BACKGROUND Residing remotely from health care resources appears to impact quality of care delivery. It remains unclear if there are differences in vascular access based on distance of one's residence to dialysis centre at time of dialysis initiation, and whether region or duration of pre-dialysis care are important effect modifiers. METHODS We studied the association of distance from a patien...

For chronic central venous dialysis catheters, the standard method for maintaining catheter patency between treatments is to instill (lock) catheters with 5000 - 10 000 units of heparin in each lumen. Sodium citrate (citrate) is an anticoagulant with intrinsic antibacterial activity (at 20% concentration or higher). Citrate has only transient anticoagulant effects if accidentally infused to the...

A malpositioned central venous catheter can cause constant excessive pressure on one particular area of a central vein, thus leading to perforation and hydrothorax. The following is a case report of an iatrogenic hydrothorax caused by a malpositioned central venous catheter. The subtle sign of malposition is a slightly curled catheter tip.

OBJECTIVE Major thromboses can occur in the venous system in association with central venous catheters. This usually necessitates removal of the catheter. METHODS The effectiveness of low dose recombinant tissue type plasminogen activator (rt-PA) in combination with heparin was assessed in patients with central venous catheter associated thrombosis. RESULTS In five patients, all suffering f...

Patients with septic shock and respiratory failure often require hemodynamic monitoring in order to guide bedside management. This is particularly true of patients with dialysis-dependent chronic kidney disease, who may be less tolerant of large volume resuscitation than individuals with normal renal function. With the declining use of pulmonary artery catheters and the introduction of early go...

Physicians spend a considerable amount of time and effort inserting catheters and needles into patients. Central venous catheters are the mainstay of measuring hemodynamic variables that cannot be assessed by noninvasive procedures. These catheters also allow hemodialysis, parenteral nutritional support, delivery of medications, and catecholamine administration. Arterial pressure catheters are ...

BACKGROUND Home parenteral nutrition is established as standard management for patients with chronic severe intestinal failure. Although the treatment is welcomed by many patients, there are psychological consequences of living with a central venous catheter and there are associated restrictions to the lives of patients on home parenteral nutrition. A subgroup of home parenteral nutrition patie...

Central venous catheters (CVCs) in neonates are associated with a risk of central line-associated bloodstream infections (CLABSI). Most reports on the incidence of CLABSI in neonates focus on umbilical venous catheters (UVCs) and peripherally inserted central catheters (PICCs). We evaluated the incidence and risk factors for CLABSI in a cohort of neonates with femoral venous catheters (FVCs), U...