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Pleural catheter AND infection

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https://www.readbyqxmd.com/read/30037711/aggressive-versus-symptom-guided-drainage-of-malignant-pleural-effusion-via-indwelling-pleural-catheters-ample-2-an-open-label-randomised-trial
#1
Sanjeevan Muruganandan, Maree Azzopardi, Deirdre B Fitzgerald, Ranjan Shrestha, Benjamin C H Kwan, David C L Lam, Christian C De Chaneet, Muhammad Redzwan S Rashid Ali, Elaine Yap, Claire L Tobin, Luke A Garske, Phan T Nguyen, Christopher Stanley, Natalia D Popowicz, Christopher Kosky, Rajesh Thomas, Catherine A Read, Charley A Budgeon, David Feller-Kopman, Nick A Maskell, Kevin Murray, Y C Gary Lee
BACKGROUND: Indwelling pleural catheters are an established management option for malignant pleural effusion and have advantages over talc slurry pleurodesis. The optimal regimen of drainage after indwelling pleural catheter insertion is debated and ranges from aggressive (daily) drainage to drainage only when symptomatic. METHODS: AMPLE-2 was an open-label randomised trial involving 11 centres in Australia, New Zealand, Hong Kong, and Malaysia. Patients with symptomatic malignant pleural effusions were randomly assigned (1:1) to the aggressive (daily) or symptom-guided drainage groups for 60 days and minimised by cancer type (mesothelioma vs others), performance status (Eastern Cooperative Oncology Group [ECOG] score 0-1 vs ≥2), presence of trapped lung, and prior pleurodesis...
July 20, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/30003096/risk-factors-related-to-peripherally-inserted-central-venous-catheter-nonselective-removal-in-neonates
#2
Xiaohe Yu, Shaojie Yue, Mingjie Wang, Chuanding Cao, Zhengchang Liao, Ying Ding, Jia Huang, Wen Li
We aimed to investigate the incidence and risk factors associated with nonselective removal of peripherally inserted central venous catheter (PICC) in neonates. In this prospective cohort study, neonates who underwent PICC placement at neonatal intensive care units (NICUs) in China from October 2012 to November 2015 were included. The patient demographics, catheter characteristics, catheter duration, PICC insertion site, indication for PICC insertion, infuscate composition, PICC tip location, and catheter complications were recorded in a computerized database...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29997964/a-comparison-between-two-types-of-indwelling-pleural-catheters-for-management-of-malignant-pleural-effusions
#3
Sushilkumar Satish Gupta, Charalampos S Floudas, Abhinav B Chandra
Background: Malignant pleural effusion (MPE) is a common cause of quality of life deterioration in patients with advanced cancer. Management options include chemical pleurodesis with a sclerosing agent such as doxycycline or talc powder, surgery, and also the placement of tunneled indwelling pleural catheters (IPCs). Two different IPC types are mostly used in the USA. Methods: We conducted a single-center retrospective study with the objective to compare the efficacy and safety profiles of two IPC systems...
May 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629920/pleural-effusions-in-hematologic-malignancies-and-their-management-with-indwelling-pleural-catheters
#4
Erik Vakil, Carlos A Jimenez, Saadia A Faiz
PURPOSE OF REVIEW: Pleural effusions in patients with hematologic malignancy may represent malignant pleural effusion (MPE) or occur secondary to infection, treatment effects, and other common causes. The impact of MPE on prognosis in this cohort remains unclear. Indwelling pleural catheters (IPCs) are routinely placed for palliation of recurrent symptomatic MPEs, but perceived concerns over infection and bleeding may limit their use in patients with hematologic malignancies. However, recent evidence suggests IPCs are both well tolerated and effective in this cohort...
July 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29478341/the-role-of-pleurodesis-in-respiratory-diseases
#5
Rachel M Mercer, Maged Hassan, Najib M Rahman
Pleurodesis is used to obliterate the pleural space, most commonly in patients with symptomatic malignant pleural effusions but also in patients with benign effusions or pneumothorax. Areas covered: Traditionally, chemical pleurodesis has been undertaken at thoracoscopy or using instillation of a slurry through a chest drain. The optimum method of achieving pleurodesis, whether surgical or medical, has yet to be proven. Evidence in the different disease areas will be reviewed, along with ongoing trial evidence, which may change practice...
April 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29372629/chest-tube-drainage-of-the-pleural-space-a-concise-review-for-pulmonologists
#6
REVIEW
José M Porcel
Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains...
April 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29367358/recurrent-migration-of-peripherally-inserted-central-catheter-into-the-azygos-vein
#7
Goutham Talari, Preetham Talari, Saurabh Parasramka, Aibek E Mirrakhimov
Peripherally inserted central catheter (PICC) migration into azygos vein (AV) is a rare complication. It is recognised only when catheter malfunction occurs or when patients develop associated complications. PICC migration into AV has been reported to be associated with various complications such as catheter malfunction, perforation, haemorrhage, thrombosis, infection and stenosis of AV. Pleural effusion and trachea-azygos fistulas have also been reported. We present a patient with recurrent migration of PICC into AV after an initial corrective repositioning during the same hospital stay...
January 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29346248/the-utility-of-ultrasound-to-diagnose-tunnel-tract-infection-related-to-indwelling-pleural-catheters
#8
Jose Cardenas-Garcia, Neal Fitzpatrick, George Z Cheng
Indwelling pleural catheter (IPC) infections lead to increased morbidity and treatment failure in patients with chronic recurrent pleural effusions. Ultrasonography is a readily available diagnostic tool used by pulmonologists on a daily basis. Ultrasonography has been used to identify the etiology of indwelling peritoneal catheter obstruction, including infection of the exit site and tunnel tract. The use of ultrasonography to identify tunnel-tract infection involving IPC has not been reported. We describe the ultrasonographic characteristics of 3 cases of confirmed tunnel-tract infection and compared them with noninfected chronic IPCs...
July 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29325199/-efficacy-and-safety-of-indwelling-pleural-catheters
#9
Eva Lücke, Uwe Steffen, Sandra Riedel, Jens Schreiber
In symptomatic malignant pleural effusions, mostly in a palliative situation, therapeutic procedures should be chosen to improve dyspnoea and the concomitant impairment of quality of life. Indwelling pleural catheters (IPC) have played an increasing role in recent years. The efficacy and safety of this method have not been adequately clarified under real-life clinical conditions. 94 patients, in whom IPC had been implanted because of a clinical indication, were analysed retrospectively with respect to efficacy and safety, together with patient characteristics, peri- and postinterventional complications, e...
June 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29188375/tunneled-pleural-catheter-use-for-pleural-palliation-does-not-increase-infection-rate-in-patients-with-treatment-related-immunosuppression
#10
Candice L Wilshire, Christopher R Gilbert, Brian E Louie, Ralph W Aye, Alexander S Farivar, Eric Vallières, Jed A Gorden
PURPOSE: Concerns for infections resulting from antineoplastic therapy-associated immunosuppression may deter referral for symptom palliation with a tunneled pleural catheter (TPC) in patients with malignant/para-malignant pleural effusions (MPE/PMPE). While rates of TPC-related infections range from 1 to 21%, those in patients receiving antineoplastic therapy with correlation to immune status has not been established. We aimed to assess TPC-related infection rates in patients on antineoplastic therapy, determine relation to immune system competency, and assess impact on the patient...
May 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29124008/rare-complicated-parapneumonic-effusion-mycoplasma-pneumoniae-with-new-onset-lupus-flare-case-report-and-literature-review
#11
Bharat Bajantri, Shaik Danial, Richard Duncalf, Misbahuddin Khaja
Mycoplasma pneumoniae has been associated with respiratory tract infections. Mycoplasma pneumoniae pneumonia-related pleural effusion is rarely reported. Extra-pulmonary abnormalities such as encephalitis, myocarditis, glomerulonephritis, and myringitis have been reported. However pulmonary manifestations in systemic lupus erythematosus include pneumonitis, pleurisy, interstitial lung disease, and thromboembolic disease. We present the case of a 26-year-old male who came for evaluation of fever, cough, and shortness of breath with right-sided chest pain...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28918827/indwelling-pleural-catheters-for-nonmalignant-effusions-evidence-based-answers-to-clinical-concerns
#12
REVIEW
David Maurice Chambers, Bilal Abaid, Umair Gauhar
Pleural effusions occur in 1.5 million patients yearly and are a common cause of dyspnea. For nonmalignant effusions, initial treatment is directed at the underlying cause, but when effusions become refractory to medical therapy, palliative options are limited. Tunneled pleural catheters (TPCs) are commonly used for palliation of malignant effusions, but many clinicians are reluctant to recommend these devices for palliation of nonmalignant effusions, citing concerns of infection, renal failure, electrolyte disturbances and protein-loss malnutrition...
September 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28409042/nephrologists-hate-the-dialysis-catheters-a-systemic-review-of-dialysis-catheter-associated-infective-endocarditis
#13
Kalyana C Janga, Ankur Sinha, Sheldon Greenberg, Kavita Sharma
A 53-year-old Egyptian female with end stage renal disease, one month after start of hemodialysis via an internal jugular catheter, presented with fever and shortness of breath. She developed desquamating vesiculobullous lesions, widespread on her body. She was in profound septic shock and broad spectrum antibiotics were started with appropriate fluid replenishment. An echocardiogram revealed bulky leaflets of the mitral valve with a highly mobile vegetation about 2.3 cm long attached to the anterior leaflet...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28359216/revisiting-ultrasound-guided-subclavian-axillary-vein-cannulations-importance-of-pleural-avoidance-with-rib-trajectory
#14
Mourad H Senussi, Phani C Kantamneni, Ali Omranian, Mani Latifi, Tarik Hanane, Eduardo Mireles-Cabodevila, Neal F Chaisson, Abhijit Duggal, Ajit Moghekar
The Centers for Disease Control and Prevention guidelines for the prevention of catheter-related bloodstream infections suggest using "a subclavian site, rather than an internal jugular or a femoral site, in adult patients." This recommendation is based on evidence of lower rates of thrombosis and catheter-related bloodstream infections in patients with subclavian central venous catheters (CVCs) compared to femoral or internal jugular sites. However, preference toward a subclavian approach to CVC insertion is hindered by increased risk of mechanical complications, especially pneumothorax, when compared to other sites...
July 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28315045/late-onset-chest-wall-abscess-due-to-a-biodegradable-rib-pin-infection-after-lung-transplantation
#15
Yasufumi Goda, Toyofumi F Chen-Yoshikawa, Masaaki Kusunose, Masatsugu Hamaji, Hideki Motoyama, Kyoko Hijiya, Akihiro Aoyama, Hiroshi Date
A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space...
March 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28242159/-hydrothorax-as-a-complication-of-a-ventricle-peritoneal-shunt-a-case-report
#16
Raúl M Yéboles, Lorena Vázquez, Marta Seoane, Susana Castro, Beatriz Ruiz
The ventricle peritoneal (VP) shunt is commonly used in the treatment of hydrocephalus. It is a relatively simple and effective technique, but around 70% of the patients with a VP shunt have a complication in their lifetime. Most of these complications are due to infection or mechanical dysfunction. The thoracic complications are rare. The present case is one of the small number of them found in the literature, describing hydrothorax as a complication of a VP shunt without catheter migration and without ascites...
July 2017: Neurocirugía
https://www.readbyqxmd.com/read/27890417/mycobacterium-fortuitum-empyema-associated-with-an-indwelling-pleural-catheter-case-report-and-review-of-the-literature
#17
Paul Blair, Mahdi Moshgriz, Marc Siegel
Mycobacterium fortuitum is a rapidly growing mycobacterium (RGM) that is an uncommon cause of healthcare-associated infections. The most common infections caused by M. fortuitum include skin, soft tissue, and catheter-related infections. Although occasionally cultured from sputum samples, M. fortuitum is a rare cause of pulmonary disease. We report a case of M. fortuitum empyema associated with an infected pleural catheter and review M. fortuitum pulmonary infections.
March 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27800290/antibiogram-of-medical-intensive-care-unit-at-tertiary-care-hospital-setting-of-pakistan
#18
Aayesha Qadeer, Aftab Akhtar, Qurat Ul Ain, Shoab Saadat, Salman Mansoor, Salman Assad, Wasib Ishtiaq, Abid Ilyas, Ali Y Khan, Yousaf Ajam
OBJECTIVE:  To determine the frequency of micro-organisms causing sepsis as well as to determine the antibiotic susceptibility and resistance of microorganisms isolated in a medical intensive care unit. MATERIALS AND METHODS:  This is a cross-sectional analysis of 802 patients from a medical intensive care unit (ICU) of Shifa International Hospital, Islamabad, Pakistan over a one-year period from August 2015 to August 2016. Specimens collected were from blood, urine, endotracheal secretions, catheter tips, tissue, pus swabs, cerebrospinal fluid, ascites, bronchoalveolar lavage (BAL), and pleural fluid...
September 29, 2016: Curēus
https://www.readbyqxmd.com/read/27629501/-chest-decompression-in-emergency-medicine-and-intensive-care
#19
REVIEW
H Drinhaus, T Annecke, J Hinkelbein
Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space (Monaldi-position) or in the anterior to mid-axillary line of the 4th/5th intercostal space (Bülau-position)...
October 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27581830/the-management-of-benign-non-infective-pleural-effusions
#20
REVIEW
Oliver J Bintcliffe, Gary Y C Lee, Najib M Rahman, Nick A Maskell
The evidence base concerning the management of benign pleural effusions has lagged behind that of malignant pleural effusions in which recent randomised trials are now informing current clinical practice and international guidelines.The causes of benign pleural effusions are broad, heterogenous and patients may benefit from individualised management targeted at both treating the underlying disease process and direct management of the fluid. Pleural effusions are very common in a number of non-malignant pathologies, such as decompensated heart failure, and following coronary artery bypass grafting...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
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