Intravenous Indwelling Catheter Research Articles

Clinical nursing of intravenous indwelling catheter

Intravenous indwelling needle; Cardiovascular disease patients; Nursing

Venous injury caused by peripheral intravenous indwelling catheter and recovery

Objective To observe the correlation factors of venous injury caused by peripheral intravenous indwelling catheter, so as to guide the rational use of clinical intravenous indwelling catheter, so as to avoid venous injury and promote vascular recovery. Methods This study was carried out in five Class Ⅲ Grade A hospitals. In each hospital, we randomly selected one of the departments: Digestive Internal Medicine, Nephrology, Hepatobiliary Surgery, Extraglandular Surgery and Respiratory Medicine as the research departments. The inpatients admitted from March to June 2018 were selected and included in the study as a whole with the consent of the patients. In this study, 81 qualified patients were successfully injected with the peripheral intravenous indwelling catheter infusion and observed. According to the prescription of the doctors and hospital department policies, peripheral intravenous indwelling catheter was used for infusion. Specialists were arranged to record the patients' infused solution, evaluate the puncture site of the indwelling catheter before puncture and the results of venous blood vessel evaluation before puncture. Observe and record the reasons for the removal of indwelling catheter, the patency during the removal, the indwelling time, the marking of indwelling vein, evaluate and record the condition of the puncture site of indwelling catheter and the grade of phlebitis. The elasticity and filling degree of venous vessels were evaluated and recorded on the 14th day after catheter removal. Results (1) The severity of local phlebitis was positively correlated with the severity of vascular injury when removing intravenous indwelling catheter; the incidence of moderate and severe vascular injury was 9.09% when local symptoms were grade Ⅰ phlebitis; the incidence of moderate and severe vascular injury was 95.83% when local symptoms were grade Ⅱ and Ⅲ phlebitis when removing intravenous indwelling catheter; and there was statistical difference in the incidence of moderate and severe vascular injury between the two groups (P 0.05) . Conclusions Phlebitis after peripheral intravenous indwelling catheter infusion is the main cause of vascular injury and hinders venous recovery. Preventive measures should be taken in clinical puncture and use of venous indwelling needles; the removal of indwelling catheters should not be based only on indwelling time; the symptoms of puncture sites and patients' reactions should be evaluated in accordance with the regulations to avoid phlebitis above grade Ⅱ; in order to avoid vascular injury caused by infusion of peripheral intravenous indwelling catheters, asymptomatic removal of intravenous indwelling catheter is recommended. Key words: Phlebitis; Peripheral intravenous indwelling catheters; Blood vessel recovery; Vascular injury; Indwelling time; Indicators for removal of catheter

Design and application effect of intravenous indwelling catheter occlusion risk warning and pre-control scheme

Objective To study and design an early warning and pre-control scheme for the risk of intravenous catheter blockage and observe the application effect in the clinical practice. Methods This study was divided into three stages: the first stage established the risk early warning plan of intravenous indwelling catheter occlusion through literature review, expert consultation, analytic hierarchy process and retrospective research; the second stage summarized the best evidence of intravenous indwelling catheter occlusion intervention through literature retrieval and literature quality evaluation, and established the risk through expert consultation. In the third stage, by convenience sampling we selected the inpatients from some departments of a Class Ⅲ Grade A hospital in Jilin Province to carry out non-synchronous control experiment. A total of 236 inpatients who used intravenous indwelling catheter from May to June of 2018 were taken as the observation group, and 218 inpatients from May to June of 2017 were taken as the control group. The occurrence of intravenous indwelling catheter occlusion and indwelling time of intravenous indwelling catheter were compared between the two groups. Results A pre-warning evaluation scheme consisting of two first-level indicators, eight second-level indicators and 17 third-level indicators was formed, and three early-warning levels, low-risk, medium-risk and high-risk, were determined. A pre-control scheme was formed for different early-warning levels. The non-synchronous control experiment showed that the incidence of intravenous indwelling catheter occlusion in the observation group was higher than that in the control group, the difference between the two groups was statistically significant (P<0.05) ; the indwelling time of intravenous indwelling catheter in the observation group was longer than that in the control group, and the difference between the two groups was statistically significant (P<0.05) . Conclusions The use of risk early warning theory, the forming of a comprehensive risk factor assessment program, and the use of forward-looking nursing thinking in the implementation of targeted pre-control program, can help to improve nurses' ability to identify and control the risk of intravenous indwelling catheter occlusion, reduce the incidence of indwelling catheter occlusion, and effectively prolong the indwelling time. Key words: Intravenous indwelling catheter; Occlusion; Early warning; Pre-control

Application of Chinese medicine method of sealing intravenous indwelling catheter in the hepatocirrhosis patients

Objective To explore the effect of positive pressure sealing intravenous indwelling catheter in the hepatocirrhosis patients by the Salvia lyophilized dilution in the apparatus infusionis .Methods Two hundred and one hepatocirrhosis patients with intravenous indwelling catheter were chosen and divided into three groups according to the random number table , each with 67 cases.The control group received the traditional positive pressure sealing tube through heparin solution （5 ml, 50 U/ml）, and the test group 1 received the positive pressure sealing tube through Salvia lyophilized dilution （5 ml）, and the test group 2 received the direct positive pressure sealing tube through the Salvia lyophilized dilution （ 5 ml, 4 mg/ml ） in the apparatus infusionis.The coagulation function, the rate of jamming, bleeding tendency, incidence rate and the average time of sealing tube of phlebitis were compared among three groups before the indwelling catheter and after the extubation catheter .Results The rates of jamming were respectively 6.2%, 10.8% and 7.6% in the control group, the test group 1 and 2, and the incidence rates of bleeding tendency were respectively 12.3%, 6.2%, and 13.8%, the incidence rates of phlebitis were respectively 9.2%, 4.6% and 7.7%, and the differences were not statistically significant （χ2 =0.83, 0.40, 0.48, respectively;P〉0.05）.The prothrombin time were respectively （18.16 ±4.82）s, （17.64 ±3.96）s, （17.28 ±3.89）s in the control group, the test group 1 and 2, and the differences were not statistically significant （F=0.71,P〉0.05）.The average time of sealing tube was （49.26 ±4.78）s in the test group 1, and was （33.41 ±3.91）s in the test group 2, and the difference was statistically significant （t=40.66,P 〈0.01）.Conclusions Three kinds of methods of sealing intravenous indwelling catheter are safe and effective .The application of the direct positive pressure sealing tube through the Salvia lyophilized dilution in the apparatus infusionis can optimize nursing process , and relieve the economic burden of patients , their families and the society , and is worthy of the clinical promotion . Key words: Hepatocirrhosis; Chinese medicine method of sealing tube; Intravenous indwelling catheter

Foam sclerotherapy

SummaryMethods to improve the efficacy of foam sclerotherapy might include: more vigorous agitation methods to produce more stable foam with smaller bubble size, increasing the volume and/or concentration of the sclerosing agent, use of an intravenous catheter, and leg elevation to evacuate as much blood as possible. Methods to improve the safety of foam sclerotherapy might include: use of an intravenous indwelling catheter; saphenofemoral junction occlusion; low foam volume; use of low silicon syringes; use of non airbased foam; avoidance of high concentration sclerosing agents in patients with duplicated femoral vein segments; leg elevation before or after injection of foam; and maintaining patient immobility after injection.A series of studies and exercises are described which call into question many methods proposed to limit the dispersal of injected foam. The use of non air-based foam may reduce the incidence of side effects.

Vincristine, doxorubicin, and dexamethasone or thalidomide plus dexamethasone for newly diagnosed patients with multiple myeloma?

Multiple myeloma (MM) is a malignant plasma cell tumor that is distributed at multiple sites within the bone marrow compartments. High-dose dexamethasone regimens [including vincristine, doxorubicin, and dexamethasone (VAD) chemotherapy] induce rapid responses, and have resulted in improved survival for many patients when followed by intensive therapy with autologous stem cell support early in the disease course. However, VAD have several disadvantages including the need for an intravenous indwelling catheter, which predisposes patients to catheter-related sepsis and thrombosis; most of the activity of VAD was from high-dose dexamethasone component. We enrolled all patients who fulfilled entire criteria for MM during the period between January 1997 and December 2005. The present study is a descriptive, retrospective, longitudinal, and observational one. The frequency of response (CR, VGPR/NCR, and PR) in the group of thalidomide and dexamethasone was 84.3% (CR 18.75% VGPR/NCR 18.75%, and PR 46.8%) being higher than VAD, 55% (CR 16%, VGPR/NCR 5%, and PR 34%). P = 0.0005. In summary, we conclude Thal/dex is an effective therapy in newly diagnosed MM inducing objective responses in over 84.3%.

Urokinase‐immobilization suppresses inflammatory responses to polyurethane tubes implanted in rabbit muscles

Urokinase and plasmin appear to have antiinflammatory activity in some injury models, and urokinase immobilization has been clinically used to prevent thrombus formation in various implants, including intravenous indwelling catheters and subcutaneous drainage tubes. In the present study, polyurethane tubes were embedded in rabbit muscle for 3 months and the effect of urokinase immobilization on inflammatory responses to the implanted tubes was studied at 1 week, 1 month, and 3 months. Mononuclear leukocyte accumulation occurred around implanted polyurethane tubes and peaked after 1 month, but was reduced significantly by urokinase immobilization. The treatment also lessened as well as delayed eosinophil accumulation, but did not affect fibrosis caused by implanted tubes. These results indicate suppressive effects of urokinase immobilization on polyurethane-elicited inflammatory responses and suggest that an approach to develop persistently active urokinase immobilization is rational for successful long-term device implantation.

Role of TRH or metoclopramide loading test in the diagnosis of so-called occult or latent hyperprolactinemia

Present study was performed to investigate whether TRH or metoclopramide (MCP) loading test was useful for the diagnosis of so-called occulted or latent hyperprolactinemia (transient increase of serum prolactin levels more than 30 ng/ml during night; OHP). The circadian profiles of serum prolactin levels were examined in 31 women (age: 23-32 years old) whose BBT charts showed biphasic patterns. Blood samplings had been done every two hours through an intravenous indwelling catheter without any disturbances. And seven cases of the OHP were selected. Five cases of the control were also selected at random. Then, LH-RH (100 micrograms) and TRH (500 micrograms) loading test and LH-RH and MCP (10 mg) loading test were performed to these cases in the mid-luteal phase of the same menstrual cycle at interval of two or three days, and serum FSH, LH and prolactin levels (at 0, 30, 60, 90, 120 min. after the loading test) were determined by radioimmunoassay. Serum prolactin levels in the OHP group showed significant higher levels than those of the control from 22 to 6 o'clock (p less than 0.05-0.005). By the administration of 500 micrograms of TRH, serum prolactin levels of the OHP group increased significantly compared to those of the control at all sampling points (p less than 0.05-0.005), and also by the administration of 10 mg of MCP, the same result was obtained (p less than 0.05-0.02). The maximum peak of serum prolactin levels appeared at 30 min. after TRH or MCP loading.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of transient or occult hyperprolactinemia on luteal function

It is well known that the luteal function in the patients with hyperprolactinemia is much suppressed by high level of serum prolactin. Present study was performed to investigate whether the luteal function in the patients with transient or occulted hyperprolactinemia was affected by the transient increase of serum prolactin level. The circadian changes of serum FSH, LH, prolactin, estrone, estradiol and progesterone levels were examined in seven cases of the transient or occulted hyperprolactinemia whose BBT charts showed biphasic patterns. Serum prolactin levels of these patients were less than 25 ng/ml at daytime and more than 150 ng/ml at 30 minutes after the administration of 500 micrograms of TRH. Blood samplings were taken every two hours through an intravenous indwelling catheter without any disturbances. All of the patients had their breakfast at 7 to 8, lunch at 11 to 12 and dinner at 17 to 18 o'clock and slept from 22 until 6 in the next morning. Serum FSH, LH, prolactin, estrone, estradiol and progesterone levels were determined by RIA and the circadian changes of these hormones were analysed. Then, 5 mg of bromocriptine was administered every day to these patients for more than 30 days and the duration of the luteal phase and the mid-luteal serum estradiol and progesterone levels for the indicators of the luteal function were examined before and after the administration of bromocriptine. The circadian changes of serum prolactin levels in the patients showed significant increase during both daytime and night compared to those of the control (p less than 0.005, p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of bromocriptine on the pulsatile pattern and the circadian profile of gonadotropins and testosterone secretion in normal adult men

To investigate the effects of bromocriptine on the secretion mechanism of pituitary gonadotropins and testosterone, 5 mg of bromocriptine was administered to five young adult men who were normal in their endocrinological states. Blood samplings were taken from two hours before until six hours after the administration every 15 min., and after that, blood samplings were continued until 21 hours every one hour by an intravenous indwelling catheter. Serum FSH, LH, prolactin and testosterone levels were determined by RIA, and the changes of the pulsatile patterns of FSH and LH, and the circadian profile of these hormones by the administration of bromocriptine were analysed. Serum prolactin levels decreased significantly (p less than 0.005) from two hours after the administration of bromocriptine and remained in a very low range until the end of the experiment. The basal levels of FSH showed a significant decrease from two to six hours after the administration (p less than 0.005). Also the basal levels of LH showed a significant decrease from two to six hours after the administration (p less than 0.005). However, the basal levels of serum FSH and LH did not show significant decreases after that until the end of the experiment. No significant change was observed in the amplitude or the frequency of the pulsatile patterns of FSH and LH until six hours after the administration of bromocriptine. The serum levels of testosterone were also significantly decreased from two to six hours after the administration (p less than 0.005), but they did not show a significant decrease after that until the end of the experiment.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of dopamine agonist (bromocriptine) on the secretion of pituitary gonadotropins and ovarian sex steroids in normally cycling women

To investigate the effects of bromocriptine on the secretion mechanism of pituitary gonadotropins and ovarian sex steroids, 5 mg of bromocriptine was administered to four normally cycling women in the follicular, pre-ovulatory, mid-luteal or menstrual phase, respectively. Blood samplings were taken from two hours before until six hours after the administration every 15 min. by an intravenous indwelling catheter. Serum FSH, LH, prolactin, estradiol and progesterone were determined by RIA, and the changes of basal levels and the pulsatile patterns of these hormones were analysed in each of the four phases. Serum prolactin levels decreased significantly (p less than 0.005) from two hours after the administration of bromocriptine and remained in a very low range in all phases of the cycles until the end of the experiments. The basal levels of FSH showed a significant decrease in the pre-ovulatory and mid-luteal phases two to six hours after the administration (p less than 0.025 approximately p less than 0.005). Also the basal levels of LH showed a significant decrease in the follicular, pre-ovulatory and mid-luteal phases two to six hours after the administration (p less than 0.05 approximately p less than 0.005). However, no significant change was observed in the amplitude or the frequency of the pulsatile patterns of FSH and LH in all phases of the menstrual cycles. The serum levels of estradiol did not show marked changes by the administration of bromocriptine, but the serum levels of progesterone were significantly decreased in the mid-luteal phase two to six hours after the administration (p less than 0.005). These facts suggest that bromocriptine acts mainly on the pituitary rather than the hypothalamus to decrease the serum levels of gonadotropins, and also may have some role in the steroidogenesis of the ovary.

Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies

Intravascular embolization of polyethylene catheter fragments continues to occur, the majority from intravenous indwelling catheters. Sixty-nine nonsurgical retrievals of embolized fragments have been reported. The various recorded retrieval techniques are reviewed as well as their respective successes and limitations. Complications of snare techniques, unsuccessful retrieval attempts, and factors influencing the choice of local surgical removal versus snare techniques are discussed. The fate of patients from whom embolized catheter fragments were not removed is reviewed in depth. Our figures indicate a 71% incidence of death or serious complication, which is significantly higher than previously reported.