A GAVeCeLT consensus on the indication, insertion, and management of central venous access devices in the critically ill.

Autor:	Pinelli F; Department of Anesthesia and Critical Care, University of Florence, 'Careggi' Hospital, Florence, Italy., Pittiruti M; Department of Surgery, Policlinico Universitario 'A.Gemelli,' Rome, Italy., Annetta MG; Department of Anesthesia and Intensive Care, Policlinico Universitario 'A.Gemelli,' Rome, Italy., Barbani F; Department of Anesthesia and Critical Care, University of Florence, 'Careggi' Hospital, Florence, Italy., Bertoglio S; Department of Surgery, University of Genova, Genova, Italy., Biasucci DG; Department of Clinical Science and Translational Medicine, 'Tor Vergata' University, Rome, Italy., Bolis D; Intensive Care Unit, Hospital 'A.Manzoni,' Lecco, Italy., Brescia F; Unit of Anesthesia and Intensive Care Medicine, Vascular Access Team, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy., Capozzoli G; Department of Anesthesiology, Hospital of Bolzano, Lehr-Krankenhaus der Paracelsus Medizinischen Privatuniversität, Bolzano, Italy., D'Arrigo S; Department of Anesthesia and Intensive Care, Policlinico Universitario 'A.Gemelli,' Rome, Italy., Deganello E; Anaesthesia and Intensive Care, Ospedali Riuniti Padova Sud, Monselice, Italy., Elli S; Vascular Access Team, Fondazione 'San Gerardo dei Tintori,' Monza, Italy., Fabiani A; Cardiac Surgery Intensive Care Unit, Vascular Access Team, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste, Italy., Fabiani F; Unit of Anesthesia and Intensive Care Medicine, Vascular Access Team, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy., Gidaro A; Department of Biomedical and Clinical Sciences, University of Milan, 'Luigi Sacco' Hospital, Milan, Italy., Giustivi D; Post-Anesthesia Care Unit and Vascular Access Team, Lodi, Italy., Iacobone E; Anesthesia and Intensive Care, Hospital of Macerata, Macerata, Italy., La Greca A; Department of Surgery, Policlinico Universitario 'A.Gemelli,' Rome, Italy., Longo F; Fondazione Policlinico 'Campus Bio-Medico,' Rome, Italy., Lucchini A; Adult and Pediatric Intensive Care Unit, Fondazione 'San Gerardo dei Tintori,' Monza, Italy., Marche B; Department of Hematology, Policlinico Universitario 'A.Gemelli,' Rome, Italy., Romagnoli S; Department of Anesthesia and Critical Care, University of Florence, 'Careggi' Hospital, Florence, Italy., Scoppettuolo G; Department of Infective Diseases, Policlinico Universitario 'A.Gemelli,' Rome, Italy., Selmi V; Vascular Access Team, Department of Anesthesia and Critical Care, University of Florence, 'Careggi' Hospital, Florence, Italy., Vailati D; Department of Anesthesia and Intensive Care, Melegnano Hospital, Milano, Italy., Villa G; Department of Anesthesia and Critical Care, University of Florence, 'Careggi' Hospital, Florence, Italy., Pepe G; Department of Surgery, Policlinico Universitario 'A.Gemelli,' Rome, Italy.
Jazyk:	angličtina
Zdroj:	The journal of vascular access [J Vasc Access] 2024 Aug 03, pp. 11297298241262932. Date of Electronic Publication: 2024 Aug 03.
DOI:	10.1177/11297298241262932
Abstrakt:	Central venous access devices are essential for the management of critically ill patients, but they are potentially associated with many complications, which may occur during or after insertion. Many evidence-based documents-consensus and guidelines-suggest practical recommendations for reducing catheter-related complications, but they have some limitations. Some documents are not focused on critically ill patients; other documents address only some special strategies, such as the use of ultrasound; other documents are biased by obsolete concepts, inappropriate terminology, and lack of considerations for new technologies and new methods. Thus, the Italian Group of Venous Access Devices (GAVeCeLT) has decided to offer an updated compendium of the main strategies-old and new-that should be adopted for minimizing catheter-related complications in the adult critically ill patient. The project has been planned as a consensus, rather than a guideline, since many issues in this field are relatively recent, and few high-quality randomized clinical studies are currently available, particularly in the area of indications and choice of the device. Panelists were chosen between the Italian vascular access experts who had published papers on peer-reviewed journals about this topic in the last few years. The consensus process was carried out according to the RAND/University of California at Los Angeles (UCLA) Appropriateness Methodology, a modification of the Delphi method, that is, a structured process for collecting knowledge from groups of experts through a series of questionnaires. The final document has been structured as statements which answer to four major sets of questions regarding central venous access in the critically ill: (1) before insertion (seven questions), (2) during insertion (eight questions), (3) after insertion (three questions), and (4) at removal (three questions). Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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