Safety multifly

Several blood cultures were employed to detect pathogens that propagate through the blood stream. A minimum of 20 ml of blood was taken through venipuncture with a blood-collection needle (Safety-Multifly®, SARSTEDT, Nümbrecht, Germany) and injected into two specific media—BACTEC Plus Aerobic/F and Plus Anaerobic/F medium (BD, Becton, Dickinson and Company, Heidelberg, Germany).

Blood from patients with COVID-19 pneumonia, community acquired pneumonia and from volunteers was drawn by venipuncture (21-gauge needles) or aspiration through venous catheters (Safety-Multifly, Sarstedt AG & Co, Nümbrecht, Germany). In ICU patients (COVID-19 ARDS or sepsis), blood sampling was performed at admission to the intensive care facility using 20-gauge catheters within the radial artery (8 cm polyethylene catheter, Vygon, Aachen, Germany). In a previous study, we showed that arterial vs. venous blood sampling has non-significant effects on EV miRNA expression (19 (link)). Blood was drawn into 9 ml serum collection tubes (S-Monovette, Sarstedt AG&Co, Nümbrecht, Germany), allowed to clot for 30 min and centrifuged at 3,400 x g for 10 min at room temperature. Within 10 min of separation, serum was aliquoted and immediately stored at -80°C. Whole blood samples for cellular RNA extraction were collected in PAXgene tubes (PAXgene, Qiagen, Hilden, Germany) in accordance with the supplier’s protocol.

PS was performed under sterile conditions, general anaesthesia and fluoroscopy guidance (Artis zee; Siemens, Forchheim, Germany). General anesthesia was performed to prevent discomfort, agitation and pain (which was observed several times in our institution during sclerotherapy under local anesthesia before the study period). Percutaneous puncture of the VMs was performed using 21 G or 23 G needles with a length of 19 mm, connected to a 200x2.3 mm plastic tube (Safety-Multifly; Sarstedt AG & Co. KG, Nümbrecht, Germany). After puncture using one or two needles, proper position was confirmed by spontaneous backflow of blood into the plastic tube and by performing a digital subtraction angiography of the VM using iodinated contrast agent (Solutrast 300, Bracco Imaging, Konstanz, Germany). According to the Tessari technique, in most of the cases, air and sclerosing agent were primarily compounded in a ratio, ranging from 1:2 to 1:1, applying a double-syringe-system-technique [18 (link)].

At least 20 ml of blood was taken through venipuncture with a blood-collection needle (Safety-Multifly®, SARSTEDT, Nümbrecht, Germany) and injected into two specific media: BACTEC Plus Aerobic/F and Plus Anaerobic/F medium (BD, Becton, Dickinson and Company, Heidelberg, Germany).