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https://www.readbyqxmd.com/read/28224103/management-of-parenteral-nutrition-in-critically-ill-patients
#1
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/28222688/vascular-access-conversion-and-patient-outcome-after-hemodialysis-initiation-with-a-nonfunctional-arteriovenous-access-a-prospective-registry-based-study
#2
Natalia Alencar de Pinho, Raphael Coscas, Marie Metzger, Michel Labeeuw, Carole Ayav, Christian Jacquelinet, Ziad A Massy, Bénédicte Stengel
BACKGROUND: Little is known about vascular access conversion and outcomes for patients starting hemodialysis with nonfunctional arteriovenous (AV) access. We assessed mortality risk associated with nonfunctional AV access at hemodialysis initiation, taking subsequent changes in vascular access into account. METHODS: We studied the 53,092 incident adult hemodialysis patients included in the French REIN registry from 2005 through 2012. AV access placed predialysis was considered nonfunctional when dialysis began with a central venous catheter...
February 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28218354/dialysis-access-infections-and-hospitalisations-in-unplanned-dialysis-start-patients-results-from-the-options-study
#3
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/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#4
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28214161/human-factors-related-to-time-dependent-infection-control-measures-scrub-the-hub-for-venous-catheters-and-feeding-tubes
#5
Lindsay Caspari, Elizabeth Epstein, Amy Blackman, Li Jin, David A Kaufman
BACKGROUND: The use of catheter hub decontamination protocols is a common practice to reduce central line-associated bloodstream infections. However, few data exist on the most effective disinfection procedure prior to hub access accounting for human factors and time-dependent practices in real time in the clinical setting. METHODS: An observational design with a multimodal intervention was used in this study in a neonatal intensive care unit. Direct observations on nurse compliance of scrub times with decontamination when accessing of venous catheter and feeding tube hubs were conducted during 3 phases: (1) baseline period prior to any interventions; (2) during an educational intervention phase; and (3) during a timer intervention period when using a timing device, either an actual timer or music button...
February 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28194064/therapeutic-plasma-exchange-in-patients-with-neurologic-disorders-review-of-63-cases
#6
Anil Tombak, Mehmet Ali Uçar, Aydan Akdeniz, Arda Yilmaz, Hakan Kaleagası, Mehmet Ali Sungur, Eyup Naci Tiftik
Therapeutic plasma exchange (TPE) is a procedure that reduces circulating autoantibodies of the patients. TPE is commonly used in neurological disorders where autoimmunity plays a major role. We report our experience with regard to the indications, adverse events and outcomes of plasma exchange in neurological disorders. Sixty-three patients were included to this retrospective study. Median age was 48 years (range 1-85), there was a predominance of males. Neurological indications included Guillain-Barrè syndrome (n = 22), myasthenia gravis (n = 21), chronic inflammatory demyelinating polyneuropathy (n = 7), polymyositis (n = 3), multifocal motor neuropathy (n = 2), acute disseminated encephalomyelitis (n = 2), neuromyelitis optica (n = 2), multiple sclerosis (n = 2), limbic encephalitis (n = 1) and transverse myelitis (n = 1)...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28191308/ralstonia-mannitolilytica-infections-in-an-oncologic-day-ward-description-of-a-cluster-among-high-risk-patients
#7
Claudia Lucarelli, Enea Gino Di Domenico, Luigi Toma, Domenico Bracco, Grazia Prignano, Maria Fortunati, Lorella Pelagalli, Fabrizio Ensoli, Patrizio Pezzotti, Aurora García-Fernández, Annalisa Pantosti, Loredana Ingrosso
BACKGROUND: Ralstonia spp, an environmental microorganism, has been occasionally associated with healthcare infections. The aim of this study was to investigate an outbreak caused by Ralstonia mannitolilytica in oncology patients. METHODS: Case definition: Oncology outpatients attending a day ward, with positive blood and/or central venous catheter (CVC) culture for Ralstonia spp from September 2013 - June 2014. We analysed medical records, procedures and environmental samples...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28188038/tunneled-central-venous-catheters-in-children-with-malignant-and-chronic-diseases-a-comparison-of-open-vs-percutaneous-implantation
#8
Lea-Valeska Blum, Ulf Abdel-Rahman, Thomas Klingebiel, Henning Fiegel, Stefan Gfroerer, Udo Rolle
PURPOSE: Tunneled central venous catheters (tCVCs) are routinely used for long-term venous access in children with cancer and chronic diseases. They may be inserted by surgical venous cut-down or percutaneously. The aim of this study was to compare the operative times and intraoperative complications of both techniques. METHODS: This study compared group A (surgical venous cut-down, years 2002-2006) with group B (percutaneous, years 2008-2012). Patient characteristics, operative times, and intraoperative complications were obtained from surgical reports...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28182818/alternative-strategies-for-central-venous-stenosis-and-occlusion-in-patients-requiring-haemodialysis-access
#9
LETTER
Keith Koh, Ye Xin Koh, Edward Tc Choke, John Cc Wang, Ch'ng Jack Kian
No abstract text is available yet for this article.
January 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28165583/chlorhexidine-impregnated-transparent-dressings-decrease-catheter-related-infections-in-hemodialysis-patients-a-quality-improvement-project
#10
Ibironke W Apata, John Hanfelt, James L Bailey, Vandana Dua Niyyar
PURPOSE: Central venous catheters (CVC) are associated with increased infection rates, morbidity and mortality compared to other hemodialysis vascular access. Chlorhexidine-impregnated transparent (CHG-transparent) dressings allow for continuous antimicrobial exposure and easy visibility of the CVC insertion site. We conducted a quality improvement project to compare catheter-related infection (CRI) rates in two dressing regimens - CHG-transparent dressings and adhesive dry gauze dressing in hemodialysis patients with tunneled CVCs...
February 4, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28165577/surgical-reconstruction-of-central-venous-obstruction-in-salvaging-upper-extremity-dialysis-accesses
#11
Jurabek Babadjanov, Rick Bernstein, Lee Kirksey
BACKGROUND: Central vein thrombosis or obstruction is a common complication associated with central venous catheters placed for intermittent hemodialysis. The reported outcomes of percutaneous catheter-based interventions reveal high rates of lesion recurrence with varying and frequently limited patency intervals. We present the case of open venous bypass in the treatment of catheter-associated chronic central vein occlusion. METHODS: We report a case of symptomatic arm swelling secondary to central vein stenosis and failed endovascular venous intervention treated by central vein bypass with prosthetic graft through median sternotomy...
February 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28165572/early-cannulation-graft-flixene%C3%A2-for-conventional-and-complex-hemodialysis-access-creation
#12
Carlos A Hinojosa, Saul Soto-Solis, Sandra Olivares-Cruz, Hugo Laparra-Escareno, Zeniff Gomez-Arcive, Javier E Anaya-Ayala
PURPOSE: The Flixene™ (Atrium™, Hudson, NH) is a trilaminate composite polytetrafluoroethylene (PTFE) graft that allows access within 72 hours. We evaluate our initial experience with this device for conventional and complex hemodialysis access creation. METHODS: Retrospective review in end-stage renal disease (ESRD) patients who underwent access creation with Flixene from January 2013 to July 2014. For our analysis, the patients were divided in two groups: those with complex access configurations tunneled in the chest and/or abdominal wall (thoraco-abdominal wall access [TAWA]), and those tunneled in conventional sites (extremity access [EA])...
February 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28163887/central-venous-access-related-adverse-events-after-trabectedin-infusions-in-soft-tissue-sarcoma-patients-experience-and-management-in-a-nationwide-multi-center-study
#13
Michiel C Verboom, Jan Ouwerkerk, Neeltje Steeghs, Jacob Lutjeboer, J Martijn Kerst, Winette T A van der Graaf, Anna K L Reyners, Stefan Sleijfer, Hans Gelderblom
BACKGROUND: Trabectedin has shown efficacy against soft tissue sarcomas (STS) and has manageable toxicity. Trabectedin is administered through central venous access devices (VAD), such as subcutaneous ports with tunneled catheters, Hickman catheters and PICC lines. Venous access related adverse events are common, but have not yet been reported in detail. METHODS: A retrospective analysis of patient files of STS patients receiving trabectedin monotherapy between 1999 and 2014 was performed in all five STS referral centers in the Netherlands...
2017: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/28163431/removal-of-a-retained-intracardiac-radiolucent-guidewire-fragment-using-an-atrieve%C3%A2-vascular-snare-using-combined-fluoroscopy-and-transesophageal-echocardiography-guidance-in-an-infant
#14
Asif Padiyath, Eudice E Fontenot, Boban P Abraham
Retained intravascular foreign body is a well-known complication of central venous access placement in children as well as adults. Most of these foreign bodies are radio-opaque and hence are removed under fluoroscopy guidance. In our case, we describe the removal of an intracardiac radiolucent foreign body in an infant utilizing a combination technique - transesophageal echocardiogram and fluoroscopy.
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28157793/ultrasound-guided-subclavian-vein-cannulation-in-low-birth-weight-neonates
#15
Ulrik Lausten-Thomsen, Zied Merchaoui, Cécile Dubois, Sergio Eleni Dit Trolli, Nolwenn Le Saché, Mostafa Mokhtari, Pierre Tissières
OBJECTIVES: Central venous access in critically ill, small infants remains technically challenging even in experienced hands. Several vascular accesses exist, but the subclavian vein is often preferred for central venous catheter insertion in infants where abdominal malformation and/or closure of the vein preclude the use of umbilical venous catheters, as catheterization of the subclavian vein is easier in very short necks than the internal jugular vein for age-related anatomical reasons...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28156625/clinical-and-health-care-setting-of-patients-admitted-at-pain-control-center-hospice-of-solofra-a-feasibility-model-of-end-of-life-care-in-the-avellino-province-of-italy
#16
Carmela Fasano, Luisa M Rizzo, A M Strollo, Elena De Vinco, Vincenzo Landolfi, Elena Altieri, Mario Nicola Vittorio Ferrante, Sergio Canzanella, Giuseppe Servillo, Lucia Genua, Maddalena Zampi, Gaetano D'Onofrio
: 59 Background: The Pain Control Center Hospice of Solofra (Italy) is managed with a mixed public / private, the first experience in the Campania region.We have evaluated the treatment procedures and the clinical outcome to make a comparison by between 123 evaluable patients in palliative care in 2015 and 232 evaluable patients in the biennium 2012-2014. METHODS: The following characteristics: patient gender, mean hospitalization time, differentiation between cancer and non cancer patients, medical weapon use, venous access type, enteral and parenteral feeding, pain killer use,Karnofsky scale...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149825/correlations-between-pulmonary-artery-pressures-and-inferior-vena-cava-collapsibility-in-critically-ill-surgical-patients-an-exploratory-study
#17
Stanislaw P Stawicki, Thomas J Papadimos, David P Bahner, David C Evans, Christian Jones
INTRODUCTION: As pulmonary artery catheter (PAC) use declines, search continues for reliable and readily accessible minimally invasive hemodynamic monitoring alternatives. Although the correlation between inferior vena cava collapsibility index (IVC-CI) and central venous pressures (CVP) has been described previously, little information exists regarding the relationship between IVC-CI and pulmonary artery pressures (PAPs). The goal of this study is to bridge this important knowledge gap...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28144088/outcomes-cost-comparison-and-patient-satisfaction-during-long-term-central-venous-access-in-cancer-patients-experience-from-a-tertiary-care-cancer-institute-in-south-india
#18
K Govind Babu, M C Suresh Babu, D Lokanatha, Gita R Bhat
INTRODUCTION: Prolonged treatment, frequent administration of chemotherapy, antibiotics and blood products in cancer patients requires long term venous access. Central venous catheters (CVC) inserted into the subclavian vein or internal jugular vein, peripherally inserted central venous catheters (PICC) and chemoport (CP) are the commonly used central venous access devices (CVAD). AIM: This study was envisaged to review our experience of CVADs over a one year period and analyze the outcome with regard to catheter life, reasons for removal, complications, patient satisfaction and cost comparison between the CVAD types in the Indian setting...
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28138728/peripherally-inserted-central-catheters-in-pediatric-patients-to-repair-or-not-repair
#19
Ralph Gnannt, Premal Patel, Michael Temple, Yahya Al Brashdi, Joao Amaral, Dimitri Parra, Vanessa Rea, Derek Stephens, Bairbre Connolly
INTRODUCTION: Preservation of venous access in children is a major concern in pediatric interventional radiology. If a peripherally inserted central catheter (PICC) breaks, there are two options: repair the line with a repair kit or exchange the line over a wire in the interventional suite. The purpose of this study is to assess the outcome of PICC repairs in children and to compare these with the outcomes of PICC exchange. MATERIALS AND METHODS: This is a single-center, retrospective study of central line-associated bloodstream infection (CLABSI) following management of externally broken PICCs (2010-2014)...
January 30, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28132565/a-blended-learning-approach-to-teaching-cvad-care-and-maintenance
#20
Karen Hainey, Linda J Kelly, Audrey Green
Nurses working within both acute and primary care settings are required to care for and maintain central venous access devices (CVADs). To support these nurses in practice, a higher education institution and local health board developed and delivered CVAD workshops, which were supported by a workbook and competency portfolio. Following positive evaluation of the workshops, an electronic learning (e-learning) package was also introduced to further support this clinical skill in practice. To ascertain whether this blended learning approach to teaching CVAD care and maintenance prepared nurses for practice, the learning package was evaluated through the use of electronic questionnaires...
January 26, 2017: British Journal of Nursing: BJN
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