Intensive Care Medicine

, Volume 41, Issue 5, pp 735–743

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

  • P. S. C. Rees
  • L. E. M. Lamb
  • T. C. Nicholson-Roberts
  • C. N. Ardley
  • M. S. Bailey
  • D. E. Hinsley
  • T. E. Fletcher
  • S. J. Dickson
Seven-Day Profile Publication

DOI: 10.1007/s00134-015-3736-y

Cite this article as:
Rees, P.S.C., Lamb, L.E.M., Nicholson-Roberts, T.C. et al. Intensive Care Med (2015) 41: 735. doi:10.1007/s00134-015-3736-y

Abstract

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.

Keywords

Ebola virus disease Central venous catheter Volume replacement Circulatory access Resuscitation 

Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • P. S. C. Rees
    • 1
    • 2
  • L. E. M. Lamb
    • 1
  • T. C. Nicholson-Roberts
    • 1
  • C. N. Ardley
    • 1
  • M. S. Bailey
    • 1
  • D. E. Hinsley
    • 1
  • T. E. Fletcher
    • 1
  • S. J. Dickson
    • 1
  1. 1.Academic Department of Military MedicineRoyal Centre for Defence Medicine (Academia and Research), Medical Directorate, Joint Medical Command, ICT Centre, Birmingham Research ParkBirminghamUK
  2. 2.Department of Interventional CardiologySt Bartholomew’s HospitalLondonUK

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