• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.641-648
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• 2018

Objective: This study examined the incidence and amount of air inflow during central venous catheter (CVC) insertion. Methods: This study was an experimental study aimed at designing an apparatus to implement blood vessel and blood flow in the human body. A 1.5-m long core tube with a Teflon tube, suction rubber tube, and polyvinyl chloride tube were made. This core tube was assumed to be the blood vessel of the human body. Blood was replaced with a saline solution. The saline solution was placed higher than the core tube and flowed into the inside of the tube by gravity. The CVC was injected 15-cm deep into the core tube. The air was collected through a 3-way valve into the upper tube. The experiments were carried out by differentiating the pressure in the tube, CVC insertion step, and diameter of the end of the catheter. The experiment was repeated 10 times under the same conditions. Results: The amount of air decreased with increasing pressure applied to the tube. Air was not generated when the syringe needle was injected, and the amount of air increased with increasing size of the distal end catheter. Conclusion: To minimize the possibility of air embolism, it is necessary to close the distal end catheter at the earliest point as soon as possible.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.283-287
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• 1996

Recently, continuous epidural catheter insertion is usually employed in operation and chronic pain control. Delayed migration of an extradural catheter into subdural space or subarachnoid space is a rare but life threatening complication of continuous epidural catheter insertion, especially with out patients. The symptoms may include lower extremity weakness, hypotension, drowsy and respiratory depression. We experienced two cases of lower extremity paralysis due to delayed migration into subdural or subarachnoid spaces at our pain clinic. The tecnical procedures for continuous epidural catheterization went smoothly without any complications. However, clinical signs of lower extremity paralysis and sensory loss developed gradually, about 2 hours and 30 minutes after the continuous epidural injection. Two cases were confirmed by subdurogram and myelogram.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.303-309
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• 2016

Purpose: Malignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. Methods: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. Results: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. Conclusion: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.

• Advances in pediatric surgery
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• v.13 no.2
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• pp.212-216
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• 2007

Migration of a peritoneal catheter of a ventriculoperitoneal shunt into the scrotum is a rare complication. We treated a case of catheter migration in the scrotum. A 12-year old boy, who had had a ventriculoperitoneal shunt at the age of 4 months due to neonatal hydrocephalus, visited the outpatient clinic because of a right inguinal hernia. On physical examination, a firm mass was found in the left scrotum. Pelvic X-ray demonstrated a coiled catheter in the left scrotum. The catheter was successfully removed by exploring the left patent processus vaginalis after high ligation of the hernia sac. This case suggests a suction action of the patent processus vaginalis and the possibility of catheter migration long after shunt catheter insertion.

• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.136-141
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• 2015

Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, $6.54{\pm}1.06$ years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was $1.57{\pm}0.34$ and $14.07{\pm}1.91$ minutes, respectively, the mean catheter dwell time was $14.73{\pm}2.5$ days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.946-948
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• 2006

The patient was a 42-year-old female with breast cancer who had an implantable central venous catheter inserted percutaneously into left subclavian vein for chemotherapy. The postinsertion chest x ray revealed that there was no compressive sigh of catheter. Three months after insertion of the catheter, the patient was admitted to the hospital for 4th chemotherapy. The port was accessed but blood could not be aspirated and the catheter could not be flushed. A chest x ray revealed that the catheter was completely transected at the point where the catheter passed under the clavicle. Percutaneous removal of the distal fragment of the catheter was accomplished. The patient was discharged after successful removal of fragment of catheter.

• Journal of Korean Academy of Nursing
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• v.37 no.7
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• pp.1149-1158
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• 2007

Purpose: The purpose of this study was to identify the risk factors for a nosocomial urinary tract infection in intensive care units with a foley catheterization which showed a positive urine culture. Method: Three-hundred eighty-seven patients were included in the study. A retrospective review of the electrical medical record system's databases and medical record sheets in hospitalized patients from January 2003 to December 2003 was used. The collected data was analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. Result: The frequency of the participants' nosocomial urinary tract infection was 72.9%. Significant risk factors for a nosocomial urinary tract infection were 'age', 'place of catheter insertion', 'frequency of catheter change', and 'duration of catheterization'. These variables explained 18.4% of variance in the experience of nosocomial urinary tract infection in intensive care units with foley catheterization. Conclusion: Medical personnel can decrease the incidence of a nosocomial urinary tract infection by recognizing and paying attention to the duration of catheterization, frequency of catheter change, and place of catheter insertion. As a result, specific and scrupulous strategies should be developed to reflect these factors for decreasing nosocomial urinary tract infections.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.50-53
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• 2007

Background: Continuous epidural catheterization is a popular and effective procedure for postoperative analgesia. However, continuous epidural catheterization has associated complications such as venous puncture, dural puncture, subarachnoid cannulation, suboptimal catheter placement, and paresthesia because the tip of the epidural catheter touches thenerves of the dura in the epidural space. In this study, we compared the incidence of paresthesia in two different lengths of epidural catheter insertion. Methods: One hundred women undergoing gynecologic or orthopedic surgery were enrolled in this prospective, double-blinded, randomized study. All patients were randomly divided into two groups based on the insertion length of the epidural catheter 2 cm (group A) or 4 cm (group B). A Tuohy needle was inserted in the lumbarspinal region with a bevel directed cephalad by use of the median approach, and then the epidural space was confirmed by the loss of resistance technique with air. While the practitioner inserted an epidural catheter into the epidural space, a blind observer checked for paresthesia or withdrawal movement. Results: In 97 included patients, 30.6% of the patients in group A (n = 49) had paresthesia, versus 31.3% in group B (n = 48). Withdrawal movements were represented in 2% and 6% of the patients in group A and group B, respectively. There was no difference in the incidence of paresthesia and withdrawal movement between the two groups. Conclusions: There is no clear relationship for the incidence of catheter-related paresthesia according to the catheter length inserted into the epidural space for epidural analgesia.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.444-447
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• 2013

In most intracranial surgery cases, a drain catheter is inserted to prevent the collection of the wound hematoma or seroma. A drain catheter is also inserted to drain the hematoma or the cerebrospinal fluid. The drain catheter itself does not cause complications; but many complications occur during its removal, such as hematoma, seroma, air collection and pseudomeningocele formation. To prevent these complications, neurosurgeons perform a suture on the catheter to remove the site. In this study, an additional horizontal mattress suture and an anchoring suture to the drainage catheter are proposed. This method maintains negative pressure in the catheter insertion site during the catheter removal, compresses the catheter tunnel site and attaches the external wounds strongly. The technique is easy and safe to perform, and does not require an additional suture to remove the catheter.

• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.1-6
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• 2009

Purpose: This study presents a classification of pure medial and inferior blow-out fracture, and confirms the relationship between the types of fractures, postoperative complications and operative methods. Methods: Sixty patients were treated by transnasal endoscopic reduction with $Medpor^{(R)}$ implantation through subciliary incision and foley catheter insertion into maxillary sinus was done if there was extensive orbital floor fracture. Fractures were classified by number of coronal sections from posterior margin of fossa for lacrimal sac to orbital apex in CT. Type I is defined when the medial wall fracture is over 50% and inferior wall fracture below 50%. Type II, when below 50% medial wall fracture and over 50% floor fracture were present. If there were both over 50%, it was classified as Type III and both below 50% for Type IV. Extreme fracture involving orbital buttress was Type V and postoperative findings in all patients were examined. Results: Type I and V were most common and preoperative findings were more likely to present according to extent of inferior fracture. Diplopia remained in 2 cases after additional insertion of foley catheter, but enophthalmos over 2 mm were presented in 3 cases and diplopia in 3 cases were observed who were not treated with foley catheter. Conclusion: Postoperative complications were increased according to extent of fracture, especially buttress involvement. Additional insertion of foley catheter proved its effectiveness in decreasing postoperative complications.