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At least 19 recordsLinked to original sources
PubMed2003

[Complications due to peripheral venous catheterization. Prospective study].

OBJECTIVE: Peripheral venous catheter (PVC)-associated complications were prospectively evaluated in a 2 month-study performed in 3 different wards. METHODS: For each inserted PVC, the following complications were observed daily by an external investigator: tenderness, erythema, swelling or induration, palpable cord and purulence. PVC that were removed were systematically sent to the Microbiology department and analysed according to the semi-quantitative method described by Brun-Buisson et al. RESULTS: A total of 525 PVC (corresponding to 1,036 catheterisation-days) were included. Main clinical complications were erythema (22.1%), tenderness (21.9%), swelling or induration (20.9%), palpable cord (2.7%) and purulence (0.2%). Phlebitis, defined by 2 or more of the following signs: tenderness, erythema, swelling or induration and palpable cord, was observed in 22%. Catheter colonization (> or = 103 CFU/ml) occurred in 13%. Bacteria isolated from colonized catheters were coagulase-negative staphylococci (88.1%), Staphylococcus aureus (7.1%) and Candida sp. (4.8%). Multivariate risk factor analysis showed that age > or = 55 y. (OR = 3.16, p = 0.003), insertion on articulation site (OR = 2.94, p = 0.01) or in jugular vein (OR = 8.18, p = 0.01) and > 72 hour-catheterisation (OR = 4.74, p = 0.0003) were significantly associated with PVC colonization. Risk factors for phlebitis were skin lesions (OR = 1.88, p < 0.016), active infection unrelated to PVC (OR = 2.8, p = 0.001), "poor quality" peripheral vein (OR = 2.46, p < 0.02) and > 72 hour-catherisation (OR = 2.38, p = 0.009). CONCLUSION: Complications associated with peripheral venous catheters are frequent but remain benign. They could probably be reduced by a systematic change every 72-96 hours as recommended by different guidelines.

Adolescent↗
PubMed1994

Vascular complications of cardiac catheterization.

Peripheral vascular complications after cardiac catheterization constitute an increasing portion of traumatic vascular injuries. To determine the incidence of these complications and the sequelae of their treatment, we reviewed 7,690 catheterizations performed over a 40-month period. One hundred eleven vascular complications were detected (1%), 41 of which required surgical repair (0.5%). Pseudoaneurysm (10), arteriovenous fistula (4), thromboembolism (9), infection (5), and other bleeding complications (83) were all found. Significantly more complications occurred in patients who were older than 60 years of age or female (P < 0.0009). In addition, the likelihood of a vascular injury after coronary angioplasty was significantly higher than after angiography alone (3% versus 1%, P < 0.00001). Secondary local and systemic complications after surgical repair were more frequent compared with those injuries that were managed nonoperatively (32% versus 11%; P = 0.015). Vascular complications continue to be a significant problem after cardiac catheterization, especially when coronary angioplasty is performed. The sequelae of surgical repair are significant, adding to their morbidity. Periodic review of these complications may identify factors that might be modified to reduce complications.

Aneurysm, False↗
PubMedDate not supplied

Peripheral nerve catheterization in the management of terminal cancer pain.

BACKGROUND AND OBJECTIVES: Peripheral nerve catheterization techniques were used in two patients with severe pain associated with the terminal stages of metastatic cancer. The first patient had severe upper limb pain and lymphedema secondary to breast carcinoma, and the second patient had an acutely ischemic leg secondary to pelvic obstruction from an ovarian tumor. The goal of treatment was to relieve the pain, which was resistant to opioid drugs, and to optimize the quality of life that remained, estimated to be only a few weeks. METHODS: The first patient received a continuous brachial plexus block via an epidural catheter, introduced by means of a Tuohy needle and a peripheral nerve stimulator to locate the plexus accurately. The second patient required catheterization of both the sciatic and femoral nerves, again with a peripheral nerve stimulator used to locate the nerves prior to inserting the catheters. RESULTS: Analgesia was established with a bolus of local anesthetic and maintained with a continuous infusion of local anesthetic in the first patient. For the second patient, fentanyl was added to the local anesthetic, as it had been shown to improve analgesia in the lower limb in previous work. In the first patient, the analgesia allowed active treatment of the lymphedema and mobilization of the limb, and she remained pain free until her death 2 weeks later. In the second patient, the infusions controlled the pain both before and after surgical amputation of the limb, until the stump was well healed. CONCLUSIONS: Peripheral nerve catheterization proved beneficial in two patients who presented with difficult pain management problems and should be more widely considered for the relief of severe cancer-related pain in both the upper and lower limbs.

Aged↗
PubMed1983

Infection and peripheral venous catheterization.

A prospective bacteriological and clinical study was carried out to determine the incidence of local and systemic infection associated with peripheral venous catheterization in a 630-bed general hospital with 24 hr intravenous team coverage. In all, 1,696 cannulas were obtained using standardized techniques and were cultured by a semiquantitative method on solid media. 41 cannulas (2.4%) yielded positive cultures (15 or more colonies). An additional 318 (18.8%) showed lesser growth indicative of contamination. No case of septicemia was encountered. Local signs of inflammation showed no correlation with positive cannula culture. The semiquantitative culture technique is easily performed and yields clear results. However, the upper limit for the number of colonies which should be regarded as contamination and criteria for phlebitis require further study. Although the infective risk of peripheral venous catheterization must not be ignored, an extremely low rate can be achieved with continuous IV team coverage and strict aseptic technique.

Bacterial Infections↗
PubMed1999

[Elements for a cost/utility analysis of long term intravenous devices].

Three long-term intravenous infusion strategies were compared, namely an implantable port (IP), a tunneled central catheter (TCC), and repeated peripheral catheterization (RPC). A decision analysis model was used in which the sequence of decisions and their possible consequences was described as a decision tree for each of the three strategies. The likelihood of each event occurring was determined based on a literature review. Each event was assigned a cost and a utility. Direct medical costs for the society include the cost of the material, the cost of implantation and removal of the device in the operating room, and the cost of treating complications directly ascribable to the strategy used. Utility is a combination of efficacy (as evaluated based on the likelihood of use of the strategy for one year) and quality of life (as evaluated by experts). In the basic analysis, RPC was the most cost-saving method but had an adverse effect on quality of life (0.82). The cost of using IC or TCC for one year was higher, with the main contributors to the excess cost being the insertion procedure and the management of complications (primarily deep vein thrombosis and infection). Quality of life was better with IC (0.98) than with TCC (0.93). IC also had a higher cost-utility ratio (11,738 French francs [FF]) versus 17,393 FF). A one-way sensitivity comparison of IC and TCC showed that the only realistic change capable of reversing the order between these two methods was a decrease by one-third in the risk of infection with TCCs. This model, used here for the first time, establishes that IC is superior over TCC.

Catheterization↗
PubMed1988

Intravascular access in pediatric cardiac arrest.

All cases of patients aged less than 48 months who presented in cardiac arrest to the Hennepin County Medical Center's emergency department (ED) during the years 1984 to 1986 were reviewed retrospectively. The ED record, initial and subsequent chest radiographs, hospital charts, and autopsy reports were analyzed. A total of 33 cases were reviewed. The average patient age was 5 months. The average time needed to establish intravascular access was 7.9 +/- 4.2 minutes. Success rates were 77% for central venous catheterization, 81% for surgical vein cutdown, 83% for intraosseous infusion, and 17% for percutaneous peripheral catheterization. Percutaneous peripheral catheterization, when successful, and bone marrow needle placement were the fastest methods of obtaining intravascular access. There were no major immediate complications, and delayed complications were minimal. Attempts at peripheral intravenous catheter placement should be brief, with rapid progression to intraosseous infusion if peripheral attempts are not successful.

Bone Marrow↗
PubMed1992

Umbilical vs peripheral vein catheterization for parenteral nutrition in sick premature neonates.

The efficacy and safety of using umbilical venous catheters vs. peripheral venous catheters for the delivery of parenteral nutrition was studied in 129 critically ill premature infants who were treated in a neonatal intensive care unit for the first 3 weeks of life. Infants who received parenteral nutrition by umbilical venous catheter had greater parenteral caloric intake, lower physiologic weight loss and greater weight gain during the study as compared to infants who received parenteral nutrition by peripheral vein. While the overall incidence of sepsis was comparable in both groups (19% vs 19.7%), benign and transient episodes of hyperglycemia were seen more commonly in infants receiving parenteral nutrition by umbilical catheters. None of the hyperglycemic infants, however, required insulin therapy. The incidence of other metabolic complication was comparable in both groups. At follow up, no evidence of portal hypertension was detected in any of the infants up to 66 months of age treated with umbilical venous catheters. We conclude that the use of umbilical venous catheter allows for a comparably safe and a more appropriate parenteral nutrition support than peripheral catheters in critically ill premature neonates.

Catheterization, Peripheral↗
PubMed2002

[Pseudo-hydrothorax in peripheral venous catheterization in an extremely premature neonate--case report].

The authors describe very rare complication (pseudopleural effusion) after peripheral venous cannulation (Introcan-W 24G3/4 through v. axilaris) in extremely premature newborn with birth weight 600 grams, which lead to worsening of patient's respiratory insufficiency. Ultrasonographic examination confirmed extrapleural process without necessity of surgical intervention. Cannula extraction and infusion interruption were followed by spontaneous regression of the complication, thereafter artificial ventilation was discontinued and baby was discharged.

Axillary Vein↗
PubMed1989

[Peripheral venous catheterization: influence of catheter composition on the occurrence of thrombophlebitis].

Infusion thrombophlebitis is a common troublesome complication of intravenous therapy. This study compared peripheral intravenous Teflon and Vialon catheters. The incidence of phlebitis, bacterial adherence and mechanical resistance (distortion) were assessed on 170 catheters, 85 of each type. The Vialon catheter resulted in less phlebitis than the Teflon one (18 vs. 35; p less than 0.01). During the period 49 to 72 h after the insertion of the catheter, the risk of phlebitis in the Teflon group was twice that in the Vialon group. The study of bacterial adherence using a semi-quantitative culture method demonstrated that 9.0% of the catheters were infected with Staphylococcus epidermidis. There was no statistically significant difference between the two groups (5.7% Vialon group vs. 12.5% Teflon group). The Teflon catheters were much more distorted than vialon catheters: 1.7% vs. 55.7% in the macroscopic study; 1.75% vs. 8.2% in the microscopic study. As Vialon softens at body temperature, it would seem likely that it generates a lesser degree of endothelial injury, explaining the lower rate of phlebitis with Vialon catheters.

Actuarial Analysis↗
PubMed1993

Safety of cardiac catheterization via peripheral vascular grafts.

There are few data concerning the complications and technical difficulties encountered when cardiac catheterization is performed using peripheral bypass grafts for vascular access. All cardiac catheterizations performed at our institution from January 1, 1984 to April 1, 1991 were retrospectively reviewed to assess the in-hospital clinical outcomes in patients who had arterial access for catheterization achieved via prosthetic graft puncture. Seventeen procedures had percutaneous puncture of a vascular graft from a total of 2,929 arterial catheterizations performed. The interval from graft placement to catheterization was 7.5 +/- 1.1 years. Arterial sheaths were employed in all cases and corresponded to the catheter size, with 5F systems used in 53% and 7F or larger systems used in the remaining patients. No intraprocedural or postprocedural complications were recognized. Technical difficulties were limited to the inability to selectively cannulate a nondominant right coronary artery in 1 patient. We conclude that percutaneous introduction of an arterial sheath and left heart catheterization via remotely implanted vascular bypass grafts is not associated with an increased risk of procedural complications or technical difficulties.

Angioplasty, Balloon, Coronary↗
PubMed1987

Experience with percutaneous indwelling peripheral arterial catheterization in neonates.

We present an experience with indwelling peripheral arterial catheters in preterm and term neonates. During a 12-month interval, 158 peripheral arterial lines were inserted in 115 infants. Eighty-eight infants required a single line while 27 infants required more than one line. Ninety-one catheters (57.6%) were electively removed, and 67 (42.4%) had to be discontinued prematurely. Vessels used included 110 radial arteries (69.6%), 27 posterior tibial arteries (17.1%), and 21 temporal arteries (13.3%). There were only two major complications (1.27%), both related to infections. The technique is described in detail. In our experience, with appropriate precaution, peripheral arterial cannulation has been a safe and reliable alternative to umbilical arterial catheterization.

Arteries↗
PubMed2003

Gelatin sponge closure device versus manual compression after peripheral arterial catheterization procedures.

PURPOSE: To evaluate the safety and efficacy of the QuickSeal system, which delivers an over-the-wire extravascular porcine gelatin sponge (nonbovine and noncollagen), compared with manual compression in a single interventional radiology practice. MATERIALS AND METHODS: This single-institution report involves 141 patients undergoing peripheral diagnostic and interventional procedures in a teaching and private-practice setting. A 3:2 device-to-control ratio was used with randomization stratified by type of procedure, interventional or diagnostic. Primary endpoints included time to hemostasis (TTH), time to ambulation (TTA), and rate of major complications. Sheaths were removed in the device group when activated clotting times (ACTs) were < or =300 seconds for patients without glycoprotein (GP) IIb/IIIa platelet inhibitors and < or =250 seconds for patients with GP IIb/IIIa platelet inhibitors. Sheaths were removed in the control group when ACTs were < or =180 seconds. RESULTS: The mean TTH was significantly shorter (P <.001) in the device group (8.2 minutes) than in the control group (14.12 minutes). Mean TTA was shorter in the device group (2.7 hours) than in the control group (7.1 hours), and the time to discharge was shorter in the device group (23.8 hours) than in the control group (43.6 hours). There were no major complications in either group, and the incidences of minor complications were not significantly different. CONCLUSION: The tested device reduced TTH, TTA, and eligibility for hospital discharge while maintaining a safety profile equivalent to that of manual compression in diagnostic and interventional procedures.

Adolescent↗