Guidewire replacement of valved tunneled-cuffed silicone catheters with power injectable polyurethane tunneled-cuffed catheters or with ports.

Background: Silicone Cuffed Centrally Inserted Central venous catheters (CICCs) were a type of catheters that have been used for a long time especially in cancer patients. Recently, thanks to biomedic research progresses, polyurethane catheters have resulted in higher surgical performances compared to classical silicone ones. Indeed, the inferior calibers of these new catheters lead to an extremely faster infusion rate.

Guidewire replacement of tunneled central venous catheters in children reusing the same subcutaneous route.

Background: Tunneled centrally inserted central venous catheters (CICCs) are a type of catheters used especially in cancer pediatric patients or affected from short bowel disease and malabsorption. Recently, thanks to biomedical research progresses, polyurethane catheters have resulted in high surgical performances with a low caliber but extremely fast infusion rate. Sometimes the replacement procedure over a Seldinger guidewire could be an appreciable technique especially reusing the same vein and the same tunnel of the previous catheter, with local anesthesia.

How to remove a tunneled and cuffed central venous catheter quickly and safely? A little trick useful in children.

Background: The aim of this study was to present our experience with a use of own variation of the traditional technique for tunneled and cuffed catheters removal.

Methods: From July 2021 to March 2023, 110 tunneled cuffed centrally inserted central catheters (CICCs) were removed at the Vascular Access Unit of ASST Spedali Civili of Brescia using our particular technique; pediatric patients were 15 admitted to "Children Hospital" of Brescia. The catheter is cut with its adhesions above the cuff and then pulled out.

Pseudo-tunneling procedure: An easy technique for insertion of PICCs and Midline catheters in patients with small veins of the arm.

Background: Axillary vein in the brachial tract or Basilic vein in the proximal third of the arm has got usually an enough diameter to receive a catheter of 4 or 5 Fr. In this case the exit site should be too proximal to the axilla with an higher risk of infection. Pseudo-tunneling procedure can create an exit site at the middle of the arm without using tunnelers during insertion of Peripherally Inserted Central Catheters and Midlines in patients who present deep veins of the arm too small to receive a catheter to consent infusion and blood samples.

Pseudo-tunneling procedure: an advantageous and safe technique for brachial catheters in younger children.

Background: The aim of this study is to present our experience with the use of a particular tunneling technique called pseudo-tunnelling, during insertion of peripherally inserted central catheters (PICCs) and Midlines in younger patients. The children's brachial veins at the middle third of the arm are usually too small for cannulation. So the veins in the axilla are the best option for implantation of a four or five French catheter.

MortalitY in caRdIAc surgery (MYRIAD): A randomizeD controlled trial of volatile anesthetics. Rationale and design.

Objective: There is initial evidence that the use of volatile anesthetics can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization following coronary artery bypass graft (CABG) surgery. Nevertheless, small randomized controlled trials have failed to demonstrate a survival advantage. Thus, whether volatile anesthetics improve the postoperative outcome of cardiac surgical patients remains uncertain.