Do not trust landmarks and your feelings while inserting pediatric central venous catheters

The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism

The use of central venous catheters (CVCs) in children is escalating, which is likely linked to the increased incidence of pediatric venous thromboembolism (VTE). In order to better understand the specific risk factors associated with CVC-VTE in children, as well as available prevention methods, a literature review was performed. The overall incidence of CVC-VTE was found to range from 0 to 74%...

Central venous catheters.

Central venous catheterisation was first performed in 1929when Werner Frossman, a German doctor, inserted a ureteric catheter into his antecubital vein. He then walked to the radiography department so that the catheter could be guided into his right ventricle using fluoroscopy. Since then, central venous access has become amainstay of modern clinical practice. An estimated 200 000 central venou...

Removal of central venous catheters.

incidences in the landmark group of carotid artery puncture (10.6%), hemothorax (1.7%), and pneumothorax (2.4%) greater than most anesthesiologists would accept. Thus it is not surprising that meta-analysis of these disparate studies (which have not been scored by traditional methods to assess for bias and scientific rigor) would find statistical significance only in success of line insertion. ...

Pulmonary artery catheters and central venous catheters did not differ for mortality in acute lung injury.

M e t h o d s Design: Randomized controlled 2×2 factorial design trial (Fluid and Catheter Treatment Trial [FACTT]). Allocation: Concealed.* Blinding: Unblinded.* Follow-up period: 60 days. Setting: 36 centers in the United States and 2 in Canada. Patients: 1001 patients ≥ 13 years of age (mean age 50 y, 53% men) who had acute lung injury for ≤ 48 hours; were receiving positive-pressure ventila...

When to Trust Your Feelings in Judgments and Decisions