Accesos vasculares colocados en decúbito prono: una serie de casos

Salvador-Ibarra, Ibzan Jahzeel; Alva-Arroyo, Nancy Verónica; Gasca-Aldama, José Carlos; Pizaña-Dávila, Alejandro; Huerta-Escobar, María Guadalupe

doi:10.1016/j.acci.2022.05.004

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…Additionally, criteria have been described to determine the supine and prone position respectively, but should be keep in mind if clinical situation allows, placement of a CVC is safer in supine position. The placement of catheters in prone positioning has been described since 2010, 12–19 nevertheless, this technique has been mostly used in CVC placement, which has a narrower lumen diameter (Table 2). Despite intermittent prone positioning is common in some hospital centers, in our hospital is continuous (24 h) without cycles of supine positioning changed, with foam wedges and pillows, alternating head, and neck rotation every 4 h. Before performing this procedure, we suggest that it is not carried out by inexperienced personnel, we recommend mastering the posteroinferior access (lower portion of SCM), with puncture in the transverse plane in supine patients.…”

Section: Discussionmentioning

confidence: 99%

“…The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 13 1 LIJV Posterior Hemodialysis None Anagnostopoulos et al 14 1 RIJV Posterior CVC None Gomez-Maldonado et al 15 1 LIJV Posterior Hemodialysis None Adams and Mousa 16 1 Popliteal vein Out of plane Hemodialysis None Yang and Ng 17 1 RIJV Posterior Hemodialysis None Lima and Cheung 18 3 RIJV Anterior CVC None Salvador-Ibarra et al 19 7…”

Section: Author Contributionsmentioning

confidence: 99%

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Hemodialysis vascular access in prone position for critically ill patients with ARDS

et al. 2023

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Introduction: Acute respiratory distress syndrome (ARDS) is defined in critically ill patients with acute hypoxemia and positive-pressure ventilation in association with several clinical disorders including trauma, pneumonia, sepsis, and aspiration. The prone position has been used for many years and is now recommended for patients with severe or moderate-to-severe ARDS on invasive mechanical ventilation. Acute kidney injury (AKI) is a common complication in patients with ARDS, with up to a 35% incidence rate. Initiation of Kidney Replacement Therapy (KRT) requires wise clinical judgment and collaboration between nephrologists and intensivists. A properly functioning vascular access is critical for an optimized KRT. Our institute is a national referral center for respiratory diseases. Results: We describe 11 cases of dialysis catheter placement for KRT in critically ill patients with ARDS on mechanical ventilation in prone position. The catheter was placed in the first puncture attempt in nine cases, Blood flows (Qb) achieved were 283.4 ± 20.4 ml/min during the session, in six cases the radiologic tip location was achieved in the peri cavoatrial junction; in four cases was achieved in mid to- deep right atrium. The dialysis quality standards were based on KTV and in URR; in nine cases (81.81%) KTV was in 1.3 and in all cases (100%) URR was >65%, lumen dysfunction was reported only in two cases (18.1%), but these cases did respond to mobilization maneuvers. The procedure time of placement was 29.8 min, no arterial punctures or complications were reported. Conclusions: We demonstrate that in our study hemodialysis non-tunneled catheter placement in the prone position is safe and effective. We believe this practice could be frequently used in the near future and represent an opportunity window for the training of interventional nephrologists and related areas.

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Section: Discussionmentioning

confidence: 99%

Section: Author Contributionsmentioning

confidence: 99%

Hemodialysis vascular access in prone position for critically ill patients with ARDS

et al. 2023

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“…In 2021, Lima and Cheung ( 2 ) published the largest case series, up to that time, of VA placed on PD. In 2022, our working group published a series of seven cases of VA in PD, three of which were placed in the internal jugular vein ( 6 ). We consider that it would be important to analyze some points on which we agree with Lussier et al ( 1 ).…”

Section: To the Editormentioning

confidence: 99%

Internal Jugular Vein Cannulation in Prone Position

Salvador-Ibarra¹

2023

Critical Care Explorations

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Since 1970, prone decubitus (PD) has been used as adjuvant therapy to treat severe hypoxia in patients with acute respiratory distress syndrome (ARDS), and now with the COVID-19 pandemic, its use has become widespread in ICUs. ARDS is characterized by diffuse bilateral radiographic infiltrates, decreased respiratory compliance, small lung volumes, and severe hypoxemia. The placement of vascular access in PD seems to be feasible and safe, since, as has been described, the number of complications such as pneumothorax, bleeding, and arterial punctures are almost nil, especially when performed under ultrasound guidance. The patients who could benefit most from this procedure seem to be those with obesity, mainly with a body mass index greater than 30 kg/m 2 , in whom the return to the supine position may represent a risk of respiratory or hemodynamic deterioration.

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Accesos vasculares colocados en decúbito prono: una serie de casos

Cited by 2 publications

References 8 publications

Hemodialysis vascular access in prone position for critically ill patients with ARDS

Hemodialysis vascular access in prone position for critically ill patients with ARDS

Internal Jugular Vein Cannulation in Prone Position

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