The Cannon Catheter—A Prospective Analysis

Caridi, James G.; Ross, Edward A.; Aspilcueta, Amanda; Wiley, Sean

doi:10.1016/j.jvir.2010.05.024

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…5,8,10,13 Reverse-tunnel dialysis catheters allow tip placement first before creating a tunnel. 14,15 This is the first known report of combining the two technologies to place a cuffed tunneled catheter at the bedside in morbidly obese patients. In Italy, there are several reports of using intracavitary ECG for positioning the tip of CVCs.…”

Section: Discussionmentioning

confidence: 99%

Use of an ECG-based confirmatory technique for bedside placement of reverse-tunneled cuffed dialysis catheters in three morbidly obese patients

Bream

2015

Kidney International

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We are currently in the midst of a worldwide obesity epidemic, including in patients with end-stage kidney disease. Placing hemodialysis catheters is a particular challenge in patients with extreme obesity. Here we describe the merging of two technologies to place catheters in patients who are too heavy (over 225 kg) to be placed safely on a procedure table for fluoroscopic guidance. The first technology is ECG-guided placement of catheters, well established for guidance of peripherally inserted central catheters (PICCs) and tunneled and nontunneled central venous catheters. The second is reverse-tunneling dialysis catheters, which allow precise placement of the tip of the catheter before creating the tunnel. We successfully placed catheters in three morbidly obese patients with acute kidney injury and followed them until their kidneys recovered and the catheters were removed. The catheters were placed in the patient's bed in a procedure room with subsequent confirmatory chest radiographs. Catheter performance based on blood flow rates was excellent and there were no complications. We suggest placement of ECG-guided tunneled hemodialysis catheters using a reversed-tunneling technique in those patients with extreme obesity who are too heavy to place on a fluoroscopy procedure table.

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Section: Discussionmentioning

confidence: 99%

Use of an ECG-based confirmatory technique for bedside placement of reverse-tunneled cuffed dialysis catheters in three morbidly obese patients

Bream

2015

Kidney International

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“…No one catheter has proven superior over its rivals, despite trials comparing various designs. [2][3][4][5][6][7] Patients who present with acute renal failure and then go on to chronic renal failure pose a particular problem in initiating access. These patients often receive a temporary catheter in the hope that their kidneys will recover.…”

Section: Types Of Cathetersmentioning

confidence: 99%

Update on Insertion and Complications of Central Venous Catheters for Hemodialysis

Bream

2016

Semin intervent Radiol

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Central venous catheters are a popular choice for the initiation of hemodialysis or for bridging between different types of access. Despite this, they have many drawbacks including a high morbidity from thrombosis and infection. Advances in technology have allowed placement of these lines relatively safely, and national guidelines have been established to help prevent complications. There is an established algorithm for location and technique for placement that minimizes harm to the patient; however, there are significant short- and long-term complications that proceduralists who place catheters should be able to recognize and manage. This review covers insertion and complications of central venous catheters for hemodialysis, and the social and economic impact of the use of catheters for initiating dialysis is reviewed.

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“…为 Diapact CR 套管路 [5] [6] ，给予低浓度、低流量、短时间氧疗，达到 70mmHg 即可，禁止使用高压氧 [6] 。本组 1 例 ARDS 行气管插管，呼吸机辅助通气。观察患者有无腹胀、黄疸的情况，避免使用对肝脏有损害的药物 [7][8][9] 。 2.3 对症护理患者均有不同程度的口腔溃疡给予口腔护理 2 次/d [8] ，并喷新净界或敷思密达以预防感染，促进口腔溃疡的愈合。9 例消化道出血患者，注意观察胃液及大便的颜色，出血停止后，选择无渣冷流质，记录每小时尿量，保持呼吸道通畅，及时清理呕吐物，必要时吸痰；鼓励患者深呼吸，积极进行肺功能锻炼。 2.4 连续性血浆滤过吸附治疗的护理一旦确诊家属同意后立即在局麻下行中心静脉置管。准备好 PAP、 CVVH 治疗所需的用物并预冲好透析器及管路，无肝素治疗前用肝素浸泡透析器。 2.4.1 治疗过程中密切观察意识、瞳孔、生命体征血压低于 90/60mmHg 全预冲上机开始选择血流速 50~80ml/min 后调至 180~200ml/min [10,11] ，治疗中密切观察血压变化，过敏和枸橼酸钠中毒引起的低血压都有头晕及心率增快，应加以区别，对因处理，可根据医嘱静脉注射地塞米松 5～10mg 或及时补充葡萄糖酸钙。观察并记录血滤机各种参数如 PA、PV、PEB 等，观察有无黄疸、出血、乏力及意识状态的改变。遵医嘱治疗前后抽取静脉血检测血常规、凝血功能、肝功能、PTA、TBIL、TBA、NH3、内毒素等水平 [12] ，治疗结束后测量白蛋白透析液总胆红素水平，并进行治疗前和治疗后对比分析。 2.4.2 血液净化机的操作和治疗参数的观察由专人操作 [13] ，熟悉机器的性能及操作程序，机器报警及时查找原因有效处理，保证机器处于正常运行状态。按医嘱设定各项治疗参数，严密观察，每 30min 记录，发现异常及时处理。低分子肝素钠抗凝治疗时监测 ACT(活化凝血时间), 枸橼酸钠抗凝治疗时监测游离 Ga + 浓度 [5] ，动脉 Ga + 游离在 1.0mmol/L 以上，静脉 Ga + 游离在 0.35~0.45mmol/L 之间，应及时调节低分子肝素钠或枸橼酸钠剂量，使机体凝血功能延长，避免血浆分离器凝血，影响治疗效果。治疗中要结合 TMP、PV、 PBE、PD2、判断血浆分离器、血滤器凝血情况。 2.4.3 置管的护理 [14]…”

Section: 附治疗操作方由软件设计而定unclassified

连续性血浆滤过吸附治疗重度百草枯中毒致多脏器功能衰竭患者的护理

et al. 2014

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Objective: To explore continuous plasma adsorption filtration in treatment with multiple organ failure in severe paraquat poisoning patients and its nursing care. Methods: 52 cases of severe paraquat poisoning were collected from December2009 to May 2009 in poisoning rescue center of affiliated hospital of logistics institute of armed police forces. They were treated with continuous plasma adsorption filtration. Summarize the experience of treatment and nursing. Results: Plasma adsorption treatment of 38 times tace, continuity of static-static hemofiltration treatment of 56 times, continuity of plasma filtration adsorption treatment 64 times, the rescue success rate of 57.96%. Conclusion: Continuity of plasma filtration adsorption treatment 64 times, can effectively improve the rescue success rate of patients with paraquat.

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The Cannon Catheter—A Prospective Analysis

Cited by 4 publications

References 5 publications

Use of an ECG-based confirmatory technique for bedside placement of reverse-tunneled cuffed dialysis catheters in three morbidly obese patients

Use of an ECG-based confirmatory technique for bedside placement of reverse-tunneled cuffed dialysis catheters in three morbidly obese patients

Update on Insertion and Complications of Central Venous Catheters for Hemodialysis

连续性血浆滤过吸附治疗重度百草枯中毒致多脏器功能衰竭患者的护理

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