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Epicutaneous cava catheter insertion with modified Seldinger technique

In this video, published by GaVeCelt on their YouTube channel, they show you how to insert an epicutaneous cava catheter with modified Seldinger technique in neonates.
You can also find a lot of other interesting information on their website: https://gavecelt.it/nuovo/home

21 March 2023

Vascular Access Video Tutorials, Video Tutorials

epicutaneo-cava catheter, insertion, modified Seldinger technique, Neonate, PICC, video
Experimental study on the hemostatic effect of cyanoacrylate intended for catheter securement

The use of cyanoacrylate for intravenous catheter securement is of interest to clinicians and patients, because of the superior adhesive strength and hemostatic effect of cyanoacrylate compared to current securement devices. The purpose of this study is to use novel in vitro and in vivo testing methods to analyze the hemostatic effect of a catheter securement cyanoacrylate (cyanoacrylate).
The cyanoacrylate rapidly achieved hemostasis in the presence of anticoagulated whole blood, platelet poor plasma, and non-anticoagulated whole blood, in vitro. The cyanoacrylate achieved hemostasis 12-fold faster than thromboplastin in the modified activated clotting time assay. The cyanoacrylate does not alter normal blood clotting, as measured by prothrombin time.
This study indicates that cyanoacrylate demonstrates a potent mechanical hemostatic effect and cyanoacrylate in the presence of anticoagulated whole blood has an activated clotting time that is 12 times quicker than thromboplastin. The cyanoacrylate was found to be significantly equivalent to two known hemostatic agents, in vivo.

Authors : Sheng Zhang¹, Amanda R Guido¹, Richard G Jones¹, Benjamin J Curry², Angela S Burke³ and Melanie E Blaisdell³

1 Adhezion Biomedical, LLC, Hudson, NC, USA
2 CirQuest Labs, LLC, Memphis, TN, USA
3 NAMSA, Northwood, OH, USA

Corresponding author : Sheng Zhang, Adhezion Biomedical, LLC, 506 Pine Mountain Road, Hudson, NC 28638, USA. Email: szhang@adhezion.com

The Journal of Vascular Access 2019, Vol. 20(1) 79–86

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17 March 2023

Glue, Studies, Vascular Access Studies

Adhesive, cyanoacrylate, hemostasis, medical device, securement
Rapid Central Vein Assessment

In this video, published by GaVeCelt on their YouTube channel, they show you how to perform
Rapid Central Vein Assessment in neonates.
You can also find a lot of other interesting information on their website: https://gavecelt.it/nuovo/home

14 March 2023

Vascular Access Video Tutorials

central vein, central vein assessment, Rapid Central Vein Assessment
Intraosseous access in neonates is feasible and safe – An analysis of a prospective nationwide surveillance study in Germany

This was a prospective surveillance study to investigate reports on the safety and frequency of use of intraosseous (IO) access in neonates.
Within this surveillance study, IO access in neonates represents a feasible, safe and fast possibility for emergency vascular access. IO access should be available for time-sensitive emergencies at all neonatal sites. Neonatal departments must ensure that medical teams receive regular, interdisciplinary training in IO placement techniques.

Authors : Eva Schwindt¹ , Daniel Pfeiffer² , Delphina Gomes² , Sebastian Brenner³ , Jens-Christian Schwindt⁴ , Florian Hoffmann²* † and Martin Olivieri²†
1 Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University Vienna, Vienna, Austria,
2 Pediatric Intensive Care Unit, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, Munich, Germany,
3 Department of Pediatrics, Division of Neonatology and Pediatrics Intensive Care, University Hospital Carl Gustav Carus, Dresden, Germany,
4 Pediatric Working Group, Austrian Resuscitation Council, Graz, Austria
†These authors have contributed equally to this work and share last authorship
*CORRESPONDENCE Florian Hoffmann florian.hoffmann@med.uni-muenchen.de

2023_wk10_Intraosseous-access-in-neonates-is-feasible-and-safe Download

COPYRIGHT © 2022 Schwindt, Pfeiffer, Gomes, Brenner, Schwindt, Hoffmann and Olivieri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).

9 March 2023

Other, Studies, Vascular Access Studies

delivery room management, emergency access, intraosseous access, Neonates, resuscitation, vascular access
Off label use of PICC as umbilical arterial catheter: Clinical

Umbilical arterial catheters are often placed at birth in critical ill neonates. Advantages of umbilical arterial catheterization include continuous blood pressure monitoring, accurate blood gas and frequent blood samplings.
The authors described the off-label use of a third generation polyurethane power injectable 3Fr single lumen peripheral inserted central catheter as umbilical arterial catheter. This clinical case series opens new scenarios about the off-label use of power PICC in newborns. Prospective studies are needed to evaluate the safety and advantages of PICCs as umbilical catheters over the conventional old generation polyurethane neonatal catheters.

Authors : Barone Giovanni , Natile Miria and Ancora Gina , Neonatal Intensive Care Unit, Ospedale Infermi, AUSL Romagna, Rimini, Italy
Corresponding author: Barone Giovanni, Neonatal Intensive Care Unit, TIN Ospedale Infermi, AUSL Romagna, Via Settembrini 2, Rimini 47923, Italy. Email: gbarone85@yahoo.it

The Journal of Vascular Access

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7 March 2023

Other, Studies, Vascular Access Studies

heamodynamic monitoring, off label PICC, techniques and procedures, umbilical arterial catheter, umbilical artery
The intracavitary electrocardiography method for positioning the tip of epicutaneous cava catheter in neonates: Pilot study

The intracavitary electrocardiography method for positioning the tip of epicutaneous cava catheter in neonates: Pilot study

The neonatologists of Sant’Anna and San Sebastiano Hospital of Caserta have carried out a pilot study investigating the safety, feasibility, and accuracy of intracavitary electrocardiography for neonatal epicutaneous cava catheter tip positioning. 39 neonates were enrolled in this study and they concluded that the intracavitary electrocardiography method is safe and accurate in neonates as demonstrated in pediatric and adult patients. The applicability of the method is 97% and its feasibility is 79%. The overall accuracy is 76% but it rises to 97% if “peak” P wave is detected.

Authors : Antonella Capasso¹, Rossella Mastroianni¹, Annalisa Passariello^2,3, Marta Palma², Francesco Messina⁴, Antonella Ansalone¹, Italo Bernardo¹, Daniela Brescia¹, Francesco Crispino¹, Carolina Grassia¹, Attilio Romano¹ and Gaetano Ausanio¹

1 Neonatal Intensive Care Unit, Hospital Sant’Anna and San Sebastiano, Caserta, Italy
2 Department of Translational Medical Science, University of Naples “Federico II,” Naples, Italy
3 Department of Pediatric Oncology, Santobono-Pausilipon Hospital, Naples, Italy
4 Neonatal Intensive Care Unit, “Villa Betania” Evangelical Hospital, Naples, Italy

Corresponding author: Gaetano Ausanio, Neonatal Intensive Care Unit, Hospital Sant’Anna and San Sebastiano, Palasciano Street, Caserta 81100, Italy. Email: ausanio1961@libero.it

The Journal of Vascular Access

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2 March 2023

ECG/Echo, Studies, Vascular Access Studies

CVC, ECG, intracavitary electrocardiography, peripherally inserted central catheter, target zone, tip position
The intracavitary ECG method for tip location of ultrasound-guided centrally inserted central catheter in neonates

The correct position of the tip of a central venous access device is important in all patients, and especially in neonates. The traditional method of tip location (approximated intra-procedural length estimation + post procedural chest X-ray) is currently considered inaccurate and not cost-effective by most recent guidelines, which recommend the adoption of tip location by intracavitary electrocardiography (IC-ECG) whenever possible.
A total of 105 neonates were enrolled in this study and the conclusion is, when applied to ultrasound guided CICCs, tip location by IC-ECG is applicable and feasible in neonates, and it is safe and accurate.

Authors : Vito D’Andrea¹ , Lucilla Pezza¹, Giorgia Prontera¹, Gina Ancora², Mauro Pittiruti³ , Giovanni Vento¹ and Giovanni Barone²
1 Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
2 Neonatal Intensive Care Unit, Azienda Sanitaria Romagna, Infermi Hospital Rimini, Rimini, Italy
3 Department of Surgery, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy

Corresponding author: Vito D’Andrea, Department of Woman and Child Health and Public Health, Division of Neonatology, University Hospital Fondazione Policlinico Gemelli IRCCS, Largo A. Gemelli, Rome, Lazio 00168, Italy. Email: dandrea.vito@gmail.com

The Journal of Vascular Access

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28 February 2023

ECG/Echo, Studies, Vascular Access Studies

CICC, CVAD, ECG, Neo-ECHOTIP, neonatal intensive care, Neonates, POCUS, techniques and procedures, tip location
Rapid Superficial Vein Assessment (RaSuVA): A pre-procedural systematic evaluation of superficial veins to optimize venous catheterization in neonates

The Rapid Superficial Vein Assessment (RaSuVA) protocol represents a systematic full anatomic evaluation to choose the best insertion site tailored on the specific patient, optimized for the specific kind of device required. The RaSuVa implies a complete assessment of the neonate, from foot to head. The superficial veins are examined systematically, both with and without NIR technology, exploring seven skin areas.

If properly carried out, the RaSuVA protocol will offer an accurate overview of:
− the patient’s superficial vein pattern
− the characteristics of each vein in terms of trajectory and flow
− the expected difficulty of cannulation for each vein

The aim of RaSuVA is to offer a complete knowledge of the superficial veins of the patient, so to lead to a rational choice of the vein to be cannulated, with the final goal of increasing the success rate at first attempt, the duration of the procedure, with puncture-related pain and stress for neonates, and possibly to limit complications: goals that we consider crucial for any NICU.

Authors : Vito D’Andrea¹ , Giorgia Prontera¹, Lucilla Pezza¹, Giovanni Barone² , Giovanni Vento¹ and Mauro Pittiruti

1. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
2. Neonatal Intensive Care Unit, Infermi Hospital, Rimini, Italy
3. Department of Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

Corresponding author: Vito D’Andrea, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, Rome 00168, Italy.

Email: dandrea.vito@gmail.com

The Journal of Vascular Access

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23 February 2023

Other, Studies, Vascular Access Studies

epicutaneo-caval catheters, neonatal intensive care unit, peripheral intravenous catheters, superficial veins
The intracavitary electrocardiography method for tip location of jugular internal vein access device in infants of less than 5kg: A pilot study

This is a prospective observational study conducted by neonatologists in neonatal intensive care unit from Sant’Anna and San Sebastiano Hospital, Caserta, Italy. The objective of the study is to verify the feasibility of intracavitary electrocardiography method for tip location of central venous access device in infants of less than 5 kg and evaluate the accuracy of the method in comparison with post-procedural echocardiographical verification of the tip position.
The conclusion of this study is that the intracavitary electrocardiography method for tip location of central venous access device is safe and accurate in infants, as demonstrated by post-procedural comparative echocardiographic controls. As an alternative to echocardiography, not always achievable, the diffusion of intracavitary electrocardiography method could reduce X-ray exposition and complications of a malpositioned tip.

Authors: Rossella Mastroianni, Antonella Capasso and Gaetano Ausanio
Neonatal Intensive Care Unit, Sant’Anna and San Sebastiano Hospital, Caserta, Italy

Corresponding author: Gaetano Ausanio, Neonatal Intensive Care Unit, Sant’Anna and San Sebastiano Hospital, Via F. Palasciano, 81100 Caserta, Italy. Email: ausanio1961@libero.it

The Journal of Vascular Access

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21 February 2023

ECG/Echo, Studies, Vascular Access Studies

centrale venous access device, complications, echocardiography, intracavitary electrocardiography, managing malposition, target zone, tip location, tip position, X-ray exposition
NEOnatal Central-venous Line Observational study on Thrombosis (NEOCLOT): evaluation of a national guideline on management of neonatal catheter-related venous thrombosis

In critically ill (preterm) neonates, catheter-related venous thromboembolism (CVTE) can be a life-threatening complication. Evidence on optimal management in the literature is lacking. In the Netherlands, a consensus-based national management guideline was developed to create uniform CVTE management.
The objectives of this publication are to evaluate the efficacy and safety of the national guideline.

Authors : C. Heleen van Ommen | Klasien A. Bergman | Marit Boerma | Heleen A. Bouma | Albertine E. Donker | Melissa Gouvernante | Christian V. Hulzebos | Dalila Khandour | Ronny Knol | Marlou A. Raets | K. Djien Liem | Richard A. van Lingen | Moniek van de Loo | Enrico Lopriore | Mayke van der Putten | Jeanine J. Sol | Monique H. Suijker | Daniel C. Vijlbrief | Remco Visser | Mirjam M. van Weissenbruch
Correspondence C. Heleen van Ommen, Department of Pediatric Hematology, Erasmus University Medical Centre, Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands. Email: c.vanommen@erasmusmc.nl

To consult the guidelines

16 February 2023

Clinical Guidelines, Vascular Access Clinical Guidelines

anticoagulation, catheter, CVTE, guidelines, Neonate, thrombolysis, venous thromboembolism

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