Abstract:
BACKGROUND:Silicone venous access devices (VADs) are commonly used for multiple intravenous infusions and blood sampling in chronically ill patients, particularly cancer patients. These devices are susceptible to malfunctions most commonly characterized by difficulty infusing fluids or withdrawing blood. We hypothesized that the incidence of such malfunctions is primarily related to the position of the catheter tip relative to the superior vena cava/right atrial junction. METHODS:We reviewed medical records for 141 patients in whom silicone venous access devices were used. Chest radiographs obtained following catheter insertion were reviewed by a single radiologist to rule out pneumothorax and determine the position of the catheter tip. Other potential factors included in the analysis were catheter brand, the vein into which the catheter was inserted, and the side (right or left). A malfunction was defined as resistance to flushing or infusion of a substance, complete inability to infuse a substance, resistance to blood aspiration attempts, or absence of blood return with aspiration, occurring any time during which the catheter was in place. Multiple logistic regression was used to determine which factor(s) most strongly predicted catheter malfunction. RESULTS:Catheter tip location was the only factor that was statistically predictive of malfunctions (coefficient 0.842, P < 0.001). A significant increase in malfunctions was observed in cases where the catheter tip was located greater than 4 cm superior to the junction of the right atrium and the superior vena cava (z-test of proportions, P = 0.003). Malfunctions were minimized in those cases where the catheter tip was located in the right atrium. CONCLUSIONS:These results indicate that malfunctions can be minimized in silicone venous access catheters by locating the catheter tip as close to the superior vena cava/right atrial junction as possible, or slightly inside the right atrium. To ensure proper location of the catheter tip, placement should be performed under fluoroscopy, and a radiograph should be obtained immediately following placement, with the patient in the upright position.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Petersen J,Delaney JH,Brakstad MT,Rowbotham RK,Bagley CM Jrdoi
10.1016/s0002-9610(99)00124-5subject
Has Abstractpub_date
1999-07-01 00:00:00pages
38-41issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(99)00124-5journal_volume
178pub_type
杂志文章abstract::Despite the advantages of aseptic nonoperative intubation of the small intestine for decompression of obstructed loops, 48% of the attempts lead to failure to pass the tube through the pylorus. The difficulty and inconvenience of passage beyond the stomach have been overcome by the development of a special tube attach...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90427-x
更新日期:1976-01-01 00:00:00
abstract::Adult male rats underwent common bile duct ligation or sham celiotomy. At intervals of 7 and 14 days postoperatively, bacteremia was induced by intravenous injection of 10(9) Escherichia coli or intraperitoneal injection of 10(6) E. coli. Serial quantitative blood cultures and quantitative whole organ cultures were ob...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90530-8
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS:This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.007
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The radial forearm free flap has become a workhorse flap in head and neck reconstruction. Its lack of bulk, ease of dissection, vascularity, and malleability are among its many advantages. PATIENTS AND METHODS:A review of 157 radial forearm free flaps performed in 155 patients between March 1988 and June 19...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80096-0
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the relationship between perforated appendicitis and patient with diabetes using a population-based data set. METHODS:This study used data from the Longitudinal Health Insurance Database 2005 in Taiwan. We identified 4,806 patients hospitalized with acute appendi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.08.041
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. METHODS:Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 201...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.04.011
更新日期:2017-11-01 00:00:00
abstract::The social, economic and political challenges accompanying our rapidly transforming global health environments have created unique social challenges that demand cross-sector solutions. Four cross-sector partnerships are reviewed with a special focus on sector roles, change management, phases of partnership development...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01143-1
更新日期:2003-01-01 00:00:00
abstract::Despite undergoing a curative resection, many patients with colorectal cancer will develop and die of metastatic disease. It has been shown clinically and experimentally that surgery causes a transient period of immunosuppression, and it is postulated that this may encourage both the implantation of surgically dissemi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90070-1
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Geriatric patients, age ≥65, frequently require no operation and only short observation after injury; yet many are prescribed opioids. We reviewed geriatric opioid prescriptions following a statewide outpatient prescribing limit. METHODS:Discharge and 30-day pain prescriptions were collected for geriatric p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.10.041
更新日期:2020-03-01 00:00:00
abstract::The relationship between platelet count and aggregability was serially evaluated after splenectomy in patients with normosplenism and hypersplenism, and the results were compared with those found in patients undergoing only upper abdominal surgery. The preoperative count and aggregability of platelets were significant...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90242-8
更新日期:1978-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the involvement of inflammatory mediators in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia repair (BH). METHODS:Thirty patients male with unilateral inguinal hernia without com...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-9610(00)00445-1
更新日期:2000-09-01 00:00:00
abstract::The diagnosis of ventilator-associated pneumonia in the surgical intensive care unit continues to be problematic. The majority of intensive care units use clinical criteria based on chest x-ray; fever; leukocytosis; alterations in the pulse oximeter observations; the need to alter modes and amounts of ventilatory supp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Mobile atheromas of the aortic arch are associated with otherwise unexplained strokes and transient ischemic attacks (TIA). They are associated with increased perioperative strokes in patients undergoing coronary artery bypass surgery. Peripheral embolization is an additional risk. Transesophageal echocardio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00115-4
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Administrative data can be used to identify cases of postoperative respiratory failure (PRF). We aimed to determine if recent changes to the Agency for Healthcare Research and Quality Patient Safety Indicator 11 (PSI 11) and adoption of clinical documentation improvement programs have improved the validity o...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2019.11.019
更新日期:2020-07-01 00:00:00
abstract:PURPOSE:The Integrated Procedural Performance Instrument (IPPI) consists of clinical scenarios in which bench-top models are positioned to simulated patients. Trainees are required to perform technical skills while engaging with the patient. The purpose of this study was to determine whether an IPPI format examination ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.08.011
更新日期:2009-01-01 00:00:00
abstract::Three patients who underwent 95 percent removal of the pancreas for chronic pancreatitis with autotransplantation of the body and tail of the gland to the femoral area are described. The follow-up periods are 18, 6, and 2 months. Pain lessened in all patients and none required exogenous insulin. Patency of the graft w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90036-3
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:Estrogen-receptor (ER)-, progesterone-receptor (PR)-, and androgen-receptor (AR)-negative breast cancer cells are unaffected by treatment with dehydroepiandrosterone-sulfate (DHEAS) and an aromatase inhibitor (AI). We hypothesized that cell growth would be inhibited with DHEAS/AI treatment after successful t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.02.004
更新日期:2006-05-01 00:00:00
abstract::The success of gastric restriction procedures for morbid obesity depends on a persistently small gastric pouch and stoma, an intact staple line, and, of equal importance, dietary compliance. Evaluation of patients with either excessive or inadequate weight loss should be directed at determining both the technical adeq...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90200-3
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:This study was designed to establish whether the spatial structure of a prosthesis conditions its behavior at the peritoneal level. METHODS:Abdominal defects comprising all the wall (except skin) were created in rabbits and repaired with a laminar (DM) or reticular (CV-4) ePTFE-prosthesis. Fourteen days pos...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00907-8
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:We previously reported that a particular type of visual-spatial ability, mental rotation of visual forms, correlates with surgical performance in residents. In the current study, we used functional magnetic resonance imaging (fMRI) to identify patterns of cortical activation associated with mental rotation a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.11.011
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Surgical length of stay (LOS) has been correlated with quality of care, with shorter stays implying better care. The relationship between LOS and postdischarge complications (PDCs) has not been evaluated effectively. METHODS:The 2005 to 2007 National Surgical Quality Improvement Program data were queried fo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.04.006
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:We describe the presentation, diagnostic pathway, and management of 28 patients with benign retroperitoneal schwannomas. METHODS:A prospectively kept soft-tissue tumor database was reviewed to identify patients who presented to the Royal Marsden Hospital with retroperitoneal schwannomas. RESULTS:From 2001 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.06.036
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The purpose of this paper is to review the experience of a community surgeon performing laparoscopic antireflux procedures (LAP). The experience has been difficult and at times unsettling, and underscores the need for advanced laparoscopic expertise not normally obtained performing laparoscopic cholecystecto...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(97)89608-0
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:The optimal surgery for patients with renal hyperparathyroidism has been controversial, as either subtotal parathyroidectomy (subtotal PTX) or total parathyroidectomy with auto-transplantation (total PTX-AT) may be employed. METHODS:Adult patients having subtotal PTX or total PTX-AT for secondary hyperparat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.07.018
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomography (HRCT) to determine resectability in this set...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.10.024
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Although increasingly administered to patients with pancreatic ductal adenocarcinoma, the role of preoperative therapy for patients with distal cholangiocarcinoma is undefined. METHODS:All patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy between 1999 and 2014 were retrospectively ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.024
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Efforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes. METHODS:A surgical qu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.11.014
更新日期:2020-11-09 00:00:00
abstract:BACKGROUND:Video broadcasting of surgical procedures is an important tool for education, training, and consultation. Current video conferencing systems are expensive and time-consuming and require preplanning. Real-time Internet video is known for its poor quality and relies on the equipment and the speed of the connec...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00203-2
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Splenectomy is generally a second-line therapy in patients with immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AHA) refractory to medical therapy. Our objective was to evaluate outcomes after splenectomy for these disorders. METHODS:A retrospective review of the medical records of pa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.05.030
更新日期:2012-12-01 00:00:00
abstract::Recently, the role and timing of surgery for treating secondary and tertiary hyperparathyroidism (HPT) have been questioned. In order to delineate the indications for surgery in these patients, a retrospective analysis of 53 consecutive patients treated with parathyroidectomy was conducted. Subtotal thyroidectomy was ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80537-9
更新日期:1990-10-01 00:00:00