Managing central venous access during a health care crisis
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Managing central venous access during a health care crisis. / Vascular Low-Frequency Disease Consortium.
in: J VASC SURG, Jahrgang 72, Nr. 4, 21.09.2020, S. 1184-1195.e3.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Managing central venous access during a health care crisis
AU - Chun, Tristen T
AU - Judelson, Dejah R
AU - Rigberg, David
AU - Lawrence, Peter F
AU - Cuff, Robert
AU - Shalhub, Sherene
AU - Wohlauer, Max
AU - Abularrage, Christopher J
AU - Anastasios, Papapetrou
AU - Arya, Shipra
AU - Aulivola, Bernadette
AU - Baldwin, Melissa
AU - Baril, Donald
AU - Bechara, Carlos F
AU - Beckerman, William E
AU - Behrendt, Christian-Alexander
AU - Benedetto, Filippo
AU - Bennett, Lisa F
AU - Charlton-Ouw, Kristofer M
AU - Chawla, Amit
AU - Chia, Matthew C
AU - Cho, Sungsin
AU - Choong, Andrew M T L
AU - Chou, Elizabeth L
AU - Christiana, Anastasiadou
AU - Coscas, Raphael
AU - De Caridi, Giovanni
AU - Ellozy, Sharif
AU - Etkin, Yana
AU - Faries, Peter
AU - Fung, Adrian T
AU - Gonzalez, Andrew
AU - Griffin, Claire L
AU - Guidry, London
AU - Gunawansa, Nalaka
AU - Gwertzman, Gary
AU - Han, Daniel K
AU - Hicks, Caitlin W
AU - Hinojosa, Carlos A
AU - Hsiang, York
AU - Ilonzo, Nicole
AU - Jayakumar, Lalithapriya
AU - Joh, Jin Hyun
AU - Johnson, Adam P
AU - Kabbani, Loay S
AU - Keller, Melissa R
AU - Khashram, Manar
AU - Koleilat, Issam
AU - Krueger, Bernard
AU - Kumar, Akshay
AU - Lee, Cheong Jun
AU - Lee, Alice
AU - Levy, Mark M
AU - Lewis, C Taylor
AU - Lind, Benjamin
AU - Lopez-Pena, Gabriel
AU - Mohebali, Jahan
AU - Molnar, Robert G
AU - Morrissey, Nicholas J
AU - Motaganahalli, Raghu L
AU - Mouawad, Nicolas J
AU - Newton, Daniel H
AU - Ng, Jun Jie
AU - O'Banion, Leigh Ann
AU - Phair, John
AU - Rancic, Zoran
AU - Rao, Ajit
AU - Ray, Hunter M
AU - Rivera, Aksim G
AU - Rodriguez, Limael
AU - Sales, Clifford M
AU - Salzman, Garrett
AU - Sarfati, Mark
AU - Savlania, Ajay
AU - Schanzer, Andres
AU - Sharafuddin, Mel J
AU - Sheahan, Malachi
AU - Siada, Sammy
AU - Siracuse, Jeffrey J
AU - Smith, Brigitte K
AU - Smith, Matthew
AU - Soh, Ina
AU - Sorber, Rebecca
AU - Sundaram, Varuna
AU - Sundick, Scott
AU - Tomita, Tadaki M
AU - Trinidad, Bradley
AU - Tsai, Shirling
AU - Vouyouka, Ageliki G
AU - Westin, Gregory G
AU - Williams, Michael S
AU - Wren, Sherry M
AU - Yang, Jane K
AU - Yi, Jeniann
AU - Zhou, Wei
AU - Zia, Saqib
AU - Woo, Karen
AU - Vascular Low-Frequency Disease Consortium
N1 - Copyright © 2020 Society for Vascular Surgery. All rights reserved.
PY - 2020/9/21
Y1 - 2020/9/21
N2 - OBJECTIVE: During the COVID-19 pandemic, central venous access line teams were implemented at many hospitals throughout the world to provide access for critically ill patients. The objective of this study was to describe the structure, practice patterns, and outcomes of these vascular access teams during the COVID-19 pandemic.METHODS: We conducted a cross-sectional, self-reported study of central venous access line teams in hospitals afflicted with the COVID-19 pandemic. To participate in the study, hospitals were required to meet one of the following criteria: development of a formal plan for a central venous access line team during the pandemic; implementation of a central venous access line team during the pandemic; placement of central venous access by a designated practice group during the pandemic as part of routine clinical practice; or management of an iatrogenic complication related to central venous access in a patient with COVID-19.RESULTS: Participants from 60 hospitals in 13 countries contributed data to the study. Central venous line teams were most commonly composed of vascular surgery and general surgery attending physicians and trainees. Twenty sites had 2657 lines placed by their central venous access line team or designated practice group. During that time, there were 11 (0.4%) iatrogenic complications associated with central venous access procedures performed by the line team or group at those 20 sites. Triple lumen catheters, Cordis (Santa Clara, Calif) catheters, and nontunneled hemodialysis catheters were the most common types of central venous lines placed by the teams. Eight (14%) sites reported experience in placing central venous lines in prone, ventilated patients with COVID-19. A dedicated line cart was used by 35 (59%) of the hospitals. Less than 50% (24 [41%]) of the participating sites reported managing thrombosed central lines in COVID-19 patients. Twenty-three of the sites managed 48 iatrogenic complications in patients with COVID-19 (including complications caused by providers outside of the line team or designated practice group).CONCLUSIONS: Implementation of a dedicated central venous access line team during a pandemic or other health care crisis is a way by which physicians trained in central venous access can contribute their expertise to a stressed health care system. A line team composed of physicians with vascular skill sets provides relief to resource-constrained intensive care unit, ward, and emergency medicine teams with a low rate of iatrogenic complications relative to historical reports. We recommend that a plan for central venous access line team implementation be in place for future health care crises.
AB - OBJECTIVE: During the COVID-19 pandemic, central venous access line teams were implemented at many hospitals throughout the world to provide access for critically ill patients. The objective of this study was to describe the structure, practice patterns, and outcomes of these vascular access teams during the COVID-19 pandemic.METHODS: We conducted a cross-sectional, self-reported study of central venous access line teams in hospitals afflicted with the COVID-19 pandemic. To participate in the study, hospitals were required to meet one of the following criteria: development of a formal plan for a central venous access line team during the pandemic; implementation of a central venous access line team during the pandemic; placement of central venous access by a designated practice group during the pandemic as part of routine clinical practice; or management of an iatrogenic complication related to central venous access in a patient with COVID-19.RESULTS: Participants from 60 hospitals in 13 countries contributed data to the study. Central venous line teams were most commonly composed of vascular surgery and general surgery attending physicians and trainees. Twenty sites had 2657 lines placed by their central venous access line team or designated practice group. During that time, there were 11 (0.4%) iatrogenic complications associated with central venous access procedures performed by the line team or group at those 20 sites. Triple lumen catheters, Cordis (Santa Clara, Calif) catheters, and nontunneled hemodialysis catheters were the most common types of central venous lines placed by the teams. Eight (14%) sites reported experience in placing central venous lines in prone, ventilated patients with COVID-19. A dedicated line cart was used by 35 (59%) of the hospitals. Less than 50% (24 [41%]) of the participating sites reported managing thrombosed central lines in COVID-19 patients. Twenty-three of the sites managed 48 iatrogenic complications in patients with COVID-19 (including complications caused by providers outside of the line team or designated practice group).CONCLUSIONS: Implementation of a dedicated central venous access line team during a pandemic or other health care crisis is a way by which physicians trained in central venous access can contribute their expertise to a stressed health care system. A line team composed of physicians with vascular skill sets provides relief to resource-constrained intensive care unit, ward, and emergency medicine teams with a low rate of iatrogenic complications relative to historical reports. We recommend that a plan for central venous access line team implementation be in place for future health care crises.
KW - Betacoronavirus/pathogenicity
KW - COVID-19
KW - Catheterization, Central Venous/adverse effects
KW - Coronavirus Infections/diagnosis
KW - Cross-Sectional Studies
KW - Delivery of Health Care, Integrated/organization & administration
KW - Health Care Surveys
KW - Health Services Needs and Demand/organization & administration
KW - Host-Pathogen Interactions
KW - Humans
KW - Iatrogenic Disease/epidemiology
KW - Infection Control/organization & administration
KW - Pandemics
KW - Pneumonia, Viral/diagnosis
KW - Risk Assessment
KW - Risk Factors
KW - SARS-CoV-2
U2 - 10.1016/j.jvs.2020.06.112
DO - 10.1016/j.jvs.2020.06.112
M3 - SCORING: Journal article
C2 - 32682063
VL - 72
SP - 1184-1195.e3
JO - J VASC SURG
JF - J VASC SURG
SN - 0741-5214
IS - 4
ER -