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https://www.readbyqxmd.com/read/27924201/central-line-associated-bloodstream-infections-in-the-intensive-care-unit-importance-of-the-care-bundle
#1
Aynur Atilla, Zahide Doğanay, Hale Kefeli Çelik, Leman Tomak, Özgür Günal, S Sırrı Kılıç
BACKGROUND: The importance and efficacy of a care bundle for preventing central line-associated bloodstream infections (CLABSIs) and infectious complications related to placing a central venous catheter (CVC) in patients in the intensive care unit (ICU). METHODS: A care bundle was implemented from July 2013 to June 2014 in a medical ICU and surgical ICU. Data were divided into three periods: the prior period (July 2012-June 2013), the intervention period (July 2013-June 2014; first and second periods), and the post-intervention period (July 2014-December 2014; third period)...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27913480/thrombosis-in-the-setting-of-cancer
#2
Michael B Streiff
Venous thromboembolism (VTE) is a common cause of adverse outcomes in patients with cancer. The risk of VTE varies with cancer type, stage and grade, cancer therapy, and supportive care, as well as patient characteristics including age, ethnicity, and inherited and acquired comorbid conditions. VTE prophylaxis should be provided to all hospitalized cancer patients and high-risk outpatients. Low-molecular-weight heparin (LMWH) remains the first-line therapy for VTE in patients with active cancer. Anticoagulation should be continued as long as there is evidence of active disease or patients are receiving cancer treatment...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#3
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27911460/retrospective-comparison-of-two-different-approaches-for-ultrasound-guided-internal-jugular-vein-cannulation-in-hemodialysis-patients
#4
Antonio Treglia, Dario Musone, Francesco Amoroso
BACKGROUND: Prevalent hemodialysis patients with vascular access consisting of a central venous catheter (CVC) are continuously increasing over the years. Improvement in evolution and CVC placement procedures represents therefore an essential tool to enhance performance and reduce intraoperative and long-term CVC complications. Internal jugular vein (IJV) catheterization techniques are different according to ultrasound probe position in relation to vein axis and to needle direction in relation to ultrasound beam...
December 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27905682/a-survey-of-pediatric-hematology-oncology-specialists-regarding-management-of-central-line-associated-venous-thrombosis
#5
Char M Witmer, Emily Sauck, Leslie J Raffini
Central venous catheters (CVCs) account for the largest proportion of thrombotic events in pediatric patients. Questions remain regarding adequate treatment and prevention methods. We surveyed pediatric hematology/oncology specialists, using hypothetical cases to assess management strategies for acute CVC thrombosis and secondary prevention. Survey respondents varied in the use of the thrombophilia evaluation (33.3%, 41/123) and duration of treatment (6 weeks: 54.1%, 66/122). Secondary CVC prophylaxis was utilized by 36...
December 1, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27905297/altered-thermoregulatory-responses-in-heart-failure-patients-exercising-in-the-heat
#6
Bryce N Balmain, Ollie Jay, Surendran Sabapathy, Danielle Royston, Glenn M Stewart, Rohan Jayasinghe, Norman R Morris
Heart failure (HF) patients appear to exhibit impaired thermoregulatory capacity during passive heating, as evidenced by diminished vascular conductance. Although some preliminary studies have described the thermoregulatory response to passive heating in HF, responses during exercise in the heat remain to be described. Therefore, the aim of this study was to compare thermoregulatory responses in HF and controls (CON) during exercise in the heat. Ten HF (NYHA classes I-II) and eight CON were included. Core temperature (Tc), skin temperature (Tsk), and cutaneous vascular conductance (CVC) were assessed at rest and during 1 h of exercise at 60% of maximal oxygen uptake...
November 2016: Physiological Reports
https://www.readbyqxmd.com/read/27902412/the-staff-education-to-reducing-ventilator-associated-pneumonia
#7
Gurdal Yilmaz, Hava Aydin, Mustafa Aydin, Sedat Saylan, Hulya Ulusoy, Iftihar Koksal
Mechanical ventilation (MV) is a life-saving invasive procedure performed in intensive care units (ICUs) where critical patients are given advanced support. The purpose of this study was to assess the effect of personnel training on the incidence of ventilator-associated pneumonia (VAP). The study, performed prospectively in the ICU, was planned in two periods. In both periods, patient's characteristics were recorded on patient data forms. In the second period, ICU physicians and assistant health personnel were given regular theoretical and practical training...
October 17, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27899248/unexplained-increases-in-serum-vancomycin-concentration-in-a-morbidly-obese-patient
#8
REVIEW
Sean P Kane, Scott D Hanes
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection...
November 26, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27895356/the-power-peripherally-inserted-central-catheter-is-superior-to-a-central-venous-catheter-in-management-of-patients-with-esophageal-variceal-bleeding-undergoing-devascularization
#9
Wen Jing, He Rong, Jiang Li, Zhang Hai Xia, Zhang Hong Yu, Zhang Ke
Peripherally-inserted central catheters (PICC) have a greater retention time and less complications compared to central venous catheters (CVC). The study was conducted from From January of 2014 to December 2015 at Beijing DiTan Hospital, Beijing, China, and comprised 70 patients undergoing devascularisation. Of the total, 36(51.4%) patients underwent placement of PICC (Group A), while 34(48.6%) underwent had CVC (Group B). Venous catheterisation was successful in all patients. The median duration of venous catheterization in Group A was greater than that in Group B (p=0...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27881572/the-roles-of-the-na-k-atpase-nkcc-and-k-channels-in-regulating-local-sweating-and-cutaneous-blood-flow-during-exercise-in-humans-in%C3%A2-vivo
#10
Jeffrey C Louie, Naoto Fujii, Robert D Meade, Glen P Kenny
Na(+)/K(+)-ATPase has been shown to regulate the sweating and cutaneous vascular responses during exercise; however, similar studies have not been conducted to assess the roles of the Na-K-2Cl co-transporter (NKCC) and K(+) channels. Additionally, it remains to be determined if these mechanisms underpinning the heat loss responses differ with exercise intensity. Eleven young (24 ± 4 years) males performed three 30-min semirecumbent cycling bouts at low (30% VO2peak), moderate (50% VO2peak), and high (70% VO2peak) intensity, respectively, each separated by 20-min recovery periods...
November 2016: Physiological Reports
https://www.readbyqxmd.com/read/27881399/intradermal-administration-of-endothelin-1-attenuates-endothelium-dependent-and-independent-cutaneous-vasodilation-via-rho-kinase-in-young-adults
#11
Naoto Fujii, Tatsuro Amano, Lyra Halili, Jeffrey C Louie, Sarah Yan Zhang, Brendan D McNeely, Glen P Kenny
We recently showed that intradermal administration of endothelin-1 diminished endothelium-dependent and -independent cutaneous vasodilation. We evaluated the hypothesis that Rho kinase may be a mediator of this response. We also sought to evaluate if endothelin-1 increases sweating. In twelve adults (25±6 years), we measured cutaneous vascular conductance (CVC) and sweating during 1) endothelium-dependent vasodilation induced via administration of incremental doses of methacholine (0.25, 5, 100, 2000mM each for 25 min) and 2) endothelium-independent vasodilation induced via administration of 50mM sodium nitroprusside (20-25 min)...
November 23, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27878445/can-non-invasive-ventilation-modify-central-venous-pressure-comparison-between-invasive-measurement-and-ultrasonographic-evaluation
#12
Maurizio Zanobetti, Alessio Prota, Alessandro Coppa, Laura Giordano, Sofia Bigiarini, Peiman Nazerian, Francesca Innocenti, Alberto Conti, Federica Trausi, Simone Vanni, Giuseppe Pepe, Riccardo Pini
Central venous pressure (CVP) is primarily measured to assess intravascular volume status and heart preload. In clinical practice, the measuring device most commonly used in emergency departments and intensive care units, is an electronic transducer that interconnects a central venous catheter (CVC) with a monitoring system. Non-invasive ventilation (NIV) consists in a breathing support that supplies a positive pressure in airways through a mask or a cask though not using an endotracheal prosthesis. In emergency settings, non-invasive ultrasonography evaluation of CVP, and hence of intravascular volume status entail the measurement by a subxiphoid approach of inferior vena cava diameter and its variations in relation to respiratory activity...
November 22, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27878131/extra-luminal-entrapment-of-guide-wire-a-rare-complication-of-central-venous-catheter-placement-in-right-internal-jugular-vein
#13
Md Abu Masud Ansari, Naveen Kumar, Shailesh Kumar, Sarita Kumari
Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels...
October 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27875289/home-parenteral-nutrition-in-adult-patients-with-chronic-intestinal-failure-catheter-related-complications-over-4-decades-at-the-main-danish-tertiary-referral-center
#14
Christopher Filtenborg Brandt, Siri Tribler, Mark Hvistendahl, Rahim M Naimi, Per Brøbech, Michael Staun, Palle Bekker Jeppesen
BACKGROUND/AIMS: Catheter-related complications (CRCs) cause mortality and morbidity in patients dependent on parenteral support at home (HPN) due to intestinal failure (IF). This study describes the incidences of CRCs in an adult IF cohort over 40 years. It illustrates the evolution and consequences of CRCs, their association to demographic characteristics, and potential risk factors in an effort to provide the rationale for preventive precautions to the relevant patients with IF at risk...
November 15, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27874841/using-the-theory-of-planned-behavior-to-explore-hospital-based-nurses-intention-to-use-peripherally-inserted-central-catheter-picc-a-survey-study
#15
Laura Bertani, Maria Carone, Luca Caricati, Serena Demaria, Silvia Fantuzzi, Alessandro Guarasci, Luca Pirazzoli
BACKGROUND AND AIM OF THE WORK: The peripherally inserted central catheters (PICC) have become an alternative to the traditional CVC. PICCs are usually inserted by trained nurses who decided to attend and complete a special training on PICC insertion and management. The present work aimed to investigate the intention of using PICC in a sample of hospital-based nurses using the theory of planned behavior as theoretical framework. METHODS: A cross-sectional design was used in which a questionnaire was delivered to 199 nurses...
November 22, 2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27868336/vascular-imaging-for-hemodialysis-vascular-access-planning
#16
Rita L McGill, Robin Ruthazer, Eduardo Lacson, Klemens B Meyer, Dana C Miskulin, Daniel E Weiner
Introduction Central venous catheters (CVC) increase risks associated with hemodialysis (HD), but may be necessary until an arteriovenous fistula (AVF) or graft (AVG) is achieved. The impact of vascular imaging on achievement of working AVF and AVG has not been firmly established. Methods Retrospective cohort of patients initiating HD with CVC in 2010-2011, classified by exposure to venography or Doppler vein mapping, and followed through December 31, 2012. Standard and time-dependent Cox models were used to determine hazard ratios (HRs) of death, working AVF, and any AVF or AVG...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27865247/implementing-a-central-venous-catheter-self-management-education-program-for-patients-with-cancer
#17
Jeong Yun Park
PURPOSE: To evaluate the effects of the central venous catheter self-management education program (CVC S-MEP) in improving knowledge, attitude, and behavior regarding CVC and in decreasing CVC-related complications in patients with cancer during homecare service. METHODS: A quasi-experimental, sequential cohort design study of patients with cancer and who have CVCs was performed to compare the effect of CVC S-MEP with usual care. RESULTS: The study group consisted of 45 participants (26 male and 19 female), and the mean age was 46...
December 2016: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/27859779/nicotinic-receptor-activation-augments-muscarinic-receptor-mediated-eccrine-sweating-but-not-cutaneous-vasodilatation-in-young-males
#18
Naoto Fujii, Jeffrey C Louie, Brendan D McNeely, Sarah Y Zhang, My-An Tran, Glen P Kenny
Acetylcholine released from cholinergic nerves can activate both muscarinic and nicotinic receptors; each is known to independently induce cutaneous vasodilatation and eccrine sweating in humans. However, it is not known whether the two receptors interact in order to mediate cutaneous vasodilatation and eccrine sweating. In ten young males (27 ± 6 years), cutaneous vascular conductance (CVC) and sweat rate were evaluated at intradermal microdialysis sites that were continuously perfused with either lactated Ringer (Control) or three different concentrations of nicotine (0...
November 18, 2016: Experimental Physiology
https://www.readbyqxmd.com/read/27850812/1176-immediate-complications-of-cvc-insertions-feasibility-pilot-of-a-uk-national-audit-icnap
#19
Adrian Wong, Nitin Arora, Olusegun Olusanya, Ben Sharif, Robert Lundin, Sam Clark, Amrit Dhadda, Tamas Szakmany
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27847699/ultrasound-for-localization-of-central-venous-catheter-a-good-alternative-to-chest-x-ray
#20
Hamid Kamalipour, Sedigheh Ahmadi, Karmella Kamali, Alireza Moaref, Masih Shafa, Parsa Kamalipour
BACKGROUND: Chest radiography after central venous catheter (CVC) insertion is the main method of verifying the catheter location. Despite the widespread use of radiography for detecting catheter position, x-ray may not always be readily available, especially in the operating room. OBJECTIVES: We aimed to compare contrast-enhanced ultrasonography (CEUS) and chest radiography for detecting the correct location of CVCs. METHODS: One hundred sixteen consecutive patients with indications for CVC before cardiac surgery were enrolled in this observational study...
October 2016: Anesthesiology and Pain Medicine
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