Assessment of subclinical venous catheter‐related diseases in horses and associated risk factors

Geraghty, Timothy; Love, S.; Taylor, David J.; Heller, Jane; Mellor, D. J.; Hughes, Kristopher

doi:10.1136/vr.164.8.227

Cited by 43 publications

(42 citation statements)

References 8 publications

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“…Ainda, o músculo cutâneo do pescoço recobre o sulco em seu terço distal, sendo mais uma estrutura incluída no trajeto do cateter. Após transpor essas camadas, finalmente o cateter perfura a parede da veia jugular ganhando seu lúmen (Ashdown et al 2011 Geraghty et al (2009b), se um cateter encontrar-se na veia quando a trombose for diagnosticada, este deve ser removido, pois com a permanência do cateter o trombo não regredirá e poderá aumentar. Entretanto, para este caso, o cateter não foi removido em T48 por não haver um segmento íntegro para que um novo cateter pudesse ser implantado, mesmo na veia contralateral.…”

Section: Resultsunclassified

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal

et al. 2018

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RESUMO.-Afecções do trato gastrointestinal de equinos podem causar distúrbios de coagulação devido à concentração elevada de mediadores inflamatórios que estimulam a hemostasia e inibem a fibrinólise, gerando um estado de hipercoagulação. Equinos submetidos à laparotomia no tratamento da síndrome cólica permanecem com cateter venoso durante vários dias para a administração de fluidos e fármacos no período pós-operatório e, a veia jugular é o principal local para a implantação de cateteres. Assim, o trauma vascular persistente causado pelo cateter, associado ao ambiente pró-trombótico induzido pela afecção gastrointestinal, aumenta o risco para o desenvolvimento de tromboflebite jugular. Objetivou-se avaliar as características físicas e ultrassonográficas da veia jugular canulada com cateter de poliuretano durante o período pós-operatório de equinos submetidos à laparotomia. O cateter foi inserido de forma asséptica à admissão e permaneceu por sete dias. A avaliação ultrassonográfica revelou o desenvolvimento de tromboflebite em um equino, 48 após o procedimento cirúrgico. Os demais equinos demonstraram espessamento da parede vascular no local de punção e pequenos trombos junto ao cateter. A monitoração ultrassonográfica demonstrou que a cateterização prolongada em equinos submetidos à Coagulation abnormalities are usually associated with equine gastrointestinal disease due to the increased levels of inflammatory mediators, which promotes hemostasis and inhibit fibrinolysis, creating a hypercoagulable state. Horses underwent laparotomy to treat colic usually require a venous catheter for several days to administrate fluids and drugs during the postoperative period, and the jugular vein is the most frequent site for catheterization. Therefore, the persistent vascular trauma caused by an implanted catheter, associated with the prothrombotic environment induced by the gastrointestinal disorder, increases the risk for the development of jugular thrombophlebitis. The purpose of the present investigation was to evaluate physical and ultrassonographic features of the jugular vein cannulated with a polyurethane catheter during the postoperative period of horses underwent colic surgery. The catheter was inserted aseptically on admission and dwell time was seven days. Upon ultrasound examination, one horse developed thrombophlebitis 48 hours after surgery and the other horses showed thickened venous wall at puncture site and small clots associated to the catheter. Ultrasound monitoration showed that long-term catheterization in horses underwent colic surgery following the present protocol minimizes vascular trauma and could prevent jugular thrombophlebitis.

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Section: Resultsunclassified

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal

et al. 2018

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“…Venous wall thickening was the most common lesion (in 27% of cases) observed in a ultrasonographic study evaluating risk factors for thrombophlebitis in horses hospitalized for a variety of conditions [27]. Thickening could be easily differentiated from thrombosis by an ultrasound examination, as described by Geraghty et al [27].…”

Section: Timementioning

confidence: 96%

“…Thickening could be easily differentiated from thrombosis by an ultrasound examination, as described by Geraghty et al [27]. Moreover, thickening usually resolves as soon as the catheter is removed.…”

Section: Timementioning

confidence: 97%

“…The pathological processes that lead to venous wall thickening are uncertain but may include inflammation, edema, and/or hemorrhage during the introduction of catheters [27]. Thrombosis does not resolve itself while catheters remain in the vein, suggesting that it is continuously stimulated by the activation of endothelial cells, platelets, intrinsic and extrinsic clotting cascades, and impaired fibrinolysis [27]. In this study, there were no differences in venous wall thickening between the two groups, whereas it was significantly different between the T2 and T3 recordings.…”

Section: Timementioning

confidence: 99%

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Using Cyanoacrylate Microbial Sealant for Skin Preparation Prior to the Placement of Intravenous Catheters in Horses

Pasolini

Passamonti

Uccello³

et al. 2015

Journal of Equine Veterinary Science

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“…Sie ermöglichen eine zuverläs-sige Applikation von Medikamenten und Infusionen, zum Beispiel auch im Rahmen einer Allgemeinanästhesie sowie regelmäßige Blutentnahmen (Hopster et al 2011). Als Komplikationen im Zusammenhang mit einem dauerhaften Venenkatheter werden häufig Thrombophlebitiden beschrieben (Geraghty et al 2009, Hopster et al 2011. Weniger oft thematisiert ist jedoch die Gefahr der Luftembolie.…”

Section: Introductionunclassified

Clinical presentation and short-term outcome in two horses with suspected air embolism

Gittel¹,

Delling²,

Brehm³

et al. 2016

PHK

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Complications associated with intravenous catheters have been reported frequently and are not only limited to thrombophlebitis of the respective vessel. There are some reports of air embolism in small and large animals described in the literature. The source of air aspiration can be traumatic, iatrogenic during surgeries and also related to venous catheters. Not only the reason for air aspiration, but also the consequences differ between human, small animals and horses. This present article describes the clinical signs, treatment and short-term outcome of two horses with suspected venous air embolism but with different underlying diseases. Both horses exhibited a sudden onset of cardiovascular shock and periods of neurological disorder during their hospitalization. One horse also showed colic symptoms. In both horses an inadvertently opened venous catheter was found at the onset of unexpected symptoms. Therefore, air embolism due to air aspiration by the open venous access might be possible. In air embolism, a decreased perfusion and reduced oxygen delivery are potential sequelae. An impairment of the cardiovascular system with subsequent cerebellar hypoperfusion and embolism might be an explanation for the observed clinical signs. These were tachycardia, delayed capillary refill time and excitement. Furthermore, ataxia, seizures and blindness was observed. Intensity and duration of clinical signs differed between both horses. Following supportive treatment, both horses were discharged from hospital in a good condition. The exact amount of air leading to clinical signs is not exactly known despite different studies aiming at finding a lethal dose. However, rate and amount of air aspiration, as well as body weight and health status of the patient may also have an effect on occurrence of overt clinical signs of venous air embolism. Due to the lack of specific treatment options, symptomatic therapy has been performed. This includes intravenous fluid administration for cardiovascular stabilization and anti-inflammatory treatment. Additionally, nasal oxygen insufflations may increase tissue oxygenation. Furthermore, neuroprotectiv treatment, like dexamethason, might also be advantageous regarding the pathophysiology of venous and cerebellar air embolism. Antithrombotic treatment can be initiated in order to avoid formation of thrombus following capillary perfusion disturbances in the circulation. Diagnostic proof is lacking in both cases, however, presence of an open venous catheter and the observed clinical signs lead to the suspected diagnosis of venous air embolism. Venous air embolism seems to have a low incidence in equine medicine, and the exact dimension of clinical signs may not always be obvious. Close attention should be paid at infusion lines, air within syringes, disconnection of catheters and their extensions and catheter caps. Problems may occur due to manipulations by the horse itself or due to improper handling by the attending veterinarian. Several medical devices aim at reducing the risk of air aspi...

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Assessment of subclinical venous catheter‐related diseases in horses and associated risk factors

Cited by 43 publications

References 8 publications

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal

Using Cyanoacrylate Microbial Sealant for Skin Preparation Prior to the Placement of Intravenous Catheters in Horses

Clinical presentation and short-term outcome in two horses with suspected air embolism

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