Introduction: Therapeutic plasma exchange (TPE) is often impacted by difficulties in obtaining an adequate and safe vascular access. This study evaluated the rates, predictive factors, and clinical outcomes associated with central venous catheter (CVC) use during the inpatient TPE procedures.
Methods: The Nationwide Readmissions Database, 2016 to 2017 was used to identify hospitalizations with TPE with and without CVC insertion.
Results: During the study period, there were 35 429 hospitalizations with TPE (pediatric 6.1%, mean ± standard deviation (SD) age 50.9 ± 20.0 years, female 52.7%). CVC insertion was documented in 24 414 (73.4%) adult and 1596 (73.5%) pediatric hospitalizations. In pediatric patients, age >15 years, higher disease severity, and private insurance were associated with higher odds of CVC insertion. In adults, female sex, obesity, concurrent hemodialysis, and higher disease severity were associated with CVC insertion. Adults with private insurance and both adult and pediatric hospitalizations at the teaching hospitals had lower odds of CVC placement. All patients with CVC insertion had longer length of hospital stay, and adults with CVC insertion also had higher hospital charges, higher in-hospital mortality, and lower likelihood of being discharged to home.
Conclusion: CVC insertion is performed for the majority of inpatient TPE procedures and CVC use appears to correlate with worse clinical outcomes.
Background: The standard of care for placement of a central venous catheter (CVC) includes a real-time ultrasound (US)-guided technique. We describe a rare case in which the guidewire penetrated the posterior wall of the vessel, forming a knot, which precluded simple removal. This occurred despite the procedure being performed under real-time US guidance.
Background And Aims: Various methods are used to predict the depth of insertion of central venous catheters (CVCs). We evaluated a bronchoscopy-based carinal measurement technique to predict this depth.
Methods: We randomised adults undergoing cardiac surgery into a bronchoscopy group or the Peres' formula-based method group.
Introduction: Central venous catheterisation (CVC) is a commonly performed procedure in clinical practice. Although usually safe, complications can arise such inadvertent vascular lesion. This report is of a case of left brachiocephalic vascular lesion due to a subclavian catheter, thus raising awareness about this potential complication, which is not always immediately recognised.
Background: The catheter tip placed between the T6 and T7 vertebrae is recognized as an optimal position for the totally implantable venous access ports (TIVAPs). This study aimed to propose a simple formula for calculating the optimal insertion depth of the right internal jugular central venous catheter (CVC) of TIVAP in Chinese patients.
Methods: This was a prospective observational study.
Central venous catheters (CVCs) are essential in modern healthcare but are associated with significant risks, particularly catheter-related bloodstream infections (CRBSIs). Current guidelines do not recommend routine replacement of CVCs based on time alone. However, recent evidence challenges this recommendation.
