Object:to raise the success rate of saving the patients with acute toxication, acute or chronic renal failure, accompanied with heart failure,coma,severe hyperkalemia. Method:Quinton Hahurbar single needle with two c...Object:to raise the success rate of saving the patients with acute toxication, acute or chronic renal failure, accompanied with heart failure,coma,severe hyperkalemia. Method:Quinton Hahurbar single needle with two cavities vessel has been adopted, instead of the traditional hemodialysis and blood access technique, since 1990 in our hospital. Results:149 severe patients with acute toxication,ARF.CRF. hepatic coma, ect have been saved with percutaneous venous access of Quinton Maburbar vessel. Because the structure of femur triangle is simple, the punctrue is easy to perform, the success rate of the puncture is near 100%, there are few complications and the blood flowing capacity reaches 200～300mL/min. It can meet the needs of all kinds of blood cleaning treatment, and get good results after treatment. Conclution: This is one of the best blood accesses to treat severe patients who need hemodialysis.展开更多
Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings(emergency, intensive care, surgery) and for diff...Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings(emergency, intensive care, surgery) and for different purposes(fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device(CVAD)(mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters(PICCs) and centrally inserted central catheters(CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe-due to their placement into peripheral veins of the armand the advantage of a central location of catheter tip suitable for all osmolarity and p H solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as wellas the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs(i.e., low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD(CICCs or PICCs). Second, an inapp展开更多
文摘Object:to raise the success rate of saving the patients with acute toxication, acute or chronic renal failure, accompanied with heart failure,coma,severe hyperkalemia. Method:Quinton Hahurbar single needle with two cavities vessel has been adopted, instead of the traditional hemodialysis and blood access technique, since 1990 in our hospital. Results:149 severe patients with acute toxication,ARF.CRF. hepatic coma, ect have been saved with percutaneous venous access of Quinton Maburbar vessel. Because the structure of femur triangle is simple, the punctrue is easy to perform, the success rate of the puncture is near 100%, there are few complications and the blood flowing capacity reaches 200～300mL/min. It can meet the needs of all kinds of blood cleaning treatment, and get good results after treatment. Conclution: This is one of the best blood accesses to treat severe patients who need hemodialysis.
文摘Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings(emergency, intensive care, surgery) and for different purposes(fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device(CVAD)(mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters(PICCs) and centrally inserted central catheters(CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe-due to their placement into peripheral veins of the armand the advantage of a central location of catheter tip suitable for all osmolarity and p H solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as wellas the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs(i.e., low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD(CICCs or PICCs). Second, an inapp
