Navegando por Palavras-chave "Central venous catheterization"

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    Long-term complications in totally implantable venous access devices: Randomized study comparing subclavian and internal jugular vein puncture
    (Wiley-Blackwell, 2012-02-01) Ribeiro, Rodrigo Chaves [UNIFESP]; Abib, Simone de Campos Vieira [UNIFESP]; Aguiar, Alexandre S.; Schettini, Sergio Tomaz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background This prospective randomized study evaluated complications related to long-term totally implantable catheters in oncologic children and adolescents by comparing venopunction performed either in the jugular or subclavian vein. Methods. A total of 83 catheters were implanted from January 2004 to April 2006 and followed-up until March 2008. Patients were randomly allocated to the subclavian or jugular vein group. the endpoint was complications that led to catheter revision or catheter removal. Results. Six patients were excluded, 43 had the catheter implanted in the subclavian and 34 in the jugular vein. Subclavian catheters were used for up to 12.6 months, while jugular catheters were kept in place for up to 14.8 months (P = 0.38). No statistical differences were found between the groups concerning age, sex, leukocyte count, platelet count, type of admission (in or outpatient), or previous chemotherapy regimens. When analyzed individually, longterm complications did not present statistically significant differences either. Infection occurred in 20 and 11% (P = 0.44), while catheter embolism took place in 23 and 8% (P = 0.11) of patients with subclavian and jugular catheters, respectively. A statistical difference was seen in the total number of complications, which occurred in 48 and 23% (P = 0.02) of patients in the subclavian and in the jugular groups, respectively. Conclusions. Catheters implanted by puncture in the subclavian vein were more prone to late complications than those implanted in the jugular vein. Pediatr Blood Cancer 2012; 58: 274-277. (C) 2011 Wiley Periodicals, Inc.
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    Método bundle na redução de infecção de corrente sanguínea relacionada a cateteres centrais: revisão integrativa
    (Universidade Federal do Rio Grande do Sul. Escola de Enfermagem, 2012-12-01) Brachine, Juliana Dane Pereira; Peterlini, Maria Angélica Sorgini [UNIFESP]; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This is an integrative review of literature aimed to identify evidence-based interventions which make up care bundles to reduce central venous catheter-related or associated bloodstream infections. To collect data in Brazilian and international databases were used the key word bundle and the descriptors catheter-related infection, infection control and central venous catheterization, resulting in fifteen articles, after inclusion criteria application. This work showed five interventions as those commonly employed in the bundles methods: hand hygiene, chlorhexidine gluconate for skin antisepsis, use of maximal sterile barrier precaution during the catheter insertion, avoid the femoral access and daily review of catheter necessity with prompt removal as no longer essential. The majority of the studies showed a significant reduction in bloodstream infection related to or associated with central venous catheters.
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    Placement of peripherally inserted central catheters in children guided by ultrasound: A prospective randomized, and controlled trial
    (Lippincott Williams & Wilkins, 2012-09-01) Onofre, Priscilla Sete de Carvalho [UNIFESP]; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]; Peterlini, Maria Angélica Sorgini [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To compare the use of vascular Doppler ultrasound with vein visualization and palpation for positioning peripherally inserted central catheters in children and to determine the influence of these methods on the success of the first puncture attempt, catheter positioning, and time required for the accomplishment.Design: A prospective randomized, controlled trial was conducted in a university hospital after ethical approval and was carried out among children (from birth to 18 yrs).Setting: São Paulo Hospital, São Paulo, Brazil.Patients: the sample comprises 42 peripherally inserted central catheters insertions allocated randomly into two groups: 1) an ultrasound group with 21 peripherally inserted central catheters guided by ultrasound; and 2) a control group with 21 catheters, in which the peripherally inserted central catheters were inserted using vein visualization and palpation.Interventions: the procedure was performed by two trained nurses using a standard protocol for peripherally inserted central catheter insertion and ultrasound use. Ultrasound group equipment was ILook25 (Sonosite, Bothell, WA) with a 25-mm, 10- to 15-MHz linear array transducer that reaches a 4-cm depth.Measurements and Main Results: Success in the first puncture attempt was higher (p=.003) in the ultrasound group (90.5%) than in the control group (47.6%). the catheter positioning success rate was 85.7% in the ultrasound group and 52.4% in the control group (p=.019). the median time spent on the procedure for the ultrasound group was 20 mins, whereas it was 50 mins for the control group (p=.001).Conclusion: the use of ultrasound increased the successful positioning of peripherally inserted central catheters in comparison with the venous anatomic landmark visualization and palpation technique and further optimized the time spent on the procedure. (Pediatr Crit Care Med 2012; 13: e282-e287)