• 제목/요약/키워드: Catheter Insertion

검색결과 154건 처리시간 0.025초

Improvement of catheter-related outcomes after application of tunneled cuffed hemodialysis catheter insertion without fluoroscopy

  • Kang, Seok Hui;Do, Jun Young
    • Journal of Yeungnam Medical Science
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    • 제37권3호
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    • pp.186-193
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    • 2020
  • Background: Non-tunneled catheters (NTCs) are used for hemodialysis (HD) in many centers in which fluoroscopy is not easily accessed despite high complication rates and conditions requiring long-term HD. Therefore, here we aimed to evaluate the superiority of catheter-related outcomes after the application of tunneled cuffed catheter (TCC) without fluoroscopy versus unconditioned NTC insertion. Methods: We divided the participants into two phases: those receiving NTCs between March 2010 and February 2011 (phase I), and those receiving TCCs or NTCs between March 2011 and February 2012 (phase II). Catheter survival, nurse satisfaction, and reasons for catheter removal were analyzed. Results: Two hundred and sixty patients in phase I and 300 patients in phase II were enrolled in this study. The success rate of TCC insertion was 99.2%. The catheter survival rate in phase I was 65.5% at 1 month, while that in phase II was 74.9% at 1 month (p=0.023). We compared catheter survival between TCCs and NTCs for all periods regardless of phase. The TCC survival rate was higher than the NTC survival rate (p<0.001). Catheter-associated problems led to catheter removal in 97 patients (26.6%) in phase I and 68 patients (18.5%) in phase II (p=0.009). Among 14 HD nurses, all reported being satisfied with manipulation during pre-/post-HD, manupulation during HD, and overall. Eleven HD nurses (78.6%) reported being satisfied with the workload. Conclusion: Compared with unconditional NTC insertion for HD, TCC insertion without fluoroscopy improved the overall catheter survival and nurse satisfaction rates.

소아 환자에서 복강경 복막 투석관 삽입술과 개복 삽입술의 비교 (Comparison of the Laparoscopic and Open Peritoneal Dialysis Catheter Insertion in Children)

  • 김현수;정수민;이석구;서정민
    • Advances in pediatric surgery
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    • 제17권2호
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    • pp.125-132
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    • 2011
  • The aim of this study was to compare peritoneal dialysis catheter insertion by the open method to the laparoscopic method. Twenty four laparoscopic and 10 open peritoneal dialysis catheter placements were performed in children between 2001 and 2008. Patient characteristics, operation related data, procedural complications and clinical outcome were compared. Although there were no cases of catheter obstruction, exit site infection or bleeding in the laparoscopic group, compared to the open method, there was no statistically significant difference between the two groups. Catheter removal rate due to complication was high in the open group and catheter survival rate was high in the laparoscopic group. We concluded that laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups with at least equivalent functional results compared to the open method. An advantage of laparoscopic catheter insertion is removal of the great omentum and easy fixation of the catheter to the abdominal wall.

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편심협착부가 있는 관상동맥내 카테터삽입에 따른 혈액유동특성 (Blood Flow Characteristics due to Catheter Insertion in the Eccentric Stenosed Coronary Artery)

  • 노형운;서상호;권혁문;이병권
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2002년도 학술대회지
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    • pp.707-708
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    • 2002
  • Catheters are used to measure translesional pressure gradients in the stenosed coronary arteries. Catheter insertions during coronary angioplasty cause flow obstructions. A narrowed flow cross section with catheter present effectively introduced a tighter stenosis than the enlarged residual stenoses after balloon angiplasty. In general, the form of stenoses are no uniform. Sometimes, these are occurred the irregularly eccentricity If the analyses are conducted for uniform stenosed artery, the results will be underestimated. Thus, in this study, three dimensional computer simulations are conducted to investigate the flow blockage effects due to the catheter insertion during the coronary angioplasty. The results for the eccentric stenosed artery are compared with those of the concentric stenosed artery.

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Massive hemothorax after central venous catheter insertion in a patient with multiple trauma

  • Park, Jeong Heon;Song, Jaegyok;Oh, Pyeong-wha
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권1호
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    • pp.81-85
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    • 2021
  • Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.

작동인형을 이용한 관심전환이 정맥주사 시 학령전기 아동의 통증에 미치는 효과 (Effects of Distraction using Operating Doll on Preschool Children's Pain during an IV Catheter Insertion)

  • 이분심;권인수
    • Child Health Nursing Research
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    • 제11권4호
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    • pp.490-497
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    • 2005
  • Purpose: The purpose of this study was to investigate the effect on pain of distraction with an operating doll in preschool children(3-6 years old) during an IV catheter insertion. Method: The research design was a nonequivalent control group posttest design, and the participants were 22 children in the experimental group, and 23 children in the control group. The children were hospitalized for enteritis and pharyngitis in a university hospital. The subjective pain was measured using FACES Pain Rating Scale by self report, and the pain behavior responses were scored using Procedure Behavior Check List by observing a film of the entire procedure, and changes in pulse and oxygen saturation as the physiological pain responses were measured by pulse oximeter. Data were analyzed with the SPSS Win 10.0 program. Result: The degree of subjective pain, pain behavior responses, and changes in pulse during IV catheter insertion were significantly lower in the experimental group. But there was no significant difference in $O_2$ saturation between the two groups. Conclusion: Distraction using an operating doll was effective in decreasing pain during inserting the IV catheter in preschool children.

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중심정맥관 번들이행에 따른 중심정맥관 균집락과 중심정맥관 관련 혈류감염: CHG테가덤과 일반테가덤 드레싱비교연구 (The Incidences of Catheter Colonization and Central Line-Associated Bloodstream Infection According to Tegaderm vs. Chlorhexidine Gluconate (CHG)-Tegaderm Dressing)

  • 김은지;이해정
    • 대한간호학회지
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    • 제50권4호
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    • pp.541-553
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    • 2020
  • Purpose: In spite of the recent application of a general infection control method, central line-associated infections is still relatively high in Korea. Central line bundle with Chlorhexidine gluconate (CHG) tegaderm dressing was reported to be effective in reducing catheter colonization and central line-associated bloodstream infections (CLABSI). Therefore, this study aimed to examine the incidences of catheter colonization occurrence and CLABSI while using Tegaderm vs. CHG Tegaderm dressings. Methods: We used a descriptive design. 400 patients who had central venous catheters were selected from four hospitals in the Korean National Healthcare-associated Infections Surveillance System. Of all subjects, 200 used Tegaderm™ (Tegaderm group), and the remaining 200 used CHG Tegaderm (CHG Tegaderm group) dressing at the catheter insertion site. Data were analyzed using the χ2 test or Fisher's exact test, t-test, and logistic regression analysis using SPSS WIN 21.0. Results: In the Tegaderm and CHG Tegaderm groups, CLABSI incidences were 5.89 and 1.79 per 1,000 catheter-days, catheter colonization incidences were 3.93 and 1.43 per 1,000 catheter-days, and central line bundle compliance rates were 26.0% and 49.0%, respectively. Catheter colonization risk factors were 'reinsertion after failure' and 'Tegaderm dressing' at the central line insertion site. CLABSI risk factors were 'incomplete performance of 7 central line bundle items' and 'Tegaderm dressing' at the central line insertion site. Conclusion: A further prospective study is needed to examine the effects of central line bundle with CHG Tegaderm dressing, avoiding central line reinsertion after failure, and improving the bundle compliance in reducing catheter colonization and CLABSI.

Central line-associated bloodstream infections in neonates

  • Cho, Hye Jung;Cho, Hye-Kyung
    • Clinical and Experimental Pediatrics
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    • 제62권3호
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    • pp.79-84
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    • 2019
  • Newborn infants, including premature infants, are high-risk patients susceptible to various microorganisms. Catheter-related bloodstream infections are the most common type of nosocomial infections in this population. Regular education and training of medical staffs are most important as a preventive strategy for central line-associated bloodstream infections (CLABSIs). Bundle approaches and the use of checklists during the insertion and maintenance of central catheters are effective measures to reduce the incidence of CLABSIs. Chlorhexidine, commonly used as a skin disinfectant before catheter insertion and dressing replacement, is not approved for infants <2 months of age, but is usually used in many neonatal intensive care units due to the lack of alternatives. Chlorhexidine-impregnated dressing and bathing, recommended for adults, cannot be applied to newborns. Appropriate replacement intervals for dressing and care sets are similar to those recommended for adults. Umbilical catheters should not be used longer than 5 days for the umbilical arterial catheter and 14 days for the umbilical venous catheter. It is most important to regularly educate, train and give feedback to the medical staffs about the various preventive measures required at each stage from before insertion to removal of the catheter. Continuous efforts are needed to develop effective and safe infection control strategies for neonates and young infants.

CT 지표를 이용한 두정-후두부 뇌실 도관의 정확한 삽입 (Accurate Placement of Parieto-occipital Ventricular Catheter Using CT Parameters)

  • 민형식;송준혁
    • Journal of Korean Neurosurgical Society
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    • 제29권7호
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    • pp.886-890
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    • 2000
  • Objective : placement of ventricular catheter is important to achieve long-term patency of the shunt system. We describe a method of calculating the insertion site, trajectory, and the length of the ventricular catheter using CT parameters in shunt surgery. Patients and Methods : These can be rapidly obtained using a caliper from a scout cut and two axial scans at lateral ventricular and upper 3rd ventricular level. To compare this technique with traditional one, we analyzed 40 consecutive patients who underwent shunt surgery. Results : Of 20 patients undergoing ventriculoperitoneal shunt insertion using this technique, none had poor location of the proximal catheter. In the counterpart, 9 patients had poor location(p=0.001). The number of patients who required revision surgery were also lower in the group using this technique, but it was not statistically significant (4 versus 2, p=0.422). Mean follow-up period was shorter in this technique group. Conclusion : This technique provides an accurate placement of the proximal catheter without special instrument or additional expenses.

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PET/CT에서 최적의 플러싱횟수를 위한 잔류방사능과의 상관분석 (Optimization of Flushing through Correlation Analysis between the Number of Flushing and Residual Activity in PET/CT)

  • 최우영;지영식;윤창용
    • 한국방사선학회논문지
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    • 제17권5호
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    • pp.701-707
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    • 2023
  • PET/CT에서 18F-FDG의 주사용량은 SUV(Standard Uptake Value)에 직접적인 영향을 끼쳐 판독결과에 영향을 미칠 수 있다. 따라서 정확한 18F-FDG의 dose 값을 주사하는 것이 중요하다. 본 연구에서는 18F-FDG 주사 시 플러싱 횟수에 따른 주사기와 혈관삽입기구의 잔류방사능간의 상관관계분석을 실시하였다. 실험장비는 CRC-25R 검량계, 3WAY line과 needle, 3 cc 주사기 및 50 cc 생리식염수를 사용하였고 결과값을 SP SS 21 Statics로 통계 분석하였다. 그 결과, 주사기와 혈관삽입기구의 총 잔류 방사능은 2회 플러싱 시 5.84 % 로 가장 높았고 5회 플러싱 시 1.49 % 로 가장 낮게 잔류하였다. 상관관계분석결과, 플러싱 횟수는 주사기의 잔류방사능과 -0.436, 혈관삽입기구와 - 0.300으로 음(-)의 상관관계를 보였다. 플러싱횟수에 따른 주사기, 혈관확보기구의 잔류 방사능 평균값을 일원배치 분산분석(One way - ANOVA)를 실시한 결과, 주사기의 잔류방사능은 4회부터 유의미한 감소를 보였고, 혈관확보기구의 잔류방사능은 5회부터 유의미한 감소를 보였다. 그러나 혈관확보기구의 평균 잔류방사능이 총 잔류방사능의 0.8 %라는 점을 고려할 때, 4회의 플러싱횟수가 가장 합리적으로 보인다.

Cerebral Air Embolism Following Pigtail Catheter Insertion for Pleural Fluid Drainage

  • Kim, Sa Il;Kwak, Hyun Jung;Moon, Ji-Yong;Kim, Sang-Heon;Kim, Tae Hyung;Sohn, Jang Won;Shin, Dong Ho;Park, Sung Soo;Yoon, Ho Joo
    • Tuberculosis and Respiratory Diseases
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    • 제74권6호
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    • pp.286-290
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    • 2013
  • Pigtail catheter drainage is a common procedure for the treatment of pleural effusion and pneumothorax. The most common complications of pigtail catheter insertion are pneumothorax, hemorrhage and chest pains. Cerebral air embolism is rare, but often fatal. In this paper, we report a case of cerebral air embolism in association with the insertion of a pigtail catheter for the drainage of a pleural effusion. A 67-year-old man is being presented with dyspnea, cough and right-side chest pains and was administered antibiotics for the treatment of pneumonia. The pneumonia failed to resolve and a loculated parapneumonic pleural effusion developed. A pigtail catheter was inserted in order to drain the pleural effusion, which resulted in cerebral air embolism. The patient was administered high-flow oxygen therapy and recovered without any neurologic complications.