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Single-lumen central venous catheter with a knot about 2.0 cm from the tip, after removal by venotomy under local anesthesia.
Source publication
Patient: Male, 63-year-old
Final Diagnosis: Spontaneous knot formation in central venous catheter
Symptoms: Central venous catheter whit any flow • associated with pain at the insertion site of the access
Medication: —
Clinical Procedure: Central venous catheterization
Specialty: General and Internal Medicine • Surgery
Objective
Challenging differ...
Context in source publication
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Citations
Background
Maintaining venous access is of great clinical importance. Running a slow continuous infusion to keep the vein open (KVO) is often used in peripheral intravenous catheters (PIVCs). Previous studies have compared the effects of intermittent flushing and continuous infusion via peripherally inserted central catheters (PICCs). In this study, we applied KVO to central venous catheters (CVCs) and compared the occlusion rate of this technique with that of the intermittent flushing technique.
Method
This is a randomized controlled trial of 14 hospitals in China. A total of 250 patients will be recruited in this study, and they will be randomized at a 1:1 ratio. After study inclusion, patients who will undergo CVC insertion will receive intermittent flushing with prefilled saline syringes (control group) or KVO infusion with elastic pumps (test group). All the catheters will be checked for patency by scoping Catheter Injection and Aspiration (CINAS) Classification on Days 3 and 7. The primary outcome is the rate of catheter occlusion in 7 days. Patients will be followed up until 9 days after CVC insertion, catheter occlusion, or catheter removal. The secondary outcomes are the rate of catheter occlusion in 3 days, nurse satisfaction, cost-effectiveness, adverse event rate, catheter-related bloodstream infection rate, catheter-related thrombosis rate, extravasation rate, phlebitis rate, and catheter migration.
Discussion
We expect that the trial will generate findings that can provide an evidence-based basis for the improvement and optimization of clinical catheter flushing techniques.
Trial registration
Chinese Clinical Trial Registry, ChiCTR2200064007. Registered on 23 September 2022. https://www.chictr.org.cn/showproj.html?proj=177311.
Epicutaneo-caval catheter (ECC) has been widely used in neonatal intensive care units (NICUs). ECC line Knots in intravascular is an unexpected complication and has been reported in adults mostly. Few cases reported knot formation during ECC insertion and removal in neonates. In this case, we introduced a spontaneous knot formation during the insertion of the central catheter, which was finally successfully removed.
