Safety and feasibility of a strategy of early central venous catheter insertion in a deployed UK military Ebola virus disease treatment unit

Purpose Early central venous catheter (CVC) insertion in Ebola virus disease (EVD) is a novel approach and has not previously been described. This report delineates the safety, feasibility and clinical implications of early CVC insertion as the optimum means of vascular access in patients with EVD,...

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Vydáno v:Intensive care medicine Ročník 41; číslo 5; s. 735 - 743
Hlavní autoři: Rees, P. S. C., Lamb, L. E. M., Nicholson-Roberts, T. C., Ardley, C. N., Bailey, M. S., Hinsley, D. E., Fletcher, T. E., Dickson, S. J.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2015
Springer
Springer Nature B.V
Témata:
Adult
Anesthesiology
Antiviral Agents - therapeutic use
Blood
Care and treatment
Catheterization
Catheterization, Central Venous - methods
Catheters
Central Venous Catheters
Critical Care Medicine
Deployment (Strategy)
Development and progression
Ebola virus
Ebola virus infections
Electrolytes
Emergency Medicine
Epidemics
Female
Health care
Hemorrhagic Fever, Ebola - drug therapy
Humans
Intensive
Intensive care
Male
Medical examination
Medicine
Medicine & Public Health
Middle Aged
Military Medicine - methods
Military Personnel
Pain Medicine
Patient Safety
Patients
Pediatrics
Personal protective equipment
Pneumology/Respiratory System
Research parks
RNA polymerase
Seven-Day Profile Publication
Sierra Leone
Time Factors
United Kingdom
Virus diseases
Young Adult
United Kingdom
United Kingdom > UK
Sierra Leone
British Isles
Central venous catheter
Volume replacement
Circulatory access
Resuscitation
Ebola virus disease
ISSN:0342-4642, 1432-1238
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Shrnutí:Purpose Early central venous catheter (CVC) insertion in Ebola virus disease (EVD) is a novel approach and has not previously been described. This report delineates the safety, feasibility and clinical implications of early CVC insertion as the optimum means of vascular access in patients with EVD, in the setting of a deployed military Ebola virus disease treatment unit in Sierra Leone. Methods In the gastrointestinal phase of EVD, a 7-French 20-cm triple-lumen CVC was inserted using aseptic technique. Data were collected prospectively on all cases to include baseline and subsequent blood test variables, insertion site and technique, and complications associated with CVC placement. Results Twenty-three patients underwent CVC insertion as follows: subclavian, 21 (88 %); internal jugular, 2 (8 %); axillary, 1 (4 %). The mean duration of CVC placement was 5 days. There were no significant procedure-related adverse events. Despite coagulopathy being present in 75 % of cases, CVC insertion was safe, and there was only 1 case of significant catheter site bleeding. A total of 152 needle venepunctures were avoided owing to the presence of a CVC, a mean of 7 (±3.8) per case over the average stay. Conclusion The early use of CVCs in Ebola virus disease is safe, effective and facilitates patient care. It should be considered a feasible additional route of venous access, where physician expertise and resources allow.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-015-3736-y