• Title/Summary/Keyword: Catheter insertion

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Changes of Blood Flow Characteristics due to Catheter Obstruction during the Coronary Angioplasty

  • Suh, Sang-Ho;Roh, Hyung-Woon;Kwon, Hyuck-Moon;Lee, Byoung-Kwon
    • International Journal of Vascular Biomedical Engineering
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    • v.2 no.1
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    • pp.25-30
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    • 2004
  • Catheters are used to measure translesional pressure gradients in the stenosed coronary arteries. Uses of catheters during coronary angioplasty cause flow obstructions. A narrowed flow cross section with catheter effectively introduced a tighter stenosis than the enlarged residual stenoses after balloon angiplasty. Catheters in blood vessels cause pressure gradient rise and blood flow drop during the measurements. In this study, three dimensional computer simulations are conducted to investigate the flow blockage effects due to the catheter obstructions during the coronary angioplasty. The computer simulation models are generated by the data, which are measured by coronary angiogram, and the blood is treated as non-Newtonian fluid. The velocity, pressure, and wall shear stress variations are observed for the estimate of damages of blood vessel. This study is also extended to investigate the effects of stenotic vessel size, and shape and catheter size and location.

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Presumed Subarachnoid Migration of an Epidural Catheter -A case report- (경막외 카테터의 지주막하강으로의 이전 -증례 보고-)

  • Kim, Ki-Jun;Park, Byoung-Hark;Lee, Youn-Woo;Yoon, Duck-Mi;Nam, Yong-Taek;Kim, Seung-Jun
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.311-313
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    • 1998
  • Continuous epidural catheter insertion is common practice in postoperative analgesia. Subarachnoid migration of epidural catheter is a rare complication. Presumed delayed subarachnoid migration of an epidural catheter occured in a 58-year-old female patient after subtotal gastrectomy. Delayed respiratory depression occured 7 hrs after transfer to admission room. She was intubated and had ventilatory care. The fluid from the epidural catheter was examined and the result showed that gucose was 107 mg% and protein was 31 mg%. Immediate naloxone administration and ventilatory care for one day was done. The patient discharged without any sequalae.

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The evaluation of image-guided catheter drainage in pleural effusion and empyema (흉수 및 농흉에서의 영상유도하 도관배액술의 유용성 평가)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.403-409
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    • 1996
  • Background : Pleural fluid collections may pose a difficult therapeutic problem. Complete drainage of complicated effusions or empyemas and reexpansion of atelectatic lung are important in obtaining a satisfactory clinical outcome. The usual approach to the diagnosis and treatment of patients with pleural effusion and empyema has been with needle thoracentesis and chest tube drainage. With chest tube drainage, technical difficulties and failures may occur as a result of improper tube drainage, particularly when there is a loculation or multiple and inaccesible collections. Fluoroscopic or sonographic guidance facilitates the proper tube insertion and drainage. Method : Twenty eight patients were required for tube drainage due to pleural fluid collections between January 1994 to February 1996. The author compared the results of drainage under applying each different method between blind chest tube insertion and image guided catheter insertion. Results : The conventional blind chest tube group comprised 14 patients; 6 empyema, 6 tuberculous effusion, and 2 parapneumonic effusion. The image guided catheter group of smaller french were composed of 14 patients; 2 empyema, 6 tuberculous effusion, 5 parapneumonic effusion, and 1 effusion of undetermined origin. Radiologic improvement with successful drainage was noticed in 79% with the blind chest tube group, whereas in 93% with the image guided catheter group. The complication with the latter method was unremarkable. Conclusion : Image guided catheter drainage was safe and highly successful in treating patients, not only with complicated effusion also with loculated empyema. Image guided catheter drainage offers an alternative in patients in whom closed drainage is required as the initial treatment.

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Comparison of Complications of Peripherally Inserted Central Catheters with Ultrasound Guidance or Conventional Methods in Cancer Patients

  • Gong, Ping;Huang, Xin-En;Chen, Chuan-Ying;Liu, Jian-Hong;Meng, Ai-Feng;Feng, Ji-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1873-1875
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    • 2012
  • Objective: To compare the complications of peripherally inserted central catheters (PICC) by a modified Seldinger technique under ultrasound guidance or the conventional (peel-away cannula) technique. Methods: From February to December of 2010, cancer patients who received PICC at the Department of Chemotherapy in Jiangsu Cancer Hospital were recruited into this study, and designated UPICC if their PICC lines were inserted under ultrasound guidance, otherwise CPICC if were performed by peel-away cannula technique. The rates of successful placement, hemorrhage around the insertion area, phlebitis, comfort of the insertion arm, infection and thrombus related to catheterization were analyzed and compared on days 1, 5 and 6 after PICC and thereafter. Results: A total of 180 cancer patients were recruited, 90 in each group. The rates of successful catheter placement between two groups differed with statistical significance (P <0.05), favoring UPICC. More phlebitis and finger swelling were detected in the CPICC group (P <0.05). From day 6 to the date the catheter was removed and thereafter, more venous thrombosis and a higher rate of discomfort of insertion arms were also observed in the CPICC group. Conclusion: Compared with CPICC, UPICC could improve the rate of successful insertion, reduce catheter related complications and increase comfort of the involved arm, thus deserving to be further investigated in randomized clinical studies.

Catheter Embolism during Chemoport Removal (Chemoport 제거 중 발생한 카테터 색전증)

  • Song, Ki-Byung;Nam, So-Hyun;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, Young-Hwue;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.238-243
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    • 2006
  • Chemoport is widely used in pediatric surgery field. But various complications can occur during the process of insertion or removal of chemoport. Surgeons must be familiar with the treatment of these complications. We had one catheter cuts off during chemoport removal, become a catheter embolism. Interventional radiologic removal was successful. Verifying the length of removed catheter and careful observation of the catheter tip during removal procedure is important to prevent the possibility of catheter embolus. Radiologic intervention was accessible to remove the retained catheter.

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The effect of 8 French catheter and chest tube on the treatment of spontaneous pneumothorax (자연기흉에 있어서 8 French 도관과 흉관의 삽입 치료 효과)

  • Kang, Yoon-Jeong;Koh, Hyoung-Gee;Shin, Jong-Wook;Lim, Seong-Yong;Choi, Jae-Sun;Yu, Ji-Hoon;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho;Seo, Seung-Cheon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.410-419
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    • 1996
  • Background : Spontaneous pneumothorax have been managed with a variety of methods. The technique most frequently used is chest tube drainage. Small caliber catheters were first used in the management of pneumothorax complicating the percutaneous needle aspiration lung biopsy, and the try to treat spontaneous pneumothorax also has been reported. However, the value of small caliber catheters in spontaneous pneumothorax has not been fully evaluated. So, we tried to elucidate the efficacy of 8 French catheter in the management of spontaneous pneumothorax. Method : From January, 1990, to April, 1994, 44 patients with spontaneous pneumothorax treated at Chung-Ang university hospital were reviewed. The patients were sub-divide into 8 French catheter insertion group (n=21) and chest tube insertion group (n=23). We compared the presence of underlying lung disease, the extent of the collapse, the duration of indwelling catheter and complication between two groups. Results : 1) The duration of indwelling showed no significant difference between 8 French catheter group and chest tube. But, complication after insertion as subcutaneous emphysema was developed in only chest tube group. (p<0.05) 2) In the primary spontaneous pneumothorax, all case of the pneumothorax of which size was less than 50% showed complete healing with 8 French catheter insertion. Whereas the success rate in patients with large pneumothorax (more than 50%) was tended to be dependent on the age. 3) In the patients with secondary spontaneous pneumothorax who were managed with 8 French catheter, the success rate was trended to be high if the underlying disease of pneumothorax was not COPD and if the patient was young. Conclusion : These results show that 8 French catheter insertion probably was effective in the pneumothorax less than 50%, the primary spontaneous pneumothorax, young age or secondary pneumothorax not associated with COPD.

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Guidelines for Determining Length of Tunneled Dialysis Catheter (터널식 투석관의 길이 결정 가이드라인)

  • Park, Ho-Sung;Kim, Jae-Seok
    • Journal of the Korean Society of Radiology
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    • v.16 no.3
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    • pp.241-248
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    • 2022
  • A guideline for determining the optimal catheter length according to the patient's physique during tunnel-type dialysis catheter insertion used in renal failure patients is presented, and the maintenance of the function of the dialysis catheter is evaluated. From October 1, 2015 to February 31, 2016, a total of 110 (male : female = 73 : 37) patients who underwent tunnel-type dialysis catheterization performed at our hospital were treated without using guidelines. The group was divided into A group, and the group treated using the guideline into B group. Results were analyzed statistically using SPSS 20.0. As a result of the dialysis catheter insertion procedure according to the use of guidelines, the function maintenance rate of group A was 81.8%, and the function maintenance rate of group B was 96.3%. In the case of tunnel dialysis catheter procedure, the function maintenance effect was statistically significant in the group treated using the guideline compared to the group not using it (p<0.05). It can be said that it is more effective when information on the patient's underlying disease is reflected in addition to the use of guidelines.

Effects of Maximal Sterile Barrier Precaution on the Central Venous Catheter-related Infection and Cost (중심정맥관 삽입시 최대멸균 차단법이 중심정맥관 관련 감염률과 비용에 미치는 효과)

  • Lim, Jung-Hye;Kim, Nam-Cho
    • Korean Journal of Adult Nursing
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    • v.22 no.3
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    • pp.229-238
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    • 2010
  • Purpose: The purpose of this study was to examine the effect of maximal sterile barrier precaution on the central venous catheter-related infection and subsequent cost savings. Methods: Study subjects were 462 hospitalized patients with central venous, catheter of more than 48 hours duration. Data collection period was from April 2008 to February 2009 at a tertiary university hospital in Seoul. Subjects were randomly assigned to either the treatment or the usual care group. Patients in the treatment group (n=209) were treated by staff using maximal sterile barrier precautions and the comparison group(n=253) received traditional care. Results: Central venous catheter-days was2,821 in treatment group and 3,515 in comparison group. The incidence density of central venous catheter-related infection was 2.1 times higher in the comparison group (8.2 per 1,000 catheter-days) compared with the treatment group (3.9 per 1,000 catheter-days). The incidence density of central venous catheter-related bloodstream infection was 4.54 times higher than in the comparison group (3.2 per 1,000 catheter-days) compared with the treatment group (0.7 per 1,000 catheter-days). The attributable cost of central venous catheter-related infection in the treatment group was 10,174,197 won and that of the comparison group was 22,224,554 won. Attributable cost by area was also significantly lower compared with that of the comparisons. Conclusion: The maximal sterile barrier precaution during central venous catheter insertion was an effective intervention to reduce central venous catheter-related infection rate and provides a significant cost savings.

Analysis of Complication in Pediatric Patients with Hickman Catheters (히크만 카테터를 삽입한 소아 환자에서 발생한 합병증 분석)

  • Kim, Tae-Hoon;Kim, Dae-Yeon;Cho, Min-Jeong;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.16 no.1
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    • pp.25-31
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    • 2010
  • Hickman catheters are tunneled central venous catheters used for long-term venous access in children with malignancies. The appropriate management for various kinds of catheter related complications has become a major issue. We retrospectively analyzed the clinical, demographic, and surgical characteristics in 154 pediatric hemato-oncology patients who underwent Hickman catheter insertion between January 2005 and December 2009. There were 92 boys and 62 girls. The mean age at surgery was $7.6{\pm}5.1$ years old. The mean operation time was $67.4{\pm}21.3$ minutes and C-arm fluoroscopy was used in 47(30.5 %). The causes of Hickman catheter removal were termination of use in 82 (57.3 %), catheter related bloodstream infection in 44(30.8 %), mechanical malfunction in 11(7.7 %), and accidents in 6(4.2 %). Univariate and multivariate analysis for associated factors with catheter related bloodstream infection showed that there were no statistically significant associated factors with catheter related infection complications. All cases except two showed clinical improvement with catheter removal and relevant antibiotics treatment. The mean catheter maintenance period in patients of catheter removal without complications was $214.9{\pm}140.2$ days. And, The mean catheter maintenance period in patients of late catheter related bloodstream infection was $198.0{\pm}116.0$ days. These data suggest that it is important to remove Hickman catheter as soon as possible after the termination of use. When symptoms and signs of complications were noticed, prompt diagnostic approach and management can lead to clinical improvements.

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