The fellows stitch: Large caliber venous hemostasis in pediatric practice
| Autor: | Lee N. Benson, Rajiv C. Chaturvedi, Tadashi Waragai, Lucas Eastaugh, Kyong-Jin Lee, Gareth J. Morgan |
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| Rok vydání: | 2011 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Catheters Adolescent medicine.medical_treatment Vascular ultrasound Hemorrhage Punctures Suture (anatomy) Pressure Humans Medicine Radiology Nuclear Medicine and imaging Vascular closure device Child Retrospective Studies Cardiac catheterization Ontario Pediatric practice Interventional cardiology Hemostatic Techniques business.industry Suture Techniques Age Factors Infant Equipment Design General Medicine Femoral Vein Surgery Treatment Outcome Caliber Child Preschool Anesthesia Hemostasis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Catheterization and Cardiovascular Interventions. 80:79-82 |
| ISSN: | 1522-1946 |
| DOI: | 10.1002/ccd.23406 |
| Popis: | Objective: To analyze safety and efficiency of a subcutaneous figure of eight suture for hemostasis after large caliber venous sheath access in children. Background: Vascular complications remain a significant cause of morbidity after pediatric cardiac catheterization. In an attempt to reduce such complications and yet improve lab efficiency and decrease length of stay, various techniques have been applied to improve time to hemostasis. Methods: Prospectively recorded were vascular complications and hemostasis times in children where hemostasis was attempted using a figure of eight subcutaneous suture following large caliber venous cannulation. These were compared to a matched group achieving hemostasis using standard manual pressure techniques. Vascular ultrasound assessments were performed within 24 hr of hemostasis in both groups. Results: Thirty-two subcutaneous sutures were placed in 26 children, mean weights 31.9 kg [median (range): 29.4 (8.4 to 96) kg], with a mean sheath French size of 9.2 [8; (6 to 22)], 11 >10 French, compared to 33 sheaths in 30 cases using manual compression, mean sheath French size 9.1 (9; (6 to 13), with 10 cases ≥10 French. The mean and median times to hemostasis were shorter in the suture group: 13.6 min (P < 0.05) and 10 min (P < 0.05), respectively. Vascular complication rate was also lower in the suture group (n = 0) compared with the control group (n = 2) but did not achieve statistical significance. Conclusions: A subcutaneous figure of eight suture hemostasis strategy can provide a safe and efficient method for large caliber venous hemostasis in a pediatric practice with improved hemostasis times and no additional morbidity. © 2011 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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