Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thrombotic occlusion of Hickman and Broviac central venous catheters is a serious obstacle to their long-term use. Because resistance to flow (R) through a catheter of lumen radius, r, is proportional to 1/r4, we hypothesized that measurement of R would provide an objective and sensitive monitor for partial occlusions. Our measurements showed that median R at a flow of 17 mL/min was 0.7 cmH2O/mL/min in normally functioning Hickman catheters, and 4.1 cmH2O/mL/min in Broviac catheters. In obstructed catheters, which by subjective standards resisted flushing or blood withdrawal, median R was 3.0 cmH2O/mL/min for Hickman and 5.6 cmH2O/mL/min for Broviac catheters, representing significant increases. In a series of obstructed lines in which urokinase was administered, R decreased from 7.7 to 4.5 in Hickman catheters and from 5.6 to 4.2 in obstructed Broviac catheters. The elevated resistance in Hickman catheters after urokinase suggested that residual catheter obstruction was present even though catheter function returned to normal. Elevated R was seen with abnormal venograms in seven of 13 patients. Four patients had normal R values and abnormal venograms, and two patients had elevated R values with normal venograms. Measurement of resistance in Hickman and Broviac catheters provides a simple technique that can supplement or replace venography in the serial assessment and treatment of partial obstruction.
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PMID:Early detection and simplified management of obstructed Hickman and Broviac catheters. 270 89

The purpose of this study was to compare angiography and angioscopy for the detection of thrombus during coronary interventional procedures. The diagnosis of coronary thrombus has important clinical implications. Angioscopy can directly visualize the coronary luminal surface and may be more accurate than angiography in the diagnosis of thrombus. Angiography and angioscopy were sequentially performed in 75 patients undergoing a variety of interventional cardiology procedures during 117 distinct procedural time points. The angiographic presence of thrombus was defined as a noncalcified filling defect outlined on at least 3 sides by contrast media. The angioscopic presence of thrombus was defined as red material protruding into the lumen (intraluminal thrombus) or adherent to the luminal wall (mural thrombus) that persisted despite flushing. Thrombus was detected on 14 occasions (12.0%) by angiography compared with 48 (41.0%) by angioscopy (p < 0.05). In 4 of the 14 episodes (28.6%) of angiographic filling defects, angioscopy found no evidence of thrombus and provided an alternative explanation for the angiographic filling defect. When angioscopy was used as a reference standard, the sensitivity of thrombus detection by angiography was 20.8%, with a specificity of 94.2% and a predictive value of 71.4%. The sensitivity of angiography for the detection of intraluminal (protruding into the lumen) thrombus was 100% compared with only 10% for mural (adherent to the luminal wall) thrombus (p < 0.05). Angioscopy was significantly more accurate than angiography for detecting coronary thrombus and may be considered an improved reference standard for this diagnosis.
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PMID:Angioscopic versus angiographic detection of thrombus during coronary interventional procedures. 776 89

Thrombotic occlusion is frequently a complication of central venous catheters (CVCs). The original designers and producers of CVCs recommended heparin flush regimens to prevent thrombosis and maintain patency. This has become standard practice although no studies have demonstrated a relationship between heparin flushing and reduction of catheter thrombosis. Many consider the routine use of heparin flushing innocuous. However, serious complications including drug interactions and heparin induced thrombocytopenia and thrombosis syndrome (HITS) have been reported in association with heparin flushing. Numerous studies comparing heparin to saline flushing in peripheral devices suggest equal rates of thrombotic occlusions. The purpose of this study was to examine the incidence of thrombotic occlusions in CVCs using heparin compared to saline flushing. The study involved 78 cancer patients undergoing apheresis collection for peripheral blood stem cells; 29 received saline flushes and 49 received heparin (100 U/ml of saline) flushes. Study endpoints included slow apheresis flow rate (< 50 ml/min), urokinase use for thrombolysis, and radiographic evidence of catheter thrombosis. No significant differences were found for any endpoint between the two groups. These findings suggest saline may be as effective as heparin for maintaining patency of CVCs.
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PMID:Normal saline versus heparin flush for maintaining central venous catheter patency during apheresis collection of peripheral blood stem cells (PBSC). 1017 83

The symptoms that result from compression of the superior vena cava are known as superior vena cava syndrome. The syndrome was originally described as secondary to infection such as tuberculosis or syphilitic aortic aneurysm. Currently, the origin is generally cancer or thrombotic events. Adenocarcinoma of the lung is the most common cause. Thrombotic causes are increasing because of the rise in use of pacemakers and central venous catheters for access or treatment purposes. Symptoms may include a feeling of fullness in the head, dyspnea, and cough. Clinical findings may include facial and neck swelling; dilated venous channels over the trunk, upper extremities, and neck; facial flushing; cyanosis; respiratory stridor and distress; and neurologic signs. Primary symptoms are in the neck and head. Treatment of superior vena cava syndrome will depend on the cause of the compression. If thrombosis is found, thrombolysis and anticoagulation may be indicated. With carcinoma or infection, specific drugs or radiation may be used. In cases of compression, dilation and stenting of the superior vena cava may be performed. In some cases a bypass of the superior vena cava may be indicated.
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PMID:Superior vena cava syndrome. 1732 62

A prospective analysis was conducted comparing dysfunction attributable to catheter thrombosis in subjects who received a heparin catheter lock three times a week (n = 15) to those who received a heparin lock six times a week (n = 15) immediately after the insertion of a temporary haemodialysis catheter. Thrombus related catheter removal occurred in two patients in control but no patients in the experiment group. Heparin locking six times a week was found to be effective in prolonging the mean of the first day where difficulty was experienced in aspiration. It also prevented any possible difficulty in catheter flushing. Increased locking frequency prevents any thrombus accumulation within the temporary catheter, while it has limited but significant preventive effect on thrombus accumulated around the catheter.
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PMID:Impact of heparin locking frequency on preventing temporary dialysis catheter dysfunction in haemodialysis patients. 1943 56