Application of turning head to the opposite insertion side in PICC patients / 中国实用护理杂志

Objective:To investigate the effects of turning head to the opposite insertion side on catheter heterotopia and degree of comfort among PICC catheter patients.Methods:The inpatients with PICC catheter in Hepatological Surgery of Changzhi People′s Hospital from January 2018 to December 2019 were collected as research object, patients from January to December 2018 was assignment to the control group, patients from January to December 2018 was assignment to the experimental group, with 174 cases in each group. They were catheterized with turning head to the opposite insertion side and turning head to the PICC insertion side, respectively. The incidence of catheter heterotopia, complications as well as degree of comfort during the placement of PICC were compared between the two groups.Results:The successful cases of one-time delivery tube and occurred catheter heterotopia were 97.1% (169/174) and 1.2% (2/174) in the experimental group, the index mentioned above were 91.4% (159/174) and 7.5% (13/174) in the control group, the differences between the two groups were statistically significant ( χ2=5.30, 8.43, both P<0.05). The results from survival curve analysis demonstrated that the occurred of catheter-related venous thrombosis and catheter-related bloodstream infections were significantly lower in the experimental group compared to the control group ( χ2=15.23, 8.76, both P<0.05). The score of comfort during the placement of PICC was (15.00 ± 2.19) in the experimental group, which was significantly lower than (16.86 ± 1.88) points in the control group ( t=8.49, P<0.05). Conclusions:Adopting turning head to the opposite insertion side method can improve the success rate of one-time delivery tube, reduce the incidence of catheter heterotopia and reduce the discomfort of patients during PICC catheterization.

Safety evaluation of ultrasound location in axillary venipuncture / 中华急诊医学杂志

Objective To explore the success rate and safety of axillary venipuncture catheterization with ultrasound localization and homologous surface localization(Magney).Method A total of 80 patients were enrolled in the EICU from January 2017 to September 2018.They were randomly assigned to the Magney method(n=35)and the ultrasound-guided method(n=45).The number of successful punctures,success rate and complications were recorded.Results Compared with ultrasound-guided method,the one-time success rate(25.7％vs 68.9％,P＜0.01),puncture greater than 2 times(34.3％vs 11.1％,P=0.012),and total success rate(82.9％vs 100％,P=0.004)in Magney method were significantly different.Both of the two puncture methods were mis-invasive,and the difference was not statistically significant.In Magney method 2 patients occurred hematoma and 1 patient brachial plexus injury,but no infection occurred within 48 h.While no such occurrence was found in ultrasound-guided method.Conclusion Ultrasound-guided method axillary venipuncture is a safe and effective method of central venous catheterization,which has higher success rate and safety than Magney method.

Safety evaluation of ultrasound location in axillary venipuncture / 中华急诊医学杂志

Objective@#To explore the success rate and safety of axillary venipuncture catheterization with ultrasound localization and homologous surface localization (Magney).@*Method@#A total of 80 patients were enrolled in the EICU from January 2017 to September 2018. They were randomly assigned to the Magney method (n=35) and the ultrasound-guided method (n=45). The number of successful punctures, success rate and complications were recorded.@*Results@#Compared with ultrasound-guided method, the one-time success rate (25.7% vs 68.9%, P<0.01), puncture greater than 2 times (34.3% vs 11.1%, P=0.012), and total success rate (82.9% vs 100%, P=0.004) in Magney method were significantly different. Both of the two puncture methods were mis-invasive, and the difference was not statistically significant. In Magney method 2 patients occurred hematoma and 1 patient brachial plexus injury, but no infection occurred within 48 h. While no such occurrence was found in ultrasound-guided method.@*Conclusion@#Ultrasound-guided method axillary venipuncture is a safe and effective method of central venous catheterization, which has higher success rate and safety than Magney method.

Study on the application of central vein and peripheral catheterizations in the chemotherapy of malignant tumor / 重庆医科大学学报

0.05).Medium time of keeping catheter in the first graup were 91 days and the second 5 days(P

Ultrasound Guidance of Central Vein Catheterization by External Jugular Vein Puncture / 中华医院感染学杂志

OBJECTIVE To develop technique of central vein catheterization by external jugular vein puncture under ultrasound guidance.METHODS A total of 224 patients with central vein catheterization by external jugular vein puncture were randomized into two groups: the control group was treated by routine manipulation and observed blood vessels by macroscopic observation;the patients from the observation group were placed catheters with the assist of ultrasound techniques.To record the one time achievement ratio of catheterization and incidence of phlebitis and thrombus.RESULTS Comparing the two groups,we found the observation group had higher one time achievement ratio of catheterization and lower incidence of phlebitis and thrombus than that of the control group.And there were statistical significances between the two groups(P

Clinical Use and Complications of Percutaneous Central Venous Catheterization in Very Low Birth Weight Infants / 소아과

PURPOSE: The administration of total parenteral nutrition (TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization (PCVC) in very low birth weight infants. METHODS: A total of 56 very low birth weight infants below 1, 500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group (n=32) included the babies who had undergone PCVC and a control group (n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. RESULTS: There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2, 000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1, 000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1, 000 to 1, 500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2, 000 g. CONCLUSION: Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

Central Vein Catheterization with an Electrocardiogram

PURPOSE: This study analyzed the value of an electrocardiogram (ECG) using an arterial pulsator in central vein catheterization (CVC). METHODS: In 442 patients who underwent CVC with an ECG and an arterial pulsator, this study evaluated the rates of change in the P wave and the QRS wave at the limb lead II before and after insertion. After insertion, a plain chest X-ray was checked in order to locate the catheter tip. RESULTS: After catheterization, the P wave and the QRS wave increased together at 97% but the P wave (change rate: 0.5~21.0) was more sensitive than the QRS wave (change rate: 0.5~5.8). For an abnormal location (3%), the rate of change in the P wave was 2.0 were 95% and 100%, and those of the QRS wave >1.4 were 90% and 100%. CONCLUSION: In central vein catheterization, an electrocardiogram with an arterial pulsator can be a useful method, and the normal position of the catheter tip can be estimated by using a rate of change in the P wave >2.0 or a rate of change in QRS wave >1.4.

Pleural Effusion Caused by Central Catheter-Related Infection in a Hemodialysis Patient / 대한신장학회잡지

Central catheterization for temporary vascular access in hemodialysis patients may cause serious catheter-related infection such as bacteremia, osteomyelitis, and septic shock. We here report a case of unusual complication of catheter-related infection in a hemodialysis patient with internal jugular catheter. A 44-year old man was admitted due to intermittent fever and right chest discomfort. Five weeks ago, right internal jugular catheter was inserted for hemodialysis. Three weeks ago, He stopped hemodialysis treatment and exit site skin care of the catheter by himself. Chest X-ray showed massive right pleural effusion. But the catherter was normally positioned in superior vena cava. Both blood and pleural fluid cultures demonstrated Staphylococcus aureus. After prompt removal of the catheter and drainage of the pleural fluid, and adequate antibiotic treatment, catheter-related bacteremia and pleural effusion improved.