Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.jvs.2020.06.112
Title: Managing central venous access during a health care crisis
Authors: Chun, Tristen T
Judelson, Dejah R
Rigberg, David
Lawrence, Peter F
Cuff, Robert
Shalhub, Sherene
Wohlauer, Max
Abularrage, Christopher J
Anastasios, Papapetrou
Arya, Shipra
Aulivola, Bernadette
Baldwin, Melissa
Baril, Donald
Bechara, Carlos F
Beckerman, William E
Behrendt, Christian-Alexander
Benedetto, Filippo
Bennett, Lisa F
Charlton-Ouw, Kristofer M
Chawla, Amit
Chia, Matthew C
Cho, Sungsin
Choong, Andrew MTL 
Chou, Elizabeth L
Christiana, Anastasiadou
Coscas, Raphael
De Caridi, Giovanni
Ellozy, Sharif
Etkin, Yana
Faries, Peter
Fung, Adrian T
Gonzalez, Andrew
Griffin, Claire L
Guidry, London
Gunawansa, Nalaka
Gwertzman, Gary
Han, Daniel K
Hicks, Caitlin W
Hinojosa, Carlos A
Hsiang, York
Ilonzo, Nicole
Jayakumar, Lalithapriya
Joh, Jin Hyun
Johnson, Adam P
Kabbani, Loay S
Keller, Melissa R
Khashram, Manar
Koleilat, Issam
Krueger, Bernard
Kumar, Akshay
Lee, Cheong Jun
Lee, Alice
Levy, Mark M
Lewis, C Taylor
Lind, Benjamin
Lopez-Pena, Gabriel
Mohebali, Jahan
Molnar, Robert G
Morrissey, Nicholas J
Motaganahalli, Raghu L
Mouawad, Nicolas J
Newton, Daniel H
Ng, Jun Jie 
O'Banion, Leigh Ann
Phair, John
Rancic, Zoran
Rao, Ajit
Ray, Hunter M
Rivera, Aksim G
Rodriguez, Limael
Sales, Clifford M
Salzman, Garrett
Sarfati, Mark
Savlania, Ajay
Schanzer, Andres
Sharafuddin, Mel J
Sheahan, Malachi
Siada, Sammy
Siracuse, Jeffrey J
Smith, Brigitte K
Smith, Matthew
Soh, Ina
Sorber, Rebecca
Sundaram, Varuna
Sundick, Scott
Tomita, Tadaki M
Trinidad, Bradley
Tsai, Shirling
Vouyouka, Ageliki G
Westin, Gregory G
Williams, Michael S
Wren, Sherry M
Yang, Jane K
Yi, Jeniann
Zhou, Wei
Zia, Saqib
Woo, Karen
Keywords: Science & Technology
Life Sciences & Biomedicine
Surgery
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Central venous access
Central line teams
Iatrogenic injuries
BLOOD-STREAM INFECTIONS
VASCULAR ACCESS
COVID-19
COMPLICATIONS
PLACEMENT
CATHETER
PROGRAM
TEAM
Issue Date: 1-Oct-2020
Publisher: MOSBY-ELSEVIER
Citation: Chun, Tristen T, Judelson, Dejah R, Rigberg, David, Lawrence, Peter F, Cuff, Robert, Shalhub, Sherene, Wohlauer, Max, Abularrage, Christopher J, Anastasios, Papapetrou, Arya, Shipra, Aulivola, Bernadette, Baldwin, Melissa, Baril, Donald, Bechara, Carlos F, Beckerman, William E, Behrendt, Christian-Alexander, Benedetto, Filippo, Bennett, Lisa F, Charlton-Ouw, Kristofer M, Chawla, Amit, Chia, Matthew C, Cho, Sungsin, Choong, Andrew MTL, Chou, Elizabeth L, Christiana, Anastasiadou, Coscas, Raphael, De Caridi, Giovanni, Ellozy, Sharif, Etkin, Yana, Faries, Peter, Fung, Adrian T, Gonzalez, Andrew, Griffin, Claire L, Guidry, London, Gunawansa, Nalaka, Gwertzman, Gary, Han, Daniel K, Hicks, Caitlin W, Hinojosa, Carlos A, Hsiang, York, Ilonzo, Nicole, Jayakumar, Lalithapriya, Joh, Jin Hyun, Johnson, Adam P, Kabbani, Loay S, Keller, Melissa R, Khashram, Manar, Koleilat, Issam, Krueger, Bernard, Kumar, Akshay, Lee, Cheong Jun, Lee, Alice, Levy, Mark M, Lewis, C Taylor, Lind, Benjamin, Lopez-Pena, Gabriel, Mohebali, Jahan, Molnar, Robert G, Morrissey, Nicholas J, Motaganahalli, Raghu L, Mouawad, Nicolas J, Newton, Daniel H, Ng, Jun Jie, O'Banion, Leigh Ann, Phair, John, Rancic, Zoran, Rao, Ajit, Ray, Hunter M, Rivera, Aksim G, Rodriguez, Limael, Sales, Clifford M, Salzman, Garrett, Sarfati, Mark, Savlania, Ajay, Schanzer, Andres, Sharafuddin, Mel J, Sheahan, Malachi, Siada, Sammy, Siracuse, Jeffrey J, Smith, Brigitte K, Smith, Matthew, Soh, Ina, Sorber, Rebecca, Sundaram, Varuna, Sundick, Scott, Tomita, Tadaki M, Trinidad, Bradley, Tsai, Shirling, Vouyouka, Ageliki G, Westin, Gregory G, Williams, Michael S, Wren, Sherry M, Yang, Jane K, Yi, Jeniann, Zhou, Wei, Zia, Saqib, Woo, Karen (2020-10-01). Managing central venous access during a health care crisis. JOURNAL OF VASCULAR SURGERY 72 (4) : 1184-+. ScholarBank@NUS Repository. https://doi.org/10.1016/j.jvs.2020.06.112
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.
Source Title: JOURNAL OF VASCULAR SURGERY
URI: https://scholarbank.nus.edu.sg/handle/10635/205868
ISSN: 07415214
10976809
DOI: 10.1016/j.jvs.2020.06.112
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