Managing central venous access during a health care crisis

Vascular Low-Frequency Disease Consortium

doi:10.1016/j.jvs.2020.06.112

Managing central venous access during a health care crisis

Standard

Managing central venous access during a health care crisis. / Vascular Low-Frequency Disease Consortium.

In: J VASC SURG, Vol. 72, No. 4, 21.09.2020, p. 1184-1195.e3.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Vascular Low-Frequency Disease Consortium 2020, 'Managing central venous access during a health care crisis', J VASC SURG, vol. 72, no. 4, pp. 1184-1195.e3. https://doi.org/10.1016/j.jvs.2020.06.112

APA

Vascular Low-Frequency Disease Consortium (2020). Managing central venous access during a health care crisis. J VASC SURG, 72(4), 1184-1195.e3. https://doi.org/10.1016/j.jvs.2020.06.112

Vancouver

Vascular Low-Frequency Disease Consortium. Managing central venous access during a health care crisis. J VASC SURG. 2020 Sep 21;72(4):1184-1195.e3. https://doi.org/10.1016/j.jvs.2020.06.112

Bibtex

@article{7c901e33e49d41148795ea1df2710fef,

title = "Managing central venous access during a health care crisis",

abstract = "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.",

keywords = "Betacoronavirus/pathogenicity, COVID-19, Catheterization, Central Venous/adverse effects, Coronavirus Infections/diagnosis, Cross-Sectional Studies, Delivery of Health Care, Integrated/organization & administration, Health Care Surveys, Health Services Needs and Demand/organization & administration, Host-Pathogen Interactions, Humans, Iatrogenic Disease/epidemiology, Infection Control/organization & administration, Pandemics, Pneumonia, Viral/diagnosis, Risk Assessment, Risk Factors, SARS-CoV-2",

author = "Chun, {Tristen T} and Judelson, {Dejah R} and David Rigberg and Lawrence, {Peter F} and Robert Cuff and Sherene Shalhub and Max Wohlauer and Abularrage, {Christopher J} and Papapetrou Anastasios and Shipra Arya and Bernadette Aulivola and Melissa Baldwin and Donald Baril and Bechara, {Carlos F} and Beckerman, {William E} and Christian-Alexander Behrendt and Filippo Benedetto and Bennett, {Lisa F} and Charlton-Ouw, {Kristofer M} and Amit Chawla and Chia, {Matthew C} and Sungsin Cho and Choong, {Andrew M T L} and Chou, {Elizabeth L} and Anastasiadou Christiana and Raphael Coscas and {De Caridi}, Giovanni and Sharif Ellozy and Yana Etkin and Peter Faries and Fung, {Adrian T} and Andrew Gonzalez and Griffin, {Claire L} and London Guidry and Nalaka Gunawansa and Gary Gwertzman and Han, {Daniel K} and Hicks, {Caitlin W} and Hinojosa, {Carlos A} and York Hsiang and Nicole Ilonzo and Lalithapriya Jayakumar and Joh, {Jin Hyun} and Johnson, {Adam P} and Kabbani, {Loay S} and Keller, {Melissa R} and Manar Khashram and Issam Koleilat and Bernard Krueger and Akshay Kumar and Lee, {Cheong Jun} and Alice Lee and Levy, {Mark M} and Lewis, {C Taylor} and Benjamin Lind and Gabriel Lopez-Pena and Jahan Mohebali and Molnar, {Robert G} and Morrissey, {Nicholas J} and Motaganahalli, {Raghu L} and Mouawad, {Nicolas J} and Newton, {Daniel H} and Ng, {Jun Jie} and O'Banion, {Leigh Ann} and John Phair and Zoran Rancic and Ajit Rao and Ray, {Hunter M} and Rivera, {Aksim G} and Limael Rodriguez and Sales, {Clifford M} and Garrett Salzman and Mark Sarfati and Ajay Savlania and Andres Schanzer and Sharafuddin, {Mel J} and Malachi Sheahan and Sammy Siada and Siracuse, {Jeffrey J} and Smith, {Brigitte K} and Matthew Smith and Ina Soh and Rebecca Sorber and Varuna Sundaram and Scott Sundick and Tomita, {Tadaki M} and Bradley Trinidad and Shirling Tsai and Vouyouka, {Ageliki G} and Westin, {Gregory G} and Williams, {Michael S} and Wren, {Sherry M} and Yang, {Jane K} and Jeniann Yi and Wei Zhou and Saqib Zia and Karen Woo and {Vascular Low-Frequency Disease Consortium}",

year = "2020",

month = sep,

day = "21",

doi = "10.1016/j.jvs.2020.06.112",

language = "English",

volume = "72",

pages = "1184--1195.e3",

journal = "J VASC SURG",

issn = "0741-5214",

publisher = "Mosby Inc.",

number = "4",

}

RIS

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

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 -