Guidelines on the insertion and management of central venous access devices in adults

Bishop, Lara; Dougherty, Lisa; Bodenham, Andrew; Mansi, Janine; Crowe, Phillip; Kibbler, C C; Shannon, Michael; Treleaven, J

doi:10.1111/j.1751-553x.2007.00931.x

Cited by 233 publications

(216 citation statements)

References 88 publications

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“…Surgical cut-down and direct cannulation of a superficial vein for long-term access in adult patients should be discouraged, as studies have shown that it appears to be less efficient and clearly associated with an increased risk of infection [14,15,59]. Patients undergoing repeated long-term venous access procedures have a much higher frequency of thrombosed veins at the puncture site.…”

Section: Integration In Clinical Practicementioning

confidence: 99%

International evidence-based recommendations on ultrasound-guided vascular access

Lamperti¹,

et al. 2012

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Section: Integration In Clinical Practicementioning

confidence: 99%

International evidence-based recommendations on ultrasound-guided vascular access

Lamperti¹,

et al. 2012

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“…Insertion of a CVC still carries the risk of improper placement and mechanical complications [47]. For this reason, a chest X-ray is advisable to verify the position of the catheter tip and exclude the possibility of iatrogenic pneumothorax (PTX) [48].…”

Section: Diagnosing Complications Of Central Venous Catheterizationmentioning

confidence: 99%

“…However, its performance was less promising with catheters introduced through the left internal jugular or left subclavian vein [56]. The main advantage of these checking systems is that they reduce the need to reposition the catheter after the postinsertion chest X-ray, which is still the reference method for verifying the correct placement [47]. However, there are no well-defined landmarks visible on chest X-rays that allow one to identify with certainty the boundary between the SVC and the right atrium.…”

Section: Diagnosing Complications Of Central Venous Catheterizationmentioning

confidence: 99%

Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications

et al. 2013

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Vascular access used in the treatment of patients involves central and peripheral vein accesses and arterial accesses. Catheterization of central veins is widely used in clinical practice; it is a necessary part of the treatment of patients in various settings. The most commonly involved vessels are the internal jugular, subclavian, and femoral veins. The mechanical, infectious, and thrombotic complications of central venous catheterization are markedly reduced when the procedure is performed with real-time ultrasound guidance or (to a slightly lesser extent) ultrasound assistance. Ultrasound guidance is also used to create peripheral venous accesses, for catheterization of peripheral veins and for peripheral insertion of central venous catheters. In this setting, it increases the catheterization success rate, especially during difficult procedures (e.g., obese patients, children) and reduces complications such as catheter-related infections and venous thrombosis. Arterial cannulation is used for invasive monitoring of arterial pressure and for access during diagnostic or therapeutic procedures. Ultrasound guidance reduces the risk of catheterization failure and complications. It is especially useful for arterial catheterization procedures performed in the absence of a palpable pulse (e.g., patient in shock, ECMO). Imaging support is being used increasingly to facilitate the creation of vascular accesses under difficult conditions, in part because of the growing use of ultrasonography as a bedside procedure. In clinical settings where patients are becoming increasingly vulnerable as a result of advanced age and/or complex disease, the possibility to reduce the risks associated with these invasive procedures should motivate clinicians to acquire the technical skills needed for routine use of sonographic support during vascular access procedures. Keywords Vascular access Á UltrasoundRiassunto Gli accessi vascolari utilizzati nella cura dei pazienti comprendono gli accessi venosi centrali e periferici e gli accessi arteriosi. L'incannulamento di accessi venosi centrali è manovra largamente diffusa nella pratica clinica e si rende necessaria per la cura dei pazienti in molteplici contesti. I vasi centrali che usualmente vengono incannulati sono la vena giugulare interna, la vena succlavia e la vena femorale. Nell'incannulamento venoso centrale sia l'eco-assistenza che l'eco-guida real time, pur con una leggera superiorità di quest'ultima, riducono drasticamente le complicanze meccaniche, infettive e trombotiche. La guida ecografica viene utilizzata anche per l'accesso venoso periferico, per l'incannulamento di vasi periferici e di vasi centrali a inserzione periferica (PICC). In questo contesto la guida ecografica aumenta il successo della manovra di incannulamento soprattutto in condizioni di difficoltà, come avviene nei pazienti obesi o nei bambini, e diminuisce le complicanze quali le infezioni catetere correlate e le trombosi venose. L'incannulamento arterioso viene utilizzato per il monitoraggio cruent...

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“…It is designed for continuous use in patients hospitalized for days or weeks 1 . CVC is mainly indicated for patients with difficult access to peripheral veins, delivery of intravenous chemotherapy, potentially sclerosing medications, and total parenteral nutrition, repeated administration of blood products or blood components, repeated collection of blood samples, and hemodynamic monitoring 2,3 .…”

Section: ■ Introductionmentioning

confidence: 99%

Fixation of the short-term central venous catheter. A comparison of two techniques

et al. 2017

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Fixation of the short-term central venous catheter. A comparison of two techniques 1Abstract Purpose: To compare the fixation of the central venous catheter (CVC) using two suture techniques. Methods: A clinical, analytical, interventional, longitudinal, prospective, controlled, singleblind and randomized study in adult, intensive care unit (ICU) patients. After admission and indication of CVC use, the patients were allocated to the Wing group (n = 35, catheter fixation with clamping wings and retainers) or Shoelace group (n = 35, catheter fixation using shoelace cross-tied sutures around the device). Displacement, kinking, fixation failure, hyperemia at the insertion site, purulent secretion, loss of the device, psychomotor agitation, mental confusion, and bacterial growth at the insertion site were evaluated. Results: Compared with the Wing group, the Shoelace group had a lower occurrence of catheter displacement (n=0 versus n =4; p = 0.04), kinking (n=0 versus n=8; p=0.001), and fixation failure (n=2 versus n=8; p=0.018). No significant difference was found in bacterial growth (n=20 versus n=14; p=0.267) between groups. Conclusion:The Shoelace fixation technique presented fewer adverse events than the Wing fixation technique.

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Guidelines on the insertion and management of central venous access devices in adults

Cited by 233 publications

References 88 publications

International evidence-based recommendations on ultrasound-guided vascular access

International evidence-based recommendations on ultrasound-guided vascular access

Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications

Fixation of the short-term central venous catheter. A comparison of two techniques

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