Objective: To study incidence and management of long term central venous catheter (CVC) placement related pneumothorax (PNX) in children. Aim: To construct a baseline value before the introduction of systematic use of...Objective: To study incidence and management of long term central venous catheter (CVC) placement related pneumothorax (PNX) in children. Aim: To construct a baseline value before the introduction of systematic use of ultrasound guidance, which requires specific training and equipment. Background: Anesthesia Service and Pediatric Oncology of the Italian National Cancer Center;patients were children (age ≤ 18 years) with solid tumors, needing long-term central venous catheters (Groshong or Port-a-Cath). Materials/Methods: Catheter placement was performed, mostly under general anesthesia, utilizing a micropuncture 5-7 Fr needle and fluoroscopy. In the study period ultrasound was used only in case of previously failed attempts. Relevant data were collected retrospectively. Results: From August 2008 to December 2011, 452 catheters were implanted to our patients. The prevalent approach was from subclavian vein (left 85.7%, right 9.7%);in few cases internal jugular vein was chosen (right 2.4%, left 2.2%). Pneumothorax occurred in 14 patients (3.1%;95%CI 1.9-5.1). In 4/14 children the PNX was considered minimal and not treated. In 10 patients the PNX was drained. In 7 cases a traditional, surgical thoracostomy was performed, while in 3 children a 14-Ga polyurethane catheter (Arrow International®) was inserted over a wire guide in the pleural space by anaesthetists. Conclusions: In our centre rates of PNX are the same as those described in literature and are expected to lower when ultrasound guidance of the puncture will be routinely applied. Percutaneous drainage of PNX seems as effective as surgically placed thoracostomy catheter, but less invasive.展开更多
BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration o...BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe condition.CASE SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer.A computed tomography showed the fractured catheter of the IVAP in the pulmonary artery.Therefore,we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck trap.CONCLUSION When the fractured catheter of an IVAP was detected,the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.展开更多
BACKGROUND Implanted intravenous infusion port(TIAP)is mainly used for patients who need central venous infusion and poor peripheral vascular conditions.With the advantages of easy to carry,long maintenance cycle,few ...BACKGROUND Implanted intravenous infusion port(TIAP)is mainly used for patients who need central venous infusion and poor peripheral vascular conditions.With the advantages of easy to carry,long maintenance cycle,few complications and excellent quality of life,it has been widely used in the fields of malignant tumor chemotherapy,parenteral nutrition support and repeated blood collection.Implanted intravenous infusion port(IVAP)dislocation can have significant complications if not recognised and reinstated immediately.CASE SUMMARY A 24-year-old man was treated with adjuvant chemotherapy for osteosarcoma.Severe displacement of IVAP catheter was found by chest X-ray examination.The IVAP cannot be used normally.Therefore,we conducted an emergency procedure to reset the catheter through double pigtail catheters,the operation was successful and the infusion port was restored.CONCLUSION When IVAP catheter displacement cannot be reset by conventional techniques,two pigtail catheters can be successfully used instead.展开更多
Background: The port catheters are used to give long-term total parenteral nutrition, intravenous fluids, blood and blood products, or to be preferred for oncology and hematological diseases. In this study, we sought ...Background: The port catheters are used to give long-term total parenteral nutrition, intravenous fluids, blood and blood products, or to be preferred for oncology and hematological diseases. In this study, we sought to review our results concerning the subcutaneous port catheter appliance in childhood malignancies. Methods: Two hundred ten subcutaneous port catheters applied to 192 patients between November 2010 and October 2015 were examined retrospectively in a cross- sectional study. Information such as demographic data, primary diagnoses, port types and implantation durations were recorded. Localization of the intervention, surgical technique, early and late complications and causes of port removal were evaluated. Results: Mean age of patients was 6.4 ± 4.9 years (1 month - 17 years), 77 (40.1%) were female and 115 (59.9%) male. One hundred twenty nine ports were inserted from the right internal jugular vein, 59 to right subclavian vein, 14 to left subclavian vein and 8 to left internal jugular vein. Total duration of implantation was 55,492 days and median duration was 289 days. Early complications were: 1 (0.5%) hemothorax, 1 (0.5%) pneumothorax, 1 (0.5%) carotid artery injury, 1 (0.5%) arrhythmia and in 2 (1%) cases port mal-positioning. Late complications were: 9 (4.3%) infection and 8 (3.8%) mechanical problems, 7 (3.3%) thrombosis, and in 1 (0.5%) port fracture was detected. Port catheter was removed in 18 (8.6%) cases. No significant difference was found when jugular and subclavian vein implantation was compared in terms of all complications, especially infection and thrombosis. Conclusion: Use of port catheter is a safe option in children who are receiving a long-term chemotherapy. Education of the medical team will diminish the complication rate in port catheter insertions.展开更多
We report a successful endovascular technique using a snare with a suture for retrieving a migrated broken peripherally inserted central catheter(PICC)in a chemotherapy patient.A 62-year-old male received monthly chem...We report a successful endovascular technique using a snare with a suture for retrieving a migrated broken peripherally inserted central catheter(PICC)in a chemotherapy patient.A 62-year-old male received monthly chemotherapy through a central venous port implanted into his right subclavian area.The patient completed chemotherapy without complications 1 mo ago;however,he experienced pain in the right subclavian area during his last chemotherapy session.Computed tomography on that day showed migration of a broken PICC in his left pulmonary artery,for which the patient was admitted to our hospital.We attempted to retrieve the ectopic PICC through the right jugular vein using a gooseneck snare,but were unsuccessful because the catheter was lodged in the pulmonary artery wall.Therefore,a second attempt was made through the right femoral vein using a snare with triple loops,but we could not grasp the migrated PICC.Finally,a string was tied to thetop of the snare,allowing us to curve the snare toward the pulmonary artery by pulling the string.Finally,the catheter body was grasped and retrieved.The endovascular suture technique is occasionally extremely useful and should be considered by interventional cardiologists for retrieving migrated catheters.展开更多
OBJECTIVE: To calculate and compare the cost of Port and PICC's application in long-term intravenous administration, and to support the decision making of hospital manager. METHODS: Literature review and patient s...OBJECTIVE: To calculate and compare the cost of Port and PICC's application in long-term intravenous administration, and to support the decision making of hospital manager. METHODS: Literature review and patient survey in 2 oncology centers in China were carried out to investigate the cost and impact of Port and PICC for patients. The cost at different time of intravenous administration was calculated and compared. One-way sensitivity analysis was performed and tornado graph was drawn. RESULTS: Direct cost of Port at 0.5, 1, 1.5, and 2 years were7442, 8005, 8553, and 9131 CNY, and 4700, 9399, 14032, 18799 CNY for PICC respectively. Direct & indirect cost at 0.5, 1, 1.5, and 2 years were 9291, 11704, 14101, 16529 CNY for Port and 9697, 19393, 29023, 38787 CNY for PICC. Sensitivity analysis showed that productivity loss and device maintenance cost were the most in?uential factors to the result. CONCLUSION: Port had higher cost in short term and less in long term compared with PICC. Patients expected to get intravenous administration more than 0.5 year should use Port if both direct and indirect costs were included.展开更多
A series of polymer- supported Pd -Fe2O3 composite catalysts were prepared and their hydrogenation property mas investigated. It was found that the above catalysts have good catalytic hydrogenation activity for carbon...A series of polymer- supported Pd -Fe2O3 composite catalysts were prepared and their hydrogenation property mas investigated. It was found that the above catalysts have good catalytic hydrogenation activity for carbon - carbon double bonds systems and reusability. Furthermore, XPS and IR spectra shouted that active component in the composite catalysts is atomic Pd(0). An addition of a small amount of Fe2O3 has a promotive action upon hydrogenation activity of the catalysts, which indicated that there are some strong interactions (electron transfer) between Pd(0) and Fe(Ⅲ) species. Based on these results, a possible catalytic hydrogenation mechanism was also suggested.展开更多
文摘Objective: To study incidence and management of long term central venous catheter (CVC) placement related pneumothorax (PNX) in children. Aim: To construct a baseline value before the introduction of systematic use of ultrasound guidance, which requires specific training and equipment. Background: Anesthesia Service and Pediatric Oncology of the Italian National Cancer Center;patients were children (age ≤ 18 years) with solid tumors, needing long-term central venous catheters (Groshong or Port-a-Cath). Materials/Methods: Catheter placement was performed, mostly under general anesthesia, utilizing a micropuncture 5-7 Fr needle and fluoroscopy. In the study period ultrasound was used only in case of previously failed attempts. Relevant data were collected retrospectively. Results: From August 2008 to December 2011, 452 catheters were implanted to our patients. The prevalent approach was from subclavian vein (left 85.7%, right 9.7%);in few cases internal jugular vein was chosen (right 2.4%, left 2.2%). Pneumothorax occurred in 14 patients (3.1%;95%CI 1.9-5.1). In 4/14 children the PNX was considered minimal and not treated. In 10 patients the PNX was drained. In 7 cases a traditional, surgical thoracostomy was performed, while in 3 children a 14-Ga polyurethane catheter (Arrow International®) was inserted over a wire guide in the pleural space by anaesthetists. Conclusions: In our centre rates of PNX are the same as those described in literature and are expected to lower when ultrasound guidance of the puncture will be routinely applied. Percutaneous drainage of PNX seems as effective as surgically placed thoracostomy catheter, but less invasive.
文摘BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe condition.CASE SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer.A computed tomography showed the fractured catheter of the IVAP in the pulmonary artery.Therefore,we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck trap.CONCLUSION When the fractured catheter of an IVAP was detected,the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.
基金Supported by Shenzhen Key Medical Discipline Construction Fund,No.SZXK052。
文摘BACKGROUND Implanted intravenous infusion port(TIAP)is mainly used for patients who need central venous infusion and poor peripheral vascular conditions.With the advantages of easy to carry,long maintenance cycle,few complications and excellent quality of life,it has been widely used in the fields of malignant tumor chemotherapy,parenteral nutrition support and repeated blood collection.Implanted intravenous infusion port(IVAP)dislocation can have significant complications if not recognised and reinstated immediately.CASE SUMMARY A 24-year-old man was treated with adjuvant chemotherapy for osteosarcoma.Severe displacement of IVAP catheter was found by chest X-ray examination.The IVAP cannot be used normally.Therefore,we conducted an emergency procedure to reset the catheter through double pigtail catheters,the operation was successful and the infusion port was restored.CONCLUSION When IVAP catheter displacement cannot be reset by conventional techniques,two pigtail catheters can be successfully used instead.
文摘Background: The port catheters are used to give long-term total parenteral nutrition, intravenous fluids, blood and blood products, or to be preferred for oncology and hematological diseases. In this study, we sought to review our results concerning the subcutaneous port catheter appliance in childhood malignancies. Methods: Two hundred ten subcutaneous port catheters applied to 192 patients between November 2010 and October 2015 were examined retrospectively in a cross- sectional study. Information such as demographic data, primary diagnoses, port types and implantation durations were recorded. Localization of the intervention, surgical technique, early and late complications and causes of port removal were evaluated. Results: Mean age of patients was 6.4 ± 4.9 years (1 month - 17 years), 77 (40.1%) were female and 115 (59.9%) male. One hundred twenty nine ports were inserted from the right internal jugular vein, 59 to right subclavian vein, 14 to left subclavian vein and 8 to left internal jugular vein. Total duration of implantation was 55,492 days and median duration was 289 days. Early complications were: 1 (0.5%) hemothorax, 1 (0.5%) pneumothorax, 1 (0.5%) carotid artery injury, 1 (0.5%) arrhythmia and in 2 (1%) cases port mal-positioning. Late complications were: 9 (4.3%) infection and 8 (3.8%) mechanical problems, 7 (3.3%) thrombosis, and in 1 (0.5%) port fracture was detected. Port catheter was removed in 18 (8.6%) cases. No significant difference was found when jugular and subclavian vein implantation was compared in terms of all complications, especially infection and thrombosis. Conclusion: Use of port catheter is a safe option in children who are receiving a long-term chemotherapy. Education of the medical team will diminish the complication rate in port catheter insertions.
文摘We report a successful endovascular technique using a snare with a suture for retrieving a migrated broken peripherally inserted central catheter(PICC)in a chemotherapy patient.A 62-year-old male received monthly chemotherapy through a central venous port implanted into his right subclavian area.The patient completed chemotherapy without complications 1 mo ago;however,he experienced pain in the right subclavian area during his last chemotherapy session.Computed tomography on that day showed migration of a broken PICC in his left pulmonary artery,for which the patient was admitted to our hospital.We attempted to retrieve the ectopic PICC through the right jugular vein using a gooseneck snare,but were unsuccessful because the catheter was lodged in the pulmonary artery wall.Therefore,a second attempt was made through the right femoral vein using a snare with triple loops,but we could not grasp the migrated PICC.Finally,a string was tied to thetop of the snare,allowing us to curve the snare toward the pulmonary artery by pulling the string.Finally,the catheter body was grasped and retrieved.The endovascular suture technique is occasionally extremely useful and should be considered by interventional cardiologists for retrieving migrated catheters.
文摘OBJECTIVE: To calculate and compare the cost of Port and PICC's application in long-term intravenous administration, and to support the decision making of hospital manager. METHODS: Literature review and patient survey in 2 oncology centers in China were carried out to investigate the cost and impact of Port and PICC for patients. The cost at different time of intravenous administration was calculated and compared. One-way sensitivity analysis was performed and tornado graph was drawn. RESULTS: Direct cost of Port at 0.5, 1, 1.5, and 2 years were7442, 8005, 8553, and 9131 CNY, and 4700, 9399, 14032, 18799 CNY for PICC respectively. Direct & indirect cost at 0.5, 1, 1.5, and 2 years were 9291, 11704, 14101, 16529 CNY for Port and 9697, 19393, 29023, 38787 CNY for PICC. Sensitivity analysis showed that productivity loss and device maintenance cost were the most in?uential factors to the result. CONCLUSION: Port had higher cost in short term and less in long term compared with PICC. Patients expected to get intravenous administration more than 0.5 year should use Port if both direct and indirect costs were included.
文摘A series of polymer- supported Pd -Fe2O3 composite catalysts were prepared and their hydrogenation property mas investigated. It was found that the above catalysts have good catalytic hydrogenation activity for carbon - carbon double bonds systems and reusability. Furthermore, XPS and IR spectra shouted that active component in the composite catalysts is atomic Pd(0). An addition of a small amount of Fe2O3 has a promotive action upon hydrogenation activity of the catalysts, which indicated that there are some strong interactions (electron transfer) between Pd(0) and Fe(Ⅲ) species. Based on these results, a possible catalytic hydrogenation mechanism was also suggested.
