 1.28; 95% CI, 1.19 to 1.37). Conclusions In this study, slightly more than one

  19. Novel paravertebral block during single-incision thoracoscopic surgery for primary spontaneous pneumothorax.

    Science.gov (United States)

    Tsuboshima, Kenji; Nagata, Machiko; Wakahara, Teppei; Matoba, Yasumi; Nishio, Wataru; Maniwa, Yoshimasa

    2016-01-01

    Recently, the use of paravertebral block (PVB) during thoracic surgery has been re-evaluated, as it is not inferior to epidural anaesthesia for postoperative pain control, and has been associated with fewer complications (e.g., hematoma of epidural, hypotension, urinary retention, postoperative nausea and vomiting). No reports have described intraoperative catheterization for PVB during single-incision thoracoscopic surgery (SITS) as distinct from thoracotomy or multi-ports video-assisted thoracoscopic surgery. We describe a case of SITS bullectomy using a chest wall pulley for lung excision to treat primary spontaneous pneumothorax and 25 catheterizations for PVB during SITS that have been performed since June 2013. Our novel technique is both easy and safe. It is ideal to combine PVB with SITS because both methods are less invasive.

  20. Corrected transposition of great arteries; Skorygowane przelozenie wielkich pni tetniczych

    Energy Technology Data Exchange (ETDEWEB)

    Erecinski, J.; Aleszewicz-Baranowska, J.; Chojnicki, M.; Sabiniewicz, R. [Inst. Pediatrii, Akademia Medyczna, Gdansk (Poland)

    1995-12-31

    20 patients with the diagnosis of congenital corrected transposition of great arteries were analyzed. The diagnosis was based on routine clinical examination, echocardiography and in certain cases on heart catheterization and angiocardiography. In the most cases c-TGA coexists with additional heart defects. The commonest coexisting defects were: ventricular septal defect (60%), pulmonary stenosis (50%), atrio-ventricular valve regurgitation, predominantly systemic (tricuspid 45%). In the most cases 2D Doppler echo examination was sufficient for morphological assessment. In order to quality to cardiosurgical treatment heart catheterization and angiocardiography were necessary. 5 children were treated surgically. 3 of them underwent palliative procedures, one - Rastelli procedure and one had corrective surgery with bad result. Clinical picture of corrected transposition of great arteries is determined by coexisting additional heart defects. (author) 15 refs, 6 figs, 1 tab