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https://www.readbyqxmd.com/read/28241247/peritoneal-dialysis-vs-furosemide-for-prevention-of-fluid-overload-in-infants-after-cardiac-surgery-a-randomized-clinical-trial
#1
David M Kwiatkowski, Stuart L Goldstein, David S Cooper, David P Nelson, David L S Morales, Catherine D Krawczeski
Importance: Fluid overload after congenital heart surgery is frequent and a major cause of morbidity and mortality among infants. Many programs have adopted the use of peritoneal dialysis (PD) for fluid management; however, its benefits compared with those of traditional diuretic administration are unknown. Objective: To determine whether infants randomized to PD vs furosemide for the treatment of oliguria have a higher incidence of negative fluid balance on postoperative day 1, as well as avoidance of 10% fluid overload; shorter duration of mechanical ventilation, intensive care unit stay, and inotrope use; and fewer electrolyte abnormalities...
February 20, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28240802/impact-of-pay-for-performance-on-access-at-first-dialysis-in-queensland
#2
Jennie Haarsager, Rathika Krishnasamy, Nicholas A Gray
AIM: Commencement of haemodialysis with an arteriovenous fistula (AVF) or arteriovenous graft (AVG) is associated with improved survival compared with commencement with a central venous catheter. In 2011-12, Queensland Health made incentive payments to renal units for early referred patients who commenced peritoneal dialysis (PD), or haemodialysis with an AVF/AVG. The aim of this study was to determine if pay-for-performance improved clinical care. METHODS: All patients who commenced dialysis in Australia between 2009 and 2014 and were registered with the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) were included...
February 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28237984/effect-of-a-quality-improvement-program-to-improve-guideline-adherence-and-attainment-of-clinical-standards-in-dialysis-care-report-of-outcomes-in-year-1
#3
Sajeda Youssouf, Azri Nache, Chandrakumaran Wijesekara, Rachel J Middleton, David Lewis, Aladdin E Shurrab, Edmond O'Riordan, Lesley P Lappin, Donal O'Donoghue, Philip A Kalra, Janet Hegarty
BACKGROUND: Best practice in dialysis is synthesised in clear international guidelines. However, a large gap remains between the international guidelines and the actual delivery of care. In this paper, we report outcomes for the first year of a multifaceted dialysis improvement programme in our network. METHODS: One year collaborative involving 3 haemodialysis units and a peritoneal dialysis (PD) programme involving 299 dialysis patients. Each unit addressed a different indicator (unit A - catheter-related bloodstream infection [CRBSI], unit B - pre-dialysis blood pressure [BP], unit C - dialysis dose, unit D - anaemia) with a shared aim to match the top 10% in the UK...
February 25, 2017: Nephron
https://www.readbyqxmd.com/read/28237090/an-intervention-to-improve-the-catheter-associated-urinary-tract-infection-rate-in-a-medical-intensive-care-unit-direct-observation-of-catheter-insertion-procedure
#4
Janet M Galiczewski, Kathleen M Shurpin
BACKGROUND: Healthcare associated infections from indwelling urinary catheters lead to increased patient morbidity and mortality. AIM: The purpose of this study was to determine if direct observation of the urinary catheter insertion procedure, as compared to the standard process, decreased catheter utilization and urinary tract infection rates. METHODS: This case control study was conducted in a medical intensive care unit. During phase I, a retrospective data review was conducted on utilsiation and urinary catheter infection rates when practitioners followed the institution's standard insertion algorithm...
February 22, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28237047/percutaneous-cholecystostomy-in-the-management-of-high-risk-patients-presenting-with-acute-cholecystitis-timing-and-outcome-at-a-single-institution
#5
S Zarour, A Imam, G Kouniavsky, G Lin, A Zbar, E Mavor
BACKGROUND: Cholecystectomy is the standard of care in acute cholecystitis (AC). Percutaneous cholecystostomy (PC) is an effective alternative for high-risk surgical cases. METHODS: A retrospective analysis is presented of AC patients treated with PC drainage at a single tertiary institution over a 21 month period, assessing outcome and complications. RESULTS: Of 119 patients, 103 had clinical improvement after PC insertion. There were 7 peri-procedural deaths (5...
February 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28231030/safety-of-patient-mobilization-and-rehabilitation-in-the-icu-systematic-review-with-meta-analysis
#6
Peter Nydahl, Thiti Sricharoenchai, Saurabh Chandra, Firuzan Sari Kundt, Minxuan Huang, Magdalena Fischill, Dale M Needham
BACKGROUND: Early mobilization and rehabilitation of patients in intensive care units (ICU) may improve physical function, and reduce the duration of delirium, mechanical ventilation and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. OBJECTIVE: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes (ETT), removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes and desaturation...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#7
Megan Moyer, Bethany Young, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
February 23, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#8
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28228969/prevention-and-treatment-of-neonatal-nosocomial-infections
#9
REVIEW
Jayashree Ramasethu
Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28226988/analysis-and-experimental-simulation-of-blood-pressure-signal-distortions-observed-on-intensive-care-patients-monitored-by-a-catheter-in-radial-artery
#10
Lisa Guigue, Carole Lavault, Francis Grimbert, Yves Lavault, Norbert Noury, Francois R Boucher, Lisa Guigue, Carole Lavault, Francis Grimbert, Yves Lavault, Norbert Noury, Francois R Boucher, Francois R Boucher, Carole Lavault, Lisa Guigue, Yves Lavault, Francis Grimbert, Norbert Noury
The follow-up of patients with hemodynamic instability in intensive care units most often requires blood pressure measurement using a fluid-filled catheter in the radial artery and a fluid-filled tubing connected to a pressure transducer. However, in this usual setup major distortions frequently occur that may alter the pressure signal. Underdamping and overdamping have been well described whereas other types of distortions, including attenuations and varied envelopes of pulse pressure, have been less studied...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225903/sphygmomanometers-and-thermometers-as-potential-fomites-of-staphylococcus-haemolyticus-biofilm-formation-in-the-presence-of-antibiotics
#11
Bruna Pinto Ribeiro Sued, Paula Marcele Afonso Pereira, Yuri Vieira Faria, Juliana Nunes Ramos, Vanessa Batista Binatti, Kátia Regina Netto Dos Santos, Sérgio Henrique Seabra, Raphael Hirata, Verônica Viana Vieira, Ana Luíza Mattos-Guaraldi, José Augusto Adler Pereira
BACKGROUND: The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES: In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated...
March 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28225897/sphygmomanometers-and-thermometers-as-potential-fomites-of-staphylococcus-haemolyticus-biofilm-formation-in-the-presence-of-antibiotics
#12
Bruna Pinto Ribeiro Sued, Paula Marcele Afonso Pereira, Yuri Vieira Faria, Juliana Nunes Ramos, Vanessa Batista Binatti, Kátia Regina Netto Dos Santos, Sérgio Henrique Seabra, Raphael Hirata, Verônica Viana Vieira, Ana Luíza Mattos-Guaraldi, José Augusto Adler Pereira
BACKGROUND: The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES: In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated...
February 16, 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28225642/interventional-management-of-venous-thromboembolism-state-of-the-art
#13
Harish Jarrett, Riyaz Bashir
OBJECTIVE: The purpose of this article is to describe the indications for and approach to catheter-based treatment of acute venous thromboembolism (VTE). CONCLUSION: Catheter-based treatment of VTE is a viable adjunct to anticoagulant therapy and is being rapidly adopted around the United States. Early data suggest that these therapies reduce postthrombotic sequelae and improve quality of life, but bleeding events are still frequent, particularly at low-volume centers...
February 22, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#14
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224103/management-of-parenteral-nutrition-in-critically-ill-patients
#15
REVIEW
Paolo Cotogni
Artificial nutrition (AN) is necessary to meet the nutritional requirements of critically ill patients at nutrition risk because undernutrition determines a poorer prognosis in these patients. There is debate over which route of delivery of AN provides better outcomes and lesser complications. This review describes the management of parenteral nutrition (PN) in critically ill patients. The first aim is to discuss what should be done in order that the PN is safe. The second aim is to dispel "myths" about PN-related complications and show how prevention and monitoring are able to reach the goal of "near zero" PN complications...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28222990/establishing-patient-specific-criteria-for-selecting-the-optimal-upper-extremity-vascular-access-procedure
#16
Karen Woo, Jesus Ulloa, Michael Allon, Christopher G Carsten, Eric S Chemla, Mitchell L Henry, Thomas S Huber, Jeffrey H Lawson, Charmaine E Lok, Eric K Peden, Larry Scher, Anton Sidawy, Melinda Maggard-Gibbons, David Cull
OBJECTIVE: The Kidney Disease Outcome Quality Initiative and Fistula First Breakthrough Initiative call for the indiscriminate creation of arteriovenous fistulas (AVFs) over arteriovenous grafts (AVGs) without providing patient-specific criteria for vascular access selection. Although the U.S. AVF rate has increased dramatically, several reports have found that this singular focus on increasing AVFs has resulted in increased AVF nonmaturation/early failure and a high prevalence of catheter dependence...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#17
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28221281/first-attempt-success-longevity-and-complication-rates-of-ultrasound-guided-peripheral-intravenous-catheters-in-children
#18
Alexandra M Vinograd, Joseph J Zorc, Anthony J Dean, Mary Kate F Abbadessa, Aaron E Chen
OBJECTIVE: The aim of this study was to examine the success rates, longevity, and complications of ultrasound-guided peripheral intravenous lines (USgPIVs) placed in a pediatric emergency department. METHODS: The study analyzed 300 USgPIV attempts in an urban tertiary-care pediatric emergency department. Data regarding USgPIV placement were collected from a 1-page form completed by the clinician placing the USgPIV. The time and reason for USgPIV removal were extracted from the medical record for patients with USgPIVs admitted to the hospital...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28218354/dialysis-access-infections-and-hospitalisations-in-unplanned-dialysis-start-patients-results-from-the-options-study
#19
Anna Machowska, Mark D Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul R Qureshi, Bengt Lindholm, Peter Rutherford
INTRODUCTION: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients. METHODS: In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients...
February 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28217732/knowledge-level-on-administration-of-chemotherapy-through-peripheral-and-central-venous-catheter-among-oncology-nurses
#20
Sevgisun Kapucu, Ayşe Özaydın Özkaraman, Neşe Uysal, Gulcan Bagcivan, Ferhan Çetin Şeref, Aygül Elöz
OBJECTIVE: The aim of this study is to determine the knowledge levels of oncology nurses about peripheral and central venous catheter during their chemotherapy administration. METHODS: Data collection of this descriptive study was started on April 15, 2015-July 15, 2015. The data presented in this summary belong to 165 nurses. Data were collected with data collection form including questions related to sociodemographic qualifications and knowledge levels of nurses...
January 2017: Asia-Pacific Journal of Oncology Nursing
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