المؤلفون: Chou, Wesley H, Rinderknecht, Tanya N, Mohabir, Paul K, Phillips, Andrew W

المصدر: Cureus. 11(1)

مصطلحات موضوعية: Aetiology, 2.1 Biological and endogenous factors, complication, rapid infusion catheter, ric, Medical and Health Sciences

الوصف: Rapid infusion catheters (RICs) allow expedient conversion of peripheral intravenous (PIV) catheters to peripheral sheaths; however, little is known about potential complications. In this case, a 64-year-old male polytrauma patient had a 20-gauge PIV catheter in the right cephalic vein upsized to an 8.5 French (Fr) RIC without incident during an arrest with pulseless electrical activity (PEA). On RIC post-placement day two, the patient developed edema and ecchymosis extending from the right dorsal mid-hand to the antecubital fossa, just distal to the RIC insertion point. Compartments were soft; the volar surface (including an arterial line location), fingers, and upper arm were normal. The RIC flushed and returned blood appropriately. Ultrasound revealed a noncompressible cephalic vein either related to the catheter or thrombosis, and imaging of the hand showed an ulnar styloid fracture and a minimally displaced triquetral fracture. The RIC was removed immediately. Over the next week, the areas of ecchymosis developed bullae and then sloughed, leaving open wounds extending into the dermis. The patient later expired from unrelated causes. The area and timing of the skin necrosis were highly suspicious for a catheter-associated complication, despite the presence of the arterial line and small distal fractures. The necrosis was potentially due to thrombosis of the superficial venous outflow system, leading to congestion and skin compromise, but we found no similar reports. Alternatively, the catheter may have ruptured the vein and caused a gravity-dependent ecchymosis, but the volar surface was not impacted, and the catheter was functioning properly. The RIC may also have encroached on the arterial space, decreasing flow, but we would have expected distal hand changes. The only published reports we could find on RIC complications involved a lost guide wire, fragmentation of a catheter during placement, and a case of compartment syndrome, raising the question of whether skin necrosis is truly a rare event or simply underreported with the RIC. Although the exact causal relationship remains unknown in our case, RICs should be removed as soon as possible after immediate stabilization.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/7pq0p97bTest

المؤلفون: A. C. Jackson, K. Memory, E. Issa, J. Isherwood, P. Graff-Baker, G. Garcea

المصدر: BMC Anesthesiology, Vol 22, Iss 1, Pp 1-8 (2022)

مصطلحات موضوعية: Wound infusion catheter, HPB surgery, Epidural, Anesthesiology, RD78.3-87.3

الوصف: Abstract Background Epidural analgesia is conventionally used as the mainstay of analgesia in open abdominal surgery but has a small life-changing risk of complications (epidural abscesses or haematomas). Local wound-infusion could be a viable alternative and are associated with fewer adverse effects. Methods A retrospective observational analysis of individuals undergoing open hepato-pancreato-biliary surgery over 1 year was undertaken. Patients either received epidural analgesia (EP) or continuous wound infusion (WI) + IV patient controlled anaesthesisa (PCA) with an intraoperative spinal opiate. Outcomes analyzed included length of stay, commencement of oral diet and opioid use. Results Between Jan 2016- Dec 2016, 110 patients were analyzed (WI n=35, EP n=75). The median length of stay (days) was 8 in both the WI and EP group (p=0.846), the median time to commencing oral diet (days) was 3 in WI group and 2 in EP group (p=0.455). There was no significant difference in the amount of oromorph, codeine or tramadol (mg) between WI and EP groups (p=0.829, p=0.531, p=0.073, respectively). Conclusions Continuous wound infusion + IV PCA provided adequate analgesia to patients undergoing open hepato-pancreato-biliary surgery. It was non-inferior to epidural analgesia with respect to hospital stay, commencement of oral diet and opioid use.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2253Test

الوصول الحر: https://doaj.org/article/3c36774bf5d34b88abe02a8d1793718bTest

المؤلفون: Ahmed Taha, MD, Assad Mohammedzein, MD, John Kimbugwe, MD, Kade Carthel, MD, David Brabham, MD

المصدر: JACC: Case Reports, Vol 1, Iss 4, Pp 622-625 (2019)

مصطلحات موضوعية: cardiogenic shock, EndoWave Infusion Catheter System, Impella RP, mechanical circulatory support, pulmonary embolism, ultrasound-assisted catheter-directed thrombolysis, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Due to the scarcity of data, Impella RP is not approved for acute right ventricular failure caused by massive pulmonary embolism. We describe here the successful use of Impella RP in acute right ventricular failure caused by massive pulmonary embolism to highlight its promising outcome in such an indication. (Level of Difficulty: Advanced.)

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2666084919303614Test; https://doaj.org/toc/2666-0849Test

الوصول الحر: https://doaj.org/article/ef503c010374411fa20c25a922451d41Test

المؤلفون: Olivier Muller, Olivier Varenne, Julien Adjedj, Lucien Sambin, Alain Bizé, Bijan Ghaleh, Bernard De Bruyne, Satoshi Mogi, Fabien Picard

المصدر: Catheterization and Cardiovascular Interventions. 99:836-843

مصطلحات موضوعية: medicine.medical_specialty, Swine, Saline infusion, Thermodilution, 030204 cardiovascular system & hematology, 03 medical and health sciences, Microvascular resistance, Coronary circulation, 0302 clinical medicine, Coronary Circulation, Internal medicine, Animals, Humans, Medicine, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, business.industry, General Medicine, Infusion catheter, Blood flow, Coronary Vessels, Coronary arteries, Catheter, Treatment Outcome, medicine.anatomical_structure, Cardiology, Thermodilution technique, Cardiology and Cardiovascular Medicine, business, Blood Flow Velocity

الوصف: OBJECTIVE To assess the accuracy of coronary thermodilution measurements made with the RayFlow® infusion catheter. BACKGROUND Measurements of absolute coronary blood flow (ABF) and absolute microvascular resistance (Rμ ) by continuous coronary thermodilution can be obtained in humans but their accuracy using a novel dedicated infusion catheter has not yet been validated. We compared ABF values obtained at different infusion rates to coronary blood flow (CBF) values obtained using flow probes, in swine. METHODS Twelve domestic swine were instrumented with coronary flow probes placed around the left anterior descending and circumflex coronary arteries. ABF was assessed with the RayFlow® infusion catheter during continuous saline infusion at fixed rates of 5 (n = 14), 10 (n = 15), 15 (n = 19), and 20 (n = 12) ml/min. RESULTS In the 60 measurements, ABF measured using thermodilution averaged 41 ± 17 ml/min (range from 17 to 90) and CBF values obtained with the coronary flow probes averaged 37 ± 18 ml/min (range from 8 to 87). The corresponding Rμ values were 1532 ± 791 (range from 323 to 5103) and 1903 ± 1162 (range from 287 to 6000) Woods units using thermodilution and coronary flow probe assessments, respectively. ABF and Rμ values measured using thermodilution were significantly correlated with the corresponding measurements obtained using coronary flow probes (R = 0.84 [0.73-0.95] and R = 0.80 [0.69-0.88], respectively). CONCLUSIONS ABF and Rμ assessed by continuous saline infusion through a RayFlow® catheter closely correlate with measurements obtained with the gold standard coronary flow probes in a swine model.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::80240fdda366459207ecffc390b7486cTest
https://doi.org/10.1002/ccd.29802Test

المؤلفون: Fernando Alfonso, Alejandro Gutierrez-Barrios, Elena Izaga-Torralba, Ana Pardo-Sanz, Teresa Bastante, Fernando Rivero, Josep Gomez-Lara, Manuel Fuentes-Ferrer, Marcos García-Guimaraes, Joan-Antoni Gomez-Hospital, Nico H.J. Pijls, Javier Cuesta, Daniëlle C J Keulards

المصدر: International Journal of Cardiology. 333:1-7

مصطلحات موضوعية: medicine.medical_specialty, Standard of care, Thermodilution, Population, Fractional flow reserve, 030204 cardiovascular system & hematology, Anterior Descending Coronary Artery, Coronary Angiography, 03 medical and health sciences, Microvascular resistance, 0302 clinical medicine, Coronary Circulation, Internal medicine, Humans, Medicine, 030212 general & internal medicine, education, education.field_of_study, business.industry, Microcirculation, Coronary flow reserve, Infusion catheter, Coronary Vessels, Fractional Flow Reserve, Myocardial, Cardiology, Vascular Resistance, Cardiology and Cardiovascular Medicine, business, Area under the roc curve

الوصف: Background This study aimed to assess the correlation between the standard of care, the index of microvascular resistance (IMR) versus the novel microvascular resistance (Rmicro) and to determine the pathologic cut-off value in a selected population with suspected coronary microvascular dysfunction (CMD). Methods One-hundred and twenty patients with high clinical suspicion of CMD due to ischemic symptoms in the absence of significant epicardial coronary lesions were prospectively included. Following a standardized systematic protocol, coronary flow reserve, IMR, fractional flow reserve, Q and Rmicro were measured in the left anterior descending coronary artery using a temperature/pressure sensor-tipped guidewire and a dedicated infusion catheter. Results There was a high prevalence of CMD with 50 (42%) patients showing an IMR ≥ 25. Median IMR was 23 [IQR: 14–34] and median Rmicro was 464 Woods Units (WU) [IQR: 354–636WU]. ROC analyses identified 500 WU as the optimal Rmicro cut-off to identify patients with an IMR ≥ 25, with an area under the ROC curve (C statistic) of 0.83 (95% CI: 0.74 to 0.89, p Conclusions Rmicro derived from continuous intracoronary thermodilution is an accurate index to measure microvascular resistances enabling the invasive diagnostic of CMD.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d01b7afdb784ddd7302b1e488d8f92d3Test
https://doi.org/10.1016/j.ijcard.2021.03.005Test

المؤلفون: Gorgis, Sarah, Mawri, Sagger, Dabbagh, Mohammed F, Aurora, Lindsey, Ali, Mahmoud, Mitchell, Giordano, Jacobsen, Gordon, Hegab, Sara, Schwartz, Scott, Kelly, Bryan, Grafton, Gillian, Awdish, Rana, Ismail, Reem, Koenig, Gerald

المصدر: Aurora GME

مصطلحات موضوعية: Anticoagulation, Catheter-directed thrombolysis, EndoWave infusion catheter system, Submassive pulmonary embolism, Ultrasound-assisted catheter-directed thrombolysis, Aurora Cardiology Fellows, Cardiology

الوصف: Background: Patients with submassive pulmonary embolism (PE) are vulnerable to sudden deterioration, recurrent PE, and progression to pulmonary hypertension and chronic right ventricular (RV) dysfunction. Previous studies have suggested a clinical benefit of using ultrasound-assisted catheter-directed thrombolysis (USCDT) to invasively manage patients with submassive PE. However, there is sparse data comparing the clinical outcomes of these patients when treated with USCDT versus anticoagulation (AC) alone. We sought to compare the outcomes of USCDT versus AC alone in the management of submassive PE. Methods: 192 consecutive patients who underwent USCDT for submassive PE between January 2013 and February 2019 were identified. ICD9/ICD10 codes were used to detect 2554 patients diagnosed with PE who did not undergo thrombolysis. Propensity matching identified 192 patients with acute PE treated with AC alone. Clinical outcomes were compared between the two groups. Baseline demographics, laboratory values, and pulmonary embolism severity index scores were similar between the two cohorts. Results: There was a significant reduction in mean systolic pulmonary artery pressure (sPAP) in the USCDT group compared to the AC group (∆11 vs ∆3.9 mmHg, p < 0.001). There was significant improvement in proportion of RV dysfunction in all patients, but the difference was larger in the USCDT group (∆43.3% vs ∆17.3%, p < 0.001). Patients who underwent USCDT had lower 30-day (4.3% vs 10.5%, p = 0.03), 90-day (5.5% vs 12.4%, p = 0.03), and 1-year mortality (6.2% vs 14.2%, p = 0.03). Conclusions: In patients with acute submassive PE, USCDT was associated with improved 30-day, 90-day, and 1 year mortality as compared to AC alone. USCDT also improved RV function and reduced sPAP to a greater degree than AC alone. Further studies are needed to verify these results in both short- and long-term outcomes.

العلاقة: https://institutionalrepository.aah.org/auroragme/106Test; https://libkey.io/libraries/1712/pmid/35643741Test

الإتاحة: https://doi.org/10.1016/j.jjcc.2022.04.008Test
https://institutionalrepository.aah.org/auroragme/106Test
https://libkey.io/libraries/1712/pmid/35643741Test

المؤلفون: Kazuhiko Nakazato, Yukiko Sugawara, Kenichi Watanabe, Yasuchika Takeishi, Takayuki Ohwada, Takayuki Sakamoto

المصدر: Journal of Coronary Artery Disease. 26:106-110

مصطلحات موضوعية: Acute coronary syndrome, medicine.medical_specialty, Myocardial ischemia, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, Infusion catheter, medicine.disease, Nitroprusside Injection, Internal medicine, No reflow phenomenon, medicine, Cardiology, business

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::66430fb7b671bfa866cd2980e7933b89Test
https://doi.org/10.7793/jcad.26.20-00024Test

المؤلفون: Yashwant Agrawal, Vince Marceau, Dominika Zoltowska, Jean-Yves R Nazroo, Kirit Patel, Michele DeGregorio, N. R. Jena

المصدر: JACC Case Reports
JACC: Case Reports, Vol 1, Iss 5, Pp 803-806 (2019)

مصطلحات موضوعية: medicine.medical_specialty, CTV, computed tomography with venogram, SVCS, superior vena cava syndrome, medicine.medical_treatment, BCV, brachiocephalic veins, Catheter directed thrombolysis, Case Report, AV, axillary vein, Malignancy, Doppler ultrasound, intravascular ultrasound, EKOS, EndoWave infusion catheter system, Clinical Case, shortness of breath, Angioplasty, Intravascular ultrasound, medicine, Diseases of the circulatory (Cardiovascular) system, IJV, internal jugular vein, CDT, catheter-directed thrombolysis, Thrombus, anticoagulation, thrombosis, Superior vena cava syndrome, medicine.diagnostic_test, business.industry, Vascular disease, imaging, computed tomography, vascular disease, medicine.disease, Thrombosis, SCLV, subclavian veins, thrombus, RC666-701, Radiology, x-ray fluoroscopy, medicine.symptom, Cardiology and Cardiovascular Medicine, business

الوصف: Superior vena cava syndrome (SVCS) is traditionally associated with malignancy. However, approximately one-third of SVCS cases are due to intravascular devices and pacemakers. No specific guidelines exist for managing catheter-associated SVCS. We present catheter-associated SVCS resistant to anticoagulation, angioplasty, and thrombectomy but resolved with ultrasound-assisted catheter directed thrombolysis. (Level of Difficulty: Intermediate.)
Graphical abstract
Superior vena cava syndrome (SVCS) is traditionally associated with malignancy. However, 20% to 40% of SVCS cases are due to intravascular devices…

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::48b04d9464a3de0e147cbabfaa440aa4Test
https://doi.org/10.1016/j.jaccas.2019.11.008Test

المؤلفون: Assad Mohammedzein, Kade Carthel, David Brabham, John Kimbugwe, Ahmed Taha

المصدر: JACC Case Reports
JACC: Case Reports, Vol 1, Iss 4, Pp 622-625 (2019)

مصطلحات موضوعية: medicine.medical_specialty, pulmonary embolism, Case Report, Impella RP, Clinical Case, Internal medicine, Intervention (counseling), medicine, Diseases of the circulatory (Cardiovascular) system, ultrasound-assisted catheter-directed thrombolysis, LV, left ventricular, Impella, EndoWave Infusion Catheter System, mechanical circulatory support, business.industry, Cardiogenic shock, PE - Pulmonary embolism, cardiogenic shock, medicine.disease, Pulmonary embolism, UCDT, ultrasound-assisted catheter-directed thrombolysis, RC666-701, PE, pulmonary embolism, Cardiology, Right ventricular failure, CTPA, computed tomography pulmonary angiography, Cardiology and Cardiovascular Medicine, business, RV, right ventricular

الوصف: Due to the scarcity of data, Impella RP is not approved for acute right ventricular failure caused by massive pulmonary embolism. We describe here the successful use of Impella RP in acute right ventricular failure caused by massive pulmonary embolism to highlight its promising outcome in such an indication. (Level of Difficulty: Advanced.)
Graphical abstract
Due to the scarcity of data, Impella RP is not approved for acute right ventricular failure caused by massive pulmonary embolism. We describe here the…

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::def1ff9c0e0476af153f88022ceff165Test
http://europepmc.org/articles/PMC8288580Test

المؤلفون: Fabian Gaupp, Alexander Moushey, Jessica Lee, David S. Kirwin

المصدر: CSurgeries.

مصطلحات موضوعية: medicine.medical_specialty, Port (medical), business.industry, Medicine, General Medicine, Infusion catheter, business, Surgery

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::47054bda5217274c5f32c71df44bf885Test
https://doi.org/10.17797/2021092402Test