Background: Removal of unnecessary catheters has been proposed as an important measure to reduce catheter-related morbidity. Nevertheless, there is scarce information about the potential magnitude of such intervention.
Objective: The present study was aimed at analyzing the appropriateness of use of vascular catheters and catheter lumens in the inpatient setting.
Design: Cross-sectional survey.
Setting: The entire population of adult inpatients admitted to a 1368-bed tertiary-care hospital in a single day.
Measurements: We used a set of preestablished criteria to evaluate the appropriateness of use of vascular catheters and catheter lumens according to the number and administration regimen of intravenous drugs.
Results: Out of 834 patients, 575 (68.9%) had ≥1 vascular catheters in place on the day of the survey. The type and distribution of the 703 surveyed catheters were peripheral venous catheter, 80.6%; central venous catheter, 15.8%; and arterial catheter, 3.6%. We found an overall mean of 2.06 ± 0.82 lumens per catheter, with significant differences between intensive care units and conventional wards (P < 0.0001). Based on our criteria, 126 out of 575 patients (21.9%) had an inappropriate number of catheters (medical wards, 20.0%; surgical wards, 23.9%; intensive care units, 26.3%), and 631 out of 14248 nonarterial catheter lumens (43.6%) were considered unnecessary.
Conclusions: Significant room exists for improving the adequacy of the number of vascular catheters and catheter lumens as a potentially useful tool for decreasing the incidence of catheter-related bloodstream infection.
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http://dx.doi.org/10.1002/jhm.2130 | DOI Listing |
Nurs Crit Care
January 2025
Department of Nursing, Shanghai General Hospital, Shanghai, China.
This is a prospective observational study designed to develop an echocardiography-guided tip location program for central venous catheter (CVC) implantation, and to assess the feasibility and the accuracy of the program. First, a multidisciplinary expert committee designed an echocardiography-guided tip location program; then, a pilot prospective observational study was conducted to assess the feasibility of the program in a vascular access clinic in a tertiary hospital. A total of 186 patients participated in the study.
View Article and Find Full Text PDFKidney Med
January 2025
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Expansion of home hemodialysis (HHD) provides an opportunity to improve clinical outcomes, reduce cost of care, and address the staffing challenges currently faced in caring for patients with kidney failure on replacement therapy. To increase HHD expansion, current practices and barriers to home dialysis must be examined and addressed. One such barrier is vascular access for HHD; although tunneled hemodialysis central venous catheters (CVCs) have been used for decades, physicians still hesitate to send patients home without a mature, functional arteriovenous access.
View Article and Find Full Text PDFJACC Adv
January 2025
Department of Cardiology, University Heart Centre, University Hospital Zürich, Zürich, Switzerland.
Background: Patients in many underserved geographies lack access to invasive coronary angiography (ICA).
Objectives: This preclinical study explored the feasibility of telerobotic ICA between separate continents.
Methods: Using a novel robotic system, attempts were made to navigate a magnetic guidewire and diagnostic catheter from the aortic arch into a target coronary artery ostium in a fluid-filled cardiac model.
J Mech Behav Biomed Mater
January 2025
Department of Biomedical Engineering, Toronto Metropolitan University, Toronto, Canada; Sunnybrook Research Institute, Toronto, Canada.
The integration of self-expandable nitinol frames with cable-driven parallel mechanisms offers a promising advancement in minimally invasive cardiovascular interventions. This study presents the design, fabrication, and verification of a miniaturized self-expandable nitinol frame to enhance catheter tip steerability and navigation within complex vascular anatomies. The frame is reduced in size for delivery through 7-8 Fr sheaths while accommodating diverse vascular diameters, allowing up to a maximum expansion of 15 mm.
View Article and Find Full Text PDFCVIR Endovasc
January 2025
Department of Radiology, Section of Vascular and Interventional Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA.
Purpose: To evaluate access site adverse events following ClotTriever-mediated large-bore mechanical thrombectomy via small upper extremity deep veins (< 6-mm).
Materials And Methods: Twenty patients, including 24 upper extremity venous access sites, underwent ClotTriever-mediated large-bore thrombectomy of the upper extremity and thoracic central veins for symptomatic deep vein obstruction unresponsive to anticoagulation. Patients without follow-up venous duplex examinations (n = 3) were excluded.
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