Abstract:
:INTRODUCTION Central venous catheterisation (CVC) is a commonly performed procedure in a wide variety of hospital settings and is associated with appreciable morbidity. There is a paucity of literature focusing on mechanical complications specifically in the trauma setting. The aim of our study was to determine the spectrum of mechanical complications in a high-volume trauma centre in a developing world setting where ultrasound guidance was not available. METHODS A retrospective study was performed analysing data from a four-year period at the Pietermaritzburg Metropolitan Trauma Service in South Africa. RESULTS A total of 178 mechanical complications (18%) occurred in 1,015 patients undergoing CVC: 117 pneumothoraces, 25 malpositions, 18 catheter dislodgements, 14 arterial cannulations, one air embolism, one chylothorax, one pleural cannulation and one retained guide-wire. The internal jugular vein (IJV) approach was associated with a higher overall complication rate than the subclavian vein (SCV) approach (24% vs. 13%, p<0.001). Pneumothorax (73% vs. 57%, p<0.001) and arterial cannulation (15% vs. 0%, p<0.001) were more common with the IJV. Catheter dislodgement (21% vs. 0%, p<0.001) was more common with the SCV. Junior doctors performed 66% of the CVCs and this was associated with a significantly higher complication rate (20% vs. 12%, p<0.001). CONCLUSIONS CVC carries appreciable morbidity, with pneumothorax being the most frequent mechanical complication. The SCV was the most commonly used approach at our institution. The majority of CVCs were performed by junior doctors and this was associated with a considerable complication rate.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Odendaal J,Kong VY,Sartorius B,Liu TY,Liu YY,Clarke DLdoi
10.1308/rcsann.2017.0022subject
Has Abstractpub_date
2017-05-01 00:00:00pages
390-393issue
5eissn
0035-8843issn
1478-7083journal_volume
99pub_type
杂志文章abstract::This report is based on a Hygienist Panel Meeting held at St Anne's Manor, Wokingham on 24-25 June 2009. The panel agreed that greater use should be made of antiseptics to reduce reliance on antibiotics with their associated risk of antibiotic resistance. When choosing an antiseptic for clinical use, the Biocompatibil...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 共识发展会议,杂志文章
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更新日期:2010-09-01 00:00:00
abstract::The increased use of day facilities for children undergoing surgery and the provision of a paediatric home nursing team has resulted in a change in overall care of surgical children in hospital in Southampton. The ratio of day patients to inpatients has fallen from 1 : 2 in 1970 to 1 : 1 in 1976 and the early discharg...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract::A mathematical model for study of blood flow has been derived from the avian egg, utilizing the theories of crystallography and photosynthesis. The model is employed to explain the form of the eye and the function of the cells of the human retina, with special reference to colour vision and the pathology of migraine. ...
journal_title:Annals of the Royal College of Surgeons of England
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更新日期:1973-05-01 00:00:00
abstract::A simple, inexpensive method for one-way collection and measurement of secretions is described. This method has been used successfully in surgical practice in Bath for more than 20 years (1). ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:INTRODUCTION:Most women who have screening mammography and undergo subsequent open biopsy following an indeterminate core biopsy result are eventually found to have benign disease. However, a significant number have malignant disease and the rate of malignancy in such cases may be influenced by various factors. This s...
journal_title:Annals of the Royal College of Surgeons of England
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更新日期:2012-03-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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journal_title:Annals of the Royal College of Surgeons of England
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journal_title:Annals of the Royal College of Surgeons of England
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journal_title:Annals of the Royal College of Surgeons of England
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-11-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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更新日期:2016-11-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588413X13629960045715
更新日期:2013-07-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588410X12699663903430
更新日期:2010-09-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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更新日期:2017-02-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
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更新日期:2014-01-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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journal_title:Annals of the Royal College of Surgeons of England
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更新日期:2013-01-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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更新日期:1999-07-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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journal_title:Annals of the Royal College of Surgeons of England
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1977-05-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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更新日期:2015-07-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1993-03-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
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更新日期:2004-05-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
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更新日期:2009-07-01 00:00:00