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S M Rivitz

Publications and source records attributed to S M Rivitz.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Migration of central venous catheters: implications for initial catheter tip positioning.

PURPOSE: To evaluate the change in position of chest wall central venous access catheters (CVACs) after placement. Complication rates associated with catheter tip position were reviewed. PATIENTS AND METHODS: Fifty patients (36 women, 14 men) with chest wall CVACs placed in the angiography suite were studied. Catheter migration was calculated as the difference between the carina-catheter tip measurements on immediate supine and upright postprocedure (within 24 hours) chest radiographs. Catheter-related complication data were gathered via telephone interview and review of the medical records. RESULTS: Peripheral catheter migration occurred in 49 of 50 patients (average, 3.2 cm +/- 1.8); central catheter migration occurred in one of 50 patients (3.9 cm). Catheter type was the only significant factor that affected the amount of migration; side of insertion or the patient's gender were not significant. Catheter malfunction and symptomatic upper extremity venous thrombosis rates tended to be lower in patients with right atrial versus superior vena cava catheters (18% vs 34%), but differences were not significant (P = .202). CONCLUSION: Catheter migration after chest wall CVAC placement is a common event. The catheter tip should be initially positioned approximately 3-4 cm more centrally than the desired final position. Further study is necessary of catheter-related complication rates relative to the final position of the catheter tip.

Catheterization, Central Venous↗
PubMedDate not supplied

Power injection of peripherally inserted central catheters.

PURPOSE: To study the tolerance of peripherally inserted central catheters (PICCs) of varying sizes and materials to power injection of radiographic contrast agents. MATERIALS AND METHODS: Eight different models of silicone and five different models of polyurethane single-lumen PICCs were injected with increasing rates of iothalamate 60% with use of a power injector. Tolerated and bursting rates and pressures were recorded. RESULTS: There was a wide range of tolerated rates and pressures, depending on the inner and outer diameters of the catheters and on the catheter material. Silicone PICCs tolerated rates between 0.4 and 7.0 mL/sec and polyurethane PICCs tolerated rates between 0.6 and 10.2 mL/sec, depending on the specific catheter. The 5-F silicone PICCs and the 4-F and 5-F polyurethane PICCs tested all tolerated rates greater than 4 mL/sec. Silicone catheters tolerated pressures between 107 and 184 psi, and polyurethane catheters tolerated pressures between 160 and 314 psi. CONCLUSIONS: Larger single-lumen silicone and polyurethane PICCs may be suitable for power injection of contrast agents.

Catheterization, Central Venous↗