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dc.contributor.authorChun, Tristen T.
dc.contributor.authorJudelson, Dejah R.
dc.contributor.authorSchanzer, Andres
dc.contributor.authorWoo, Karen
dc.date2022-08-11T08:08:11.000
dc.date.accessioned2022-08-23T15:45:51Z
dc.date.available2022-08-23T15:45:51Z
dc.date.issued2020-07-15
dc.date.submitted2020-07-22
dc.identifier.citation<p>Chun TT, Judelson DR, Rigberg D, Lawrence PF, Cuff R, Shalhub S, Wohlauer M, Abularrage CJ, Anastasios P, Arya S, Aulivola B, Baldwin M, Baril D, Bechara CF, Beckerman WE, Behrendt CA, Benedetto F, Bennett LF, Charlton-Ouw KM, Chawla A, Chia MC, Cho S, Choong AMTL, Chou EL, Christiana A, Coscas R, De Caridi G, Ellozy S, Etkin Y, Faries P, Fung AT, Gonzalez A, Griffin CL, Guidry L, Gunawansa N, Gwertzman G, Han DK, Hicks CW, Hinojosa CA, Hsiang Y, Ilonzo N, Jayakumar L, Joh JH, Johnson AP, Kabbani LS, Keller MR, Khashram M, Koleilat I, Krueger B, Kumar A, Lee CJ, Lee A, Levy MM, Lewis CT, Lind B, Lopez-Pena G, Mohebali J, Molnar RG, Morrissey NJ, Motaganahalli RL, Mouawad NJ, Newton DH, Ng JJ, O'Banion LA, Phair J, Rancic Z, Rao A, Ray HM, Rivera AG, Rodriguez L, Sales CM, Salzman G, Sarfati M, Savlania A, Schanzer A, Sharafuddin MJ, Sheahan M, Siada S, Siracuse JJ, Smith BK, Smith M, Soh I, Sorber R, Sundaram V, Sundick S, Tomita TM, Trinidad B, Tsai S, Vouyouka AG, Westin GG, Williams MS Jr, Wren SM, Yang JK, Yi J, Zhou W, Zia S, Woo K. Managing Central Venous Access during a Healthcare Crisis. J Vasc Surg. 2020 Jul 15:S0741-5214(20)31588-3. doi: 10.1016/j.jvs.2020.06.112. Epub ahead of print. PMID: 32682063; PMCID: PMC7362805. <a href="https://doi.org/10.1016/j.jvs.2020.06.112">Link to article on publisher's site</a></p>
dc.identifier.issn0741-5214 (Linking)
dc.identifier.doi10.1016/j.jvs.2020.06.112
dc.identifier.pmid32682063
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27626
dc.description<p>Full author list omitted for brevity. For the full list of authors, see article.</p>
dc.description.abstractINTRODUCTION: 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. In order to participate in the study, hospitals were required to meet one of the following criteria: a) development of a formal plan for a central venous access line team during the pandemic, b) implementation of a central venous access line team during the pandemic, c) placement of central venous access by a designated practice group during the pandemic as part of routine clinical practice, or d) 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 2,657 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(R) catheters and non-tunneled hemodialysis catheters were the most common types of central venous lines placed by the teams. Eight (14%) sites reported experience placing central venous lines in prone, ventilated patients with COVID-19. A dedicated line cart was used by 35 (59%) of hospitals. Less than 50% (24, 41%) of the participating sites reported managing thrombosed central lines in COVID-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 healthcare crisis is a way by which physicians trained in central venous access can contribute their expertise to a stressed healthcare system. A line team composed of physicians with vascular skill sets provides relief to resource-constrained ICU, 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 healthcare crises.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=32682063&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362805/
dc.subjectCOVID-19
dc.subjectpandemic
dc.subjectcentral venous access
dc.subjectvascular access teams
dc.subjectimplementation
dc.subjectEquipment and Supplies
dc.subjectHealth Services Administration
dc.subjectInfectious Disease
dc.subjectSurgery
dc.subjectVirus Diseases
dc.titleManaging Central Venous Access during a Healthcare Crisis
dc.typeJournal Article
dc.source.journaltitleJournal of vascular surgery
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/covid19/77
dc.identifier.contextkey18618148
html.description.abstract<p>INTRODUCTION: 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.</p> <p>METHODS: We conducted a cross sectional, self-reported study of central venous access line teams in hospitals afflicted with the COVID-19 pandemic. In order to participate in the study, hospitals were required to meet one of the following criteria: a) development of a formal plan for a central venous access line team during the pandemic, b) implementation of a central venous access line team during the pandemic, c) placement of central venous access by a designated practice group during the pandemic as part of routine clinical practice, or d) management of an iatrogenic complication related to central venous access in a patient with COVID-19.</p> <p>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 2,657 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(R) catheters and non-tunneled hemodialysis catheters were the most common types of central venous lines placed by the teams. Eight (14%) sites reported experience placing central venous lines in prone, ventilated patients with COVID-19. A dedicated line cart was used by 35 (59%) of hospitals. Less than 50% (24, 41%) of the participating sites reported managing thrombosed central lines in COVID-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).</p> <p>CONCLUSIONS: Implementation of a dedicated central venous access line team during a pandemic or other healthcare crisis is a way by which physicians trained in central venous access can contribute their expertise to a stressed healthcare system. A line team composed of physicians with vascular skill sets provides relief to resource-constrained ICU, 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 healthcare crises.</p>
dc.identifier.submissionpathcovid19/77
dc.contributor.departmentDepartment of Surgery, Division of Vascular and Endovascular Surgery


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