Placement of a central venous catheter in cases of persistent left superior vena cava.
This article presents a case report on the placement of a central venous catheter (CVC) in a patient with an unknown persistent left superior vena cava (PLSVC). Normally, PLSVCs remain asymptomatic but can be associated with disastrous consequences for the patient during placement of a CVC particularly due to vascular perforation and pulmonary injury. A PLSCV is particularly common in association with congenital heart defects; however, otherwise healthy patients can also be affected. As the presence of a PLSCV is normally unknown special attention must be paid in every patient during placement of a CVC. PMID: 24566941 [PubMed - as supplied by publisher]
OBTAINING vascular access is a vital component of patient care both in anesthesia and intensive care practice. Ultrasound-assisted vascular access can provide a safer and more efficient means of obtaining both peripheral and central venous access by reducing complications.1-3
How good is artificial intelligence in decision-making? Not bad according to findings from a pilot study that was recently presented at the American College of Surgeons Clinical Congress 2019. Findings from the study show AI in the form of a machine-learned algorithm correctly triaged the vast majority of postoperative patients to the intensive care unit in its first proof-of-concept application in a university hospital setting. As it stands now surgical teams typically rely on clinical judgment to decide which patients need postoperative intense care because there is no single set of fixed criteria to make the determinati...
PMID: 31637593 [PubMed - as supplied by publisher]
Conclusions: It is feasible to conduct an efficacy randomized control trial of the studied interventions. Further research is required to definitively identify clinical, cost-effective methods to prevent central venous access device failure by examining new dressing and securement technologies and techniques.
PMID: 31621689 [PubMed - in process]
Conclusions: The "proximal pen-holding method" for real-time USG-IJV cannulation helped in avoiding PVWP with lesser complication rate and greater performer's ease. PMID: 31621672 [PubMed - in process]
CONCLUSIONS: In the current database analysis, no significant association was found between the use of peripheral intravenous norepinephrine infusions and adverse events. PMID: 31569163 [PubMed - as supplied by publisher]
Conclusions: Extreme VAE during seated intracranial neurosurgical procedures is infrequent. Extreme VAE-associated CO2 exchange and hemodynamic consequences from VAE were transient, recovering quickly back to baseline without significant neurological or cardiopulmonary morbidity.
Conclusions. The elevated baseline CVP, elevated baseline RVEDV after anesthesia induction, and decreased SvO2 during anhepatic phase were associated with postoperative AKI. Prospective trials are required to evaluate whether the optimization of these variables may decrease the risk of AKI after LDLT.
Authors: Strandby RB, Ambrus R, Achiam MP, Henriksen A, Goetze JP, Secher NH, Svendsen LB Abstract Purpose: Changes in plasma pro-atrial natriuretic peptide (proANP) may indicate deviations in the central blood volume (CBV). We evaluated the plasma proANP response to hypotensive hypovolemia under the influence of thoracic epidural anesthesia (TEA) in pigs. We hypothesized that plasma proANP would decrease in response to hypotensive hypovolemia and that TEA would aggravate the proANP response, reflecting a further decrease in CBV. Design: Randomized, blinded, controlled trial. Setting: A university-affiliate...