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"Central Line" OR "Central Venous Line"

Anita J Campbell, Christopher C Blyth, Christopher J Hewison, Yu-Ping Chen, Leanne Gough, Zoy Goff, Asha C Bowen
AIM: Bacteraemia episodes were assessed to calculate a hospital-wide central line-associated blood stream infection (CLABSI) rate per 1000 catheter-days. Secondary objectives were to describe risk factors, microbiology and outcomes of children with CLABSI. METHODS: A retrospective study was conducted at an Australian tertiary paediatric hospital in children <18 years who had blood culture sampling during the 2-year period, 2014-2015. All blood culture results were extracted from the hospital's laboratory information system...
October 13, 2018: Journal of Paediatrics and Child Health
Zhaoyu Xiong, Haiyan Chen
OBJECTIVE: To identify, describe, and evaluate interventions to reduce unnecessary central venous catheter (CVC) use to prevent central-line-associated bloodstream infections (CLABSIs) in adults. DESIGN: Systematic review. METHODS: The review has been registered in PROSPERO, an international prospective register of systematic reviews. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cumulative Index to Nursing and Allied Health (CINAHL) from inception until August 28, 2018, to collect experimental and observational studies...
October 11, 2018: Infection Control and Hospital Epidemiology
Satyaranjan Pegu, Poornima Murthy
The ease of access and advantages of a secure central line makes use of umbilical venous catheter (UVC) and umbilical artery catheters a part of the standard of care in the extremely premature babies in the neonatal intensive care unit. However, there are complications associated with their use. One of the uncommon complications reported is total parenteral nutrition (TPN) ascites secondary to vessel perforation or hepatic erosion by the tip of the catheter due to malposition of a UVC. We present here a case of such catheter perforation causing ascites and right hepatic collection of TPN in a 28-week-old infant...
October 8, 2018: BMJ Case Reports
Cory N Criss, Samir K Gadepalli, Niki Matusko, Marcus D Jarboe
BACKGROUND: Use of ultrasound-guidance for central venous access in adults is the standard of care. There is, however, less clarity in the role of routine ultrasound use in obtaining venous access in children. We sought to evaluate safety and efficiency of the placement of central lines utilizing an ultrasound-guided approach compared to the traditional, landmark approach in pediatric patients. STUDY DESIGN: A single-institution retrospective chart review, using CPT codes, was performed for all tunneled central venous catheters in children between 2005 and 2017 by the same pediatric surgery group...
September 13, 2018: Journal of Pediatric Surgery
Alexandra M Hanretty, Ishminder Kaur, Alan T Evangelista, Wayne S Moore, Adela Enache, Arun Chopra, Jeffrey J Cies
INTRODUCTION: Meropenem-vaborbactam is a new β-lactam/β-lactamase inhibitor combination designed to target Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae. Meropenem-vaborbactam was Food and Drug Administration FDA approved for complicated urinary tract infections (cUTI) in patients 18 years of age or older. An understanding of the pharmacokinetics of meropenem when given in combination with vaborbactam is important to understanding the dosing of meropenem-vaborbactam...
October 9, 2018: Pharmacotherapy
Stephen Y Liang, Madison Riethman, Josephine Fox
The emergency department (ED) presents unique challenges to infection control and prevention. Hand hygiene, transmission-based precautions, environmental cleaning, high-level disinfection and sterilization of reusable medical devices, and prevention of health care-associated infections (catheter-associated urinary tract infection, ventilator-associated pneumonia, central line-associated bloodstream infection) are key priorities in ED infection prevention. Effective and sustainable infection prevention strategies tailored to the ED are necessary and achievable...
November 2018: Emergency Medicine Clinics of North America
Warren Clements, David Sneddon, Helen Kavnoudias, Tim Joseph, Gerard S Goh, Jim Koukounaras, Thomas Snow
INTRODUCTION: Interventional Radiology procedures can provoke anxiety and may be painful. Current practice, Radiologist Controlled Sedation (RCS), involves titrating aliquots of midazolam and fentanyl to patient response but underdosing and overdosing may occur. This study tests a new method of titrating sedation/analgesia during the procedure, Patient Controlled Sedation (PCS), in which a combination of fentanyl and midazolam are administered using a patient-controlled analgesia pump...
October 8, 2018: Journal of Medical Imaging and Radiation Oncology
Yannick Wouters, Britt Roosenboom, Erna Causevic, Wietske Kievit, Hans Groenewoud, Geert J A Wanten
BACKGROUND & AIMS: Central venous access device (CVAD)-related complications, such as central-line associated bloodstream infections (CLABSIs), CVAD-related venous thromboses (CRVTs) and -occlusions frequently occur in home parenteral nutrition (HPN) patients. A preventive strategy to decrease the incidence of CLABSIs is the use of CVAD lock solutions, such as 2% taurolidine. The aim of this study was to evaluate long-term clinical outcomes of our HPN cohort while using taurolidine as lock solution...
September 20, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Isabelle M Werner, Markus J Ernst, Julia Treleaven, Rebecca J Crawford
BACKGROUND: Pattern tracing tasks can be used to assess cervical spine movement sense (CMS). A simple clinical measure of CMS (tracing fixed figure-of-eight (F8) and zigzag (ZZ) patterns with a head mounted laser) has been proposed and assessed in asymptomatic subjects. It is important to determine if examiner ratings of the traces are reliable and feasible for clinical use in those with neck pain. We therefore examined the intra- and inter-rater reliability of rating video recordings of the CMS tasks, and the feasibility of undertaking the tests in clinic by comparing slow motion versus real-time video ratings...
October 5, 2018: BMC Musculoskeletal Disorders
Shayne D Hauglum, Nichole A Crenshaw, Karina A Gattamorta, Greta Mitzova-Vladinov
INTRODUCTION: Ultrasound-guided central venous catheter insertion (UGCVC) is a commonly performed procedure taught through simulation. The aims of the study were to examine the utilization of an animal model and compare it with two currently used Blue Phantom central line models to determine whether an animal model provides good or better simulated conditions for the performance of UGCVC insertion. METHODS: Using a randomized cross-over study, 46 advanced practice nursing students were assessed using a task-specific performance tool in their performance of UGCVC insertion on both the animal model and the Blue Phantom models...
October 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Bart Rijnders, Gino DiSciullo, Botond Csiky, Boleslaw Rutkowski, Krzysztof Appelt, John Cheronis, Roger Aitchison, Gilad Gordon, Michel Jadoul, Richard Fluck
Background: Central line associated bloodstream infections(CLABSI) often result from intraluminal microbial colonization and are associated with morbidity, mortality, and substantial costs. The use of antimicrobial catheter lock solutions may reduce the incidence of CLABSI. Methods: Patients undergoing hemodialysis through a prevalent central venous catheter(CVC) were randomly assigned to have their CVC locked between dialysis sessions with an antimicrobial catheter lock solution containing trimethoprim 5 mg/mL, Ethanol 25% and Ca-EDTA 3%(Investigational Medical Device, IMD) or heparin 5,000 U/mL(Active Control Heparin, ACH)...
October 3, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Nobuhiko Arai, Yutaka Mine, Hiroshi Kagami, Makoto Inaba
BACKGROUND: Catheter-related blood stream infection (CRBSI) is one of the most common intractable healthcare-associated infections because catheters can be easily contaminated by resistant bacteria, and is associated with a high mortality. Central lines are currently used for administering medication to patients with severe stroke, and may thus cause CRBSI. CASE PRESENTATION: A 71-year-old woman with cirrhosis presented with subarachnoid hemorrhage (SAH) that was treated by clipping surgery...
September 29, 2018: BMC Neurology
Carlo Pallotto, Maurizio Fiorio, Verena De Angelis, Andrea Ripoli, Elisabetta Franciosini, Lucilla Quondam Girolamo, Francesca Volpi, Paolo Iorio, Daniela Francisci, Carlo Tascini, Franco Baldelli
OBJECTIVES: to investigate whether daily bathing with a soap-like solution of 4% chlorhexidine (CHG) followed by water rinsing (CHGwr) would decrease the incidence of hospital acquired infections (HAI) in intensive care settings. METHODS: randomized, controlled trial; infectious diseases specialists were blinded to the intervention status. All patients admitted to the Intensive Care Unit (ICU) and to the Post-operative Cardiosurgical Intensive Care Unit (PC-ICU) of the University Hospital of Perugia were enrolled and randomized to intervention arm (daily bathing with 4% CHGwr) or to control arm (daily bathing with standard soap)...
September 26, 2018: Clinical Microbiology and Infection
Jarone Lee, J Matthew Austin, Jungyeon Kim, Paola D Miralles, Haytham M A Kaafarani, Peter J Pronovost, Vipra Ghimire, Sean M Berenholtz, Karen Donelan, Elizabeth Martinez
Quality measures are increasingly used to measure the performance of providers, hospitals, and health care systems. Intensive care units (ICUs) are an important clinical area in hospitals, given that they generate high costs and present high risks to patients. Yet, currently, few valid and clinically significant ICU-specific outcome measures are reported nationally. This study reports on the creation and evaluation of new abstraction tools that evaluate ICU patients for the following clinically important outcomes: central line-associated bloodstream infection, methicillin-resistant Staphylococcus aureus, gastrointestinal bleed, and pressure ulcer...
September 28, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Sara L Bonnes, Manpreet S Mundi, Ryan T Hurt, Bradley R Salonen
PURPOSE OF REVIEW: Catheter-related blood stream infections (CRBSI) pose a significant risk to patients on home parenteral nutrition (HPN). Recurrent loss of catheters can lead to scarring and eventual loss of central access, a potentially fatal situation for patients dependent on HPN. RECENT FINDINGS: In the past, the standard of care to treat these infections required catheter removal. More recently, several studies have indicated that many CRBSI can be treated without removal of the catheter...
September 28, 2018: Current Nutrition Reports
Alissa S Chen, Lee Revere, Alissa Ratanatawan, Christopher L Beck, Julio A Allo
Academic hospitals contribute to health care through patient care, research, and teaching; however, their outcomes may not be equivalent to nonacademic hospitals. Multivariate analysis of variance is used to compare publicly reported data on patient satisfaction, readmission rates, mortality rates, and hospital-acquired injury scores between 1906 academic and nonacademic hospitals, while controlling for hospital-level covariates. Results show that academic hospitals have higher levels of patient satisfaction on 7 of the 11 measures and are equivalent to nonacademic hospitals on the remaining 4 measures...
September 23, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Molly Bannatyne, Judith Smith, Malavika Panda, Mohamed E Abdel-Latif, Tejasvi Chaudhari
Background: Central Line Associated Bloodstream Infections (CLABSI) constitute a leading cause of morbidity and mortality in neonatal populations. There has been an overwhelming increase in the use of evidence-based care practices, also known as bundles, in the reduction of these infections. In this report, rates of CLABSI and central line utilisation were examined following the introduction of a central line bundle in our Neonatal Intensive Care Unit (NICU) at the Canberra Hospital. Methods: The research undertaken was a retrospective cohort study in which newborn infants admitted to the Canberra Hospital NICU between January 2011 and December 2016 and had a central line inserted were included in the study...
2018: International Journal of Pediatrics
Julia Johnson, Nuntra Suwantarat, Elizabeth Colantuoni, Tracy L Ross, Susan W Aucott, Karen C Carroll, Aaron M Milstone
OBJECTIVE: To assess the impact of chlorhexidine gluconate (CHG) bathing on skin bacterial burden in neonates. STUDY DESIGN: In this prospective observational study, arm and groin skin bacterial growth was measured in 40 CHG-exposed and nonexposed neonates admitted to the NICU. Exposed neonates received 2% CHG baths per protocol for central line-associated bloodstream infection (CLABSI) prevention or Staphylococcus aureus decolonization. RESULTS: Forty neonates were enrolled, 18 of whom were CHG-exposed...
September 20, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Kathryn Watson, Ada Lam, Shane Arishenkoff, Samantha Halman, Neil E Gibson, Jeffrey Yu, Kathryn Myers, Marcy Mintz, Irene W Y Ma
BACKGROUND: Significant gaps currently exist in the Canadian internal medicine point-of-care ultrasound (POCUS) curriculum. From a learner's perspective, it remains unknown what key POCUS skills should be prioritized. This needs assessment study seeks to establish educational priorities for POCUS for internal medicine residents at five Canadian residency training programs. METHODS: All internal medicine trainees [postgraduate year (PGY) 1-5] from five internal medicine residency training programs in Canada (n = 598) were invited to complete an online survey on 15 diagnostic POCUS applications, 9 bedside procedures, and 18 POCUS knowledge items...
September 20, 2018: BMC Medical Education
Thomas W Conlon, Adam S Himebauch, Anne Marie Cahill, Blair M Kraus, Chinonyerem R Madu, Mark D Weber, Carol A Czajka, Ruby L Baker, Torron M Brinkley, Melanie D Washington, Anne Marie Frey, Eileen M Nelson, Cara T Jefferies, Charlotte Z Woods-Hill, Heather A Wolfe, Daniela H Davis
OBJECTIVES: To create a bedside peripherally inserted central catheter service to increase placement of bedside peripherally inserted central catheter in PICU patients. DESIGN: Two-phase observational, pre-post design. SETTING: Single-center quaternary noncardiac PICU. PATIENTS: All patients admitted to the PICU. INTERVENTIONS: From June 1, 2015, to May 31, 2017, a bedside peripherally inserted central catheter service team was created (phase I) and expanded (phase II) as part of a quality improvement initiative...
September 17, 2018: Pediatric Critical Care Medicine
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