A new site for venous access: superficial veins of portal collateral circulation

Turc, Jean; Gergelé, Laurent; Attof, R.; Mottard, Nicolas; Berend, M.; David, Jean-Stéphane

doi:10.1016/j.ajem.2010.10.027

Cited by 3 publications

(5 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subcutaneous abdominal access was reported in a cirrhotic patient with portal hypertension who required parenteral antibiotherapy. The line allowed for delivery of medications and no complications were observed [ 1 ]. Using a superficial abdomen wall veins for induction of anesthesia has been proposed as an option in children [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of a Superficial Abdominal Wall Vein in a Gravida Patient for Emergency Vascular Access

Naftalovich

Chaudhry

et al. 2023

Case Reports in Anesthesiology

View full text Add to dashboard Cite

Obtaining vascular access through a superficial vein of the abdominal wall of a gravida patient is an option in an emergency Cesarean surgery when other means fail. Such superficial veins may be mistaken for striae gravidarum on physical exam. A small intravenous (IV) cannula is not ideal but could save valuable time and avoid delaying induction of general anesthesia. Once the airway is secured, a larger bore IV can then be inserted while surgical exposure is undergoing. Analysis of the risks and benefits of inducing general anesthesia with a small gauge IV for a gravida patient should take into consideration risk factors for massive peripartum hemorrhage such as placental disorders (accreta, increta, precreta, abruption, or previa), presence of uterine fibroids, preeclampsia, hemolysis, elevated liver enzymes, low platelet count (HELP syndrome), severe polyhydramnios, history of grand multiparty, and bleeding disorders such as Von Willibrands and hemophilia.

show abstract

Section: Discussionmentioning

confidence: 99%

“…A superficial vein of the abdomen can, at times, be an option for venous access when conventional options fail [ 1 ]. Obtaining access in superficial veins of the abdomen can be considered even in patients undergoing Cesarean deliveries.…”

Section: Discussionmentioning

confidence: 99%

Use of a Superficial Abdominal Wall Vein in a Gravida Patient for Emergency Vascular Access

Naftalovich

Chaudhry

et al. 2023

Case Reports in Anesthesiology

View full text Add to dashboard Cite

show abstract

“…Although lower extremity veins are best avoided due to increased risks of phlebitis, line-related sepsis and lower extremity embolism from immobilization, [22] the saphenous veins are usually prominent and may prove useful if no other veins are suitable. One may even have to resort to unusual sites such as superficial veins of the shoulder, chest wall, thigh or even dilated subcutaneous abdominal wall collateral veins [23] in emergency.…”

Section: Vein Identificationmentioning

confidence: 99%

Management of difficult intravenous access: a qualitative review

Ng¹,

Mark²,

Lateef³

2022

World Journal of Emergency Medicine

View full text Add to dashboard Cite

Establishing peripheral intravenous access (PIV) is one of the most ubiquitous and crucial steps in managing critically ill patients. Yet only 74% of first attempts during emergency resuscitation in adults [1] are successful and this falls to an even-more-dismal 33% in difficult intravenous access (DIVA) patients. [2] A perennial challenge faced by clinicians, DIVA impacts patient outcomes adversely by causing downstream delays in both diagnoses (difficulty in obtaining blood specimens and administering intravenous contrast for advanced imaging) and therapy (provision of parenteral fluids, blood products or drug administration to facilitate procedures such as sedation or rapid-sequence intubation). [3] Failed cannulation attempts often cause patient and clinician alike considerable frustration and distress and may lead to complications like thrombophlebitis, infection and haematoma. [4] Moreover, time-to-cannulation averages 2.5-13.0 min for most patients but can take up to 30 min to hours in DIVA cases. [5] As DIVA patients tend to distract disproportionately more time and attention of the attending emergency physicians, this inevitably compromises the care of other patients.Although there is no consensus or universallyaccepted definition, DIVA is commonly defined as either two or more failed attempts by an experienced operator using traditional landmark-based methods BAcKGRound: A perennial challenge faced by clinicians and made even more relevant with the global obesity epidemic, difficult intravenous access (DIVA) adversely impacts patient outcomes by causing significant downstream delays with many aspects of diagnoses and therapy. As most published DIVA strategies are limited to various point-of-care ultrasound techniques while other "tricks-of-the-trade" and pearls for overcoming DIVA are mostly relegated to informal nonpublished material, this article seeks to provide a narrative qualitative review of the iterature on DIVA and consolidate these strategies into a practical algorithm. MEtHodS:We conducted a literature search on PubMed using the keywords "difficult intravenous access", "peripheral vascular access" and "peripheral venous access" and searched emergency medicine and anaesthesiology resources for relevant material. These strategies were then categorized and incorporated into a DIVA algorithm. RESuLtS:We propose a Vortex approach to DIVA that is modelled after the Difficult Airway Vortex concept: starting off with standard peripheral intravenous cannulation (PIVC) techniques, progressing sequentially on to ultrasound-guided cannulation and central venous cannulation and finally escalating to the most invasive intraosseous access should the patient be in extremis or should best efforts with the other lifelines fail. concLuSIon: DIVA is a perennial problem that healthcare providers across various disciplines will be increasingly challenged with. It is crucial to have a systematic stepwise approach such as the DIVA Vortex when managing such patients and have at hand a wide repertoire of techniques t...

show abstract

“…The direction of blood flow should be determined in the selected vessel on the surface of the abdomen to ensure resuscitation fluids and drugs are more rapidly delivered in parallel with the patient's venous return. 1 There have been no reports of i.v. cannulation in visible veins on the anterior abdominal wall.…”

mentioning

confidence: 99%

“…cannulation in visible veins on the anterior abdominal wall. Turc et al 1 describe an adult with decompensated chronic liver failure being resuscitated using an i.v. placed in the anterior abdominal wall vein that formed from portal hypertension-related collateral circulation.…”

mentioning

confidence: 99%

Abdominal surface i.v. access as a temporising measure in resuscitation

Ting

2016

Emerg Medicine Australasia

View full text Add to dashboard Cite

A new site for venous access: superficial veins of portal collateral circulation

Cited by 3 publications

References 3 publications

Use of a Superficial Abdominal Wall Vein in a Gravida Patient for Emergency Vascular Access

Use of a Superficial Abdominal Wall Vein in a Gravida Patient for Emergency Vascular Access

Management of difficult intravenous access: a qualitative review

Abdominal surface i.v. access as a temporising measure in resuscitation

Contact Info

Product

Resources

About