Effectiveness of different central venous catheter fixation suture techniques: An in vitro crossover study.

Purpose: Proper fixation of central venous catheters (CVCs) is an integral part of safety to avoid dislodgement and malfunction. However, the effectiveness of different CVC securement sutures is unknown.

Methods: Analysis of maximum dislodgement forces for CVCs from three different manufacturers using four different suture techniques in an in vitro tensile loading experiment: 1.

Central venous catheterization for acute trauma resuscitation: Tip position analysis using routine emergency computed tomography.

Purpose: Central venous catheter insertion for acute trauma resuscitation may be associated with mechanical complications, but studies on the exact central venous catheter tip positions are not available. The goal of the study was to analyze central venous catheter tip positions using routine emergency computed tomography.

Methods: Consecutive acute multiple trauma patients requiring large-bore thoracocervical central venous catheters in the resuscitation room of a university hospital were enrolled retrospectively from 2010 to 2015.

Central venous catheter tip migration due to tracheal extubation: a prospective randomized study.

Considerable numbers of patients undergo central venous catheterization (CVC) under mechanical ventilation. We hypothesized that the return of spontaneous breathing and tracheal extubation could be associated with distal CVC tip migration towards intracardiac positions due to decreasing intrathoracic pressures and subsequent readjustment of mediastinal organs. Patients scheduled for cardiac surgery were randomized for right or left internal jugular vein (IJV) CVC placement under general anesthesia and mechanical ventilation.

Different mechanical properties in Seldinger guide wires.

Background And Aims: Most central venous catheters are placed using Seldinger guide wires. EN ISO 11070 is the guideline for testing guide wire flexing performance and tensile strength, and we can safely assume that guide wires in use meet these requirements. Unfortunately, EN ISO 11070 guidelines do not reflect the clinical requirements and we continue to see mechanical failures and their associated complications.

Formulas for prediction of insertion depths of internal jugular vein catheters adjusted to body height categories.

Purpose: Whether formulas for prediction of central venous catheter (CVC) insertion depths have different applicability in patients with different body heights is not known. Goal of study was to test formulas for catheterizations of internal jugular veins (IJVs) in a population of different body height classes with correct CVC tip positions.

Methods: Consecutive adult patients requiring CVC for cardiac surgery were enrolled and those with tip positions at the junction of the superior vena cava and the right atrium ±1 cm underwent formula analysis.

Mechanical properties of Seldinger guidewires.

Background: Almost all central venous catheters are placed using the Seldinger technique. Despite the introduction of ISO 11070 in 1998, we continue to see mechanical wire failures and their associated complications.

Methods: Seven different wire types were tested regarding their tensile strength and eight different types for their flexing performance.

Prospective clinical evaluation of a new manometer syringe that distinguishes pressures below 30 and above 50 mmHg.

Study Objective: To evaluate a new disposable syringe (Certofix PresSure Check [B Braun Melsungen AG, Melsungen, Germany]) that serves as a manometer.

Design: Prospective study.

Setting: University hospital's cardiac surgery suite.

The pivotal role of vasopressin in refractory anaphylactic shock.

Background: Severe anaphylaxis can be associated with cardiovascular collapse that is difficult to manage and does not respond to treatment with epinephrine. Because anaphylaxis is uncommon, unpredictable and may be fatal, a prospective, randomized, controlled trial in humans on the best management is difficult and guidelines are based on theory and anecdotes only.

Methods And Results: We report six cases in which the use of vasopressin was successful in the treatment of anaphylactic shock.

Mechanical complications and malpositions of central venous cannulations by experienced operators. A prospective study of 1794 catheterizations in critically ill patients.

Objective: Incidence of primary mechanical complications and malpositions associated with landmark-guided central venous access procedures (CVAP) performed by experienced operators.

Design: Prospective 5-year observational study on two intensive care units.

Intervention: Only CVAPs using Seldinger technique were evaluated.

Implication of the anatomy of the pericardial reflection on positioning of central venous catheters.

Objective: Central venous catheterization is associated with a significant incidence of complications (5%-20%). The incidence of perforation is approximately 0.25% to 0.