• Journal of Chest Surgery
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• 제5권2호
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• pp.97-106
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• 1972

We will report 6 cases of cardiac tamponade treated surgically at Severance Hospital during the past 9 years from 1964 to 1972 and reviewed literatures on cardiac tamponade. The age of patients was from 13 years to 45 years old. The male was 4 cases and the female 2 cases. The sites of injury were right atrium; 1 case, right ventricle; 2 cases, right ventricle and coronary artery; 1 case, left atrium; 1 case, and left ventricle; 1 case. 2 cases of cardiac tamponade developed following chest injury, 2 cases following pericardiocentesis,1 case due to continuous bleeding from sutured cardiotomy wound of left atrium following open mitral commissurotomy using cardiopulmonary bypass machine, and 1 case due to traumatic penetration of polyethylene catheter through right ventricle to pericardial sac, introduced via right jugular vein in order to monitor the central venous pressure. Central venous pressure was checked preoperatlvely in 5 cases. In all cases, central venous pressure was rised [the range of central venous pressure was 240 to 330 mmHg]. Immediately after operation,central venous pressure lowered to normal [the range was 80-100 mmHg]. Recently serial gas analysis of arterial blood were checked pre- and post-operatively for the evaluation of hemodynamic change of cardiac tamponade, but our data was not enough for evaluation. It should be studied further.

• Clinical and Experimental Pediatrics
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• 제58권4호
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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.

• 종양간호연구
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• 제11권1호
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• pp.1-8
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• 2011

Purpose: The purpose of this study was to identify the types of venous access devices (VAD) for cancer patients and investigate the factors related to the insertions of central venous catheter (CVC) in cancer patients. Methods: The subjects were 379 cancer patients. A retrospective review of all patients who were discharged from a cancer unit from November 1st to 21st in 2008 was done using a structured questionnaire. Results: A total of 82 CVC (21.6%) was inserted among 379 patients for administering anticancer therapy. There were statistically significant differences in age, length of stay (LOS), cumulative LOS, medical department, history of CVC insertion, cancer category, and albumin level between patients using peripheral intravenous (IV) catheters and CVC. In addition, factors influencing the use of CVC were LOS (odds ratio [OR]=0.286, confidence interval [CI]=1.043-1.124), history of CVC insertion (OR=3.920, CI=0.128-0.637), albumin level (OR=1.010, CI=1.879-8.179), cumulative LOS (OR=1.010, CI=1.001-1.018), and hematological diseases (OR=4.863, CI=2.162-10.925). Conclusion: We found that central venous catheterization for anticancer therapy was minimal even though CVC was safe and effective device for IV access. It is necessary to develop a strategy to use VADs efficiently and timely for cancer patients.

• Clinical and Experimental Pediatrics
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• 제49권8호
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• pp.902-905
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• 2006

중심 정맥 도관술은 미숙아들의 출생과 생존율의 증가로 현재 신생아실에서 많이 시행 되고 있는 수기이며, 최근 중심 정맥 카테터 사용이 증가함에 따라 혈전이나 색전, 혈관 손상과 파열, 흉막 삼출, 화학적 폐렴과 같은 합병증이 보고되고 있다. 이에 저자들은 경피 중심 정맥 카테터 삽입 후 우측성 흉막 삼출액이 발생하여 시행한 혈관조영술에서 카테터가 홀정맥에 위치하였던 초극소 저출생 체중아에서 경피 중심 정맥 카테터를 제거한 후 흉막 삼출액이 호전되었던 1례를 경험하였기에 보고하는 바이다.

• Journal of Korean Medical Science
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• 제33권45호
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• pp.280.1-280.9
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• 2018

Background: Surveillance and interventions of central line-associated bloodstream infections (CLABSIs) had mainly been targeted in intensive care units (ICUs). Central lines are increasingly used outside ICUs. Therefore, we performed a hospital-wide survey of CLABSIs to evaluate the current status and develop strategies to reduce CLBASI rates. Methods: All hospitalized patients with central venous catheters (CVCs) were screened for CLABSIs from January 2014 through December 2015 at a 1,328 bed tertiary care teaching hospital in Korea using an electronic data-collecting system. Clinical information including type of CVC was collected. CLABSI rates were calculated using the definitions of the National Health and Safety Network after excluding mucosal barrier injury laboratory-confirmed bloodstream infection (BSI). Results: A total of 154 CLABSIs were identified, of which 72 (46.8%) occurred in general wards and 82 (53.2%) in ICUs (0.81 and 2.71 per 1,000 catheter days), respectively. Nontunneled CVCs were most common (68.6%) among 70 CLABSI events diagnosed within one week of their maintenance. On the other hand, tunneled CVCs and peripherally inserted central catheters (PICCs) were more common (60.5%) among 114 CLABSI events diagnosed more than a week after maintenance. Whereas the majority (72.2%) of CLABSIs in ICUs were associated with non-tunneled CVCs, tunneled CVCs (38.9%) and PICCs (36.8%) were more common in general wards. Conclusion: CLABSIs are less common in general wards than in ICUs, but they are more often associated with long-term indwelling catheters. Therefore, interventions to prevent CLABSIs should be tailored according to the type of ward and type of catheter.

• 대한영상의학회지
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• 제84권3호
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• pp.586-595
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• 2023

제대 정맥 카테터는 미숙아 혹은 위중한 만삭아에게 중심 정맥을 통한 총 비경구 영양 및 약물을 제공하기 위해 흔하게 사용된다. 하지만 제대 정맥 사용은 감염, 문맥 혈전증 및 간 조직 손상을 포함하는 합병증을 유발할 수 있다. 잘못 거치된 제대 정맥 카테터를 통하여 부주의하게 고장성 액체를 투여 시 액체 저류를 동반한 간실질 손상을 유발할 수 있으며, 영상검사에서 이러한 액체 저류는 종양성 병변으로 오인될 수 있다. 초음파와 엑스선 검사는 이러한 제대 정맥 카테터 관련 합병증을 감지하는 데 필수적인 역할을 한다. 이 논문에서는 신생아의 제대 정맥 카테터 관련 간 합병증의 영상 소견에 대해 기술할 것이다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권1호
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• pp.31-34
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• 2015

Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.

• Tuberculosis and Respiratory Diseases
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• 제63권5호
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• pp.449-453
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• 2007

항암제 치료 등을 위해서 피하매몰 중심정맥포트를 유치한 환자에서 도관 골절 및 원위부의 색전증은 드물게 발생하는 합병증으로 일반적인 경우는 경피적으로 도관의 제거가 가능하나, 임상의사들이 미리 이러한 합병증을 예측할 수 있는 임상적 및 방사선학적인 소견을 인지하고 조기에 발견하여 올바른 처치를 하는 것이 중요하며, 이러한 합병증을 예방하기 위한 방법 등에 대해서 숙지하는 것이 필요하다.

• 대한의생명과학회지
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• 제13권3호
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• pp.175-182
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• 2007

In vitro ciprofloxacin (CFX)-release study and bioassay using microorganisms were performed to estimate the retention of the antimicrobial activity of the CFX-incorporated central venous catheters (CFX-CVCs). The release experiments were carried out under the optional CFX-release conditions to mimic the in vivo environment. The release of CFX experienced an initial burst followed by a slow and steady matrix-diffusion controlled release. The 1.0CP (polyurethane catheter containing 1.0% (w/w) of CFX) under dynamic condition showed a near zero-order CFX release profile, which is beneficial for the long-tenn antimicrobial activity. The modified Kirby-Bauer method was performed employing S. aureus and E. coli to evaluate the retention of antimicrobial activity of the catheters retrieved from the release experiments. The 1.0CP showed the long-term antimicrobial activity (${\geq}\;21$ days) against both S. aureus and E. coli. These results indicate that 1.0CP is useful as a long-tenn indwelling CVC.

• 대한의생명과학회지
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• 제15권1호
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• pp.73-80
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• 2009

Bloodstream infections (BSI) are caused by planktonic microorganisms, sometimes leading to serious infections such as bacteremia and sepsis. BSI occurs more frequently to the patients wearing the central venous catheter (CVC). The ciprofloxacin-incorporated CVC (CFX-CVC) has been reported previously to possess antimicrobial activity. In this study, the antibacterial activity of CFX-CVC and its mechanism against planktonic BSI cells were explored by using the shake flask test and by examining the release rate of 260 nm-absorbing substances from the bacterial cells indicative of the membrane damage of the bacterial cells. CFX-CVC reduced more than 99.9% of the viable planktonic BSI cells demonstrating its potent antibacterial activity. It provoked bacteriolysis causing leakage of a large amount of 260 nm-absorbing materials from the planktonic bacterial cells like S. aureus and E. coli. These results provide evidence that the antibacterial activity of CFX-CVC came from the inhibition of the stability of the planktonic bacterial cells.