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Central venous catheter infections

Masaaki Murakami, Genichi Sakaguchi, Noriko Mori
OBJECTIVE: In patients with a high risk of fistula immaturity, we created arteriovenous fistulas (AVFs) combined with brachial artery superficialization. With this procedure, the superficialized arteries are used as drawing routes and the AVFs as returning routes. This is a technical report about AVFs combined with brachial artery superficialization. METHODS: Twenty-four consecutive patients with a high risk of fistula immaturity who underwent AVFs with brachial artery superficialization were included in this single-center retrospective study...
October 12, 2016: Journal of Vascular Surgery
S M Johnson, G M Garnett, R K Woo
Maintenance of central venous access in patients with chronic medical conditions such as short bowel syndrome demands forethought and ingenuity. We describe an innovative technique for re-utilizing central venous access sites in patients who have chronic central venous access needs. Records of patients undergoing this technique were reviewed between August 2012 and December 2015. The technique involves "cutting-down" to the sterile fibrous tunnel that naturally forms around tunneled catheters. The fibrous sheath is then isolated and controlled much as would be done for a venous "cut-down...
October 14, 2016: Pediatric Surgery International
X Yuan, C Chen, J Zhou, M Han, X Wang, C Wang, X He
OBJECTIVES: Donors with bacteremia and sepsis are often considered to be controversial for organ retrieval due to potential transmission of an infectious agent to the recipient. Herein we report our initial experience of organ donation and transplantation results from donors with systemic infection. MATERIALS AND METHODS: From January 2013 to December 2014, 125 cases of donation were completed in our organ procurement organization including 90 cases of donation after brain death (DBD) and 35 cases of donation after circulatory death (DCD)...
September 2016: Transplantation Proceedings
Max B van Gent, Wendeline J van der Made, Perla J Marang-van de Mheen, Koen E van der Bogt
OBJECTIVE: To analyze the rate of infections and complications after surgeon-performed, largely ultrasound-guided, central venous catheter (CVC) placement in a pediatric population and to identify patients at high risk of complications. METHODS: All children aged between 4 months and 19 years with a percutaneous CVC inserted between January 1, 2000, and July 31, 2013, were included. Patient records were reviewed retrospectively for the occurrence of infection and other complications until CVC removal or the last outpatient clinic visit and compared between patient groups and with the recent literature...
October 14, 2016: Surgical Infections
Silvia Calviño Günther, Carole Schwebel, Rebecca Hamidfar-Roy, Agnès Bonadona, Maxime Lugosi, Claire Ara-Somohano, Clémence Minet, Leïla Potton, Jean-Charles Cartier, Aurelien Vésin, Magalie Chautemps, Lenka Styfalova, Stephane Ruckly, Jean-François Timsit
PURPOSE: To describe all post-insertion complications involving most used intravascular access, and to determine whether the use of a new-generation transparent dressing (3M™ IV Advanced) might reduce their number and impact on ICU patient outcomes. METHODS: Patients older than 18, with an expected length of stay ≥48 h and requiring at least one central venous catheter (CVC), arterial catheter (AC), haemodialysis catheter (HDC), pulmonary arterial catheters (PAC) or peripheral venous catheter (PVC) were randomized into two groups: a new-generation transparent dressing, or the hospital's classical transparent dressing, and were followed daily for any infectious and non-infectious complications...
October 12, 2016: Intensive Care Medicine
Ö Ergönül, M Aydin, A Azap, S Başaran, S Tekin, Ş Kaya, S Gülsün, G Yörük, E Kurşun, A Yeşilkaya, F Şimşek, E Yılmaz, H Bilgin, Ç Hatipoğlu, H Cabadak, Y Tezer, T Togan, I Karaoğlan, A İnan, A Engin, H E Alışkan, S Ş Yavuz, Ş Erdinç, L Mulazimoglu, Ö Azap, F Can, H Akalın, F Timurkaynak
This article describes the prevalence of antibiotic resistance and predictors of mortality for healthcare-associated (HA) Gram-negative bloodstream infections (GN-BSI). In total, 831 cases of HA GN-BSI from 17 intensive care units in different centres in Turkey were included; the all-cause mortality rate was 44%. Carbapenem resistance in Klebsiella pneumoniae was 38%, and the colistin resistance rate was 6%. Multi-variate analysis showed that age >70 years [odds ratio (OR) 2, 95% confidence interval (CI) 1...
August 21, 2016: Journal of Hospital Infection
Michał Ławiński, Karol Forysiński, Agnieszka Bzikowska, Justyna Z Kostro, Aleksandra Gradowska, Marek Pertkiewicz
INTRODUCTION: The ESPEN guidelines on long-term (> 3 months) parenteral nutrition recommend the use of tunnelled central venous catheters (CVCs) to minimise the risk of insertion site infection. A developed symptomatic infection of the soft tissue tunnel surrounding a CVC may rapidly become directly life threatening if the infection progresses along the catheter tunnel towards its end inserted into the venous system. This requires immediate management to eliminate infection and limit its effects...
2016: Przegla̜d Gastroenterologiczny
Amanda J Ullman, Marie Cooke, Tricia Kleidon, Claire M Rickard
AIM: To identify the prevalence, management and complications associated with central venous access devices (CVADs) within Australian paediatric facilities, providing a map for clinicians, researchers and managers to focus solutions. METHODS: A point prevalence audit and survey of CVAD practices in Australian tertiary paediatric hospitals between September and November 2015, using validated data collection tools. RESULTS: Across the six sites, 1027 patients were screened with CVADs prevalent in 26...
October 6, 2016: Journal of Paediatrics and Child Health
Carlos A Hinojosa, Javier E Anaya-Ayala, Alejandra Lopez-Mendez, Zeniff Gomez-Arcive, Hugo Laparra-Escareno, Cesar Cuen-Ojeda, Rene Lizola, Adriana Torres-Machorro
Exhaustion of superficial veins coupled with the presence of intrathoracic central venous occlusions remains a significant obstacle for hemodialysis access creation; complex arteriovenous graft (AVG) configurations have been described. The axillary-iliac AVG was first reported in 1987, and few authors have explored this access. We evaluated our experience with this AVG configuration utilizing the early cannulation (EC) graft Flixene™ (Atrium ™, Hudson, NH, USA). Eight patients (75 % men; mean age 37 ± 10 years) with End-Stage Renal Disease (ESRD) underwent axillo-iliac AVG creation with Flixene™ grafts; all had exhausted peripheral veins, occluded thoracic central veins, and inadequate femoral veins...
October 5, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
J Abram, J Klocker, N Innerhofer-Pompernigg, M Mittermayr, M C Freund, N Gravenstein, V Wenzel
Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible...
October 5, 2016: Der Anaesthesist
Sara C Keller, Deborah Williams, Mitra Gavgani, David Hirsch, John Adamovich, Dawn Hohl, Amanda Krosche, Sara Cosgrove, Trish M Perl
BACKGROUND Patients are frequently discharged with central venous catheters (CVCs) for home infusion therapy. OBJECTIVE To study a prospective cohort of patients receiving home infusion therapy to identify environmental and other risk factors for complications. DESIGN Prospective cohort study between March and December 2015. SETTING Home infusion therapy after discharge from academic medical centers. PARTICIPANTS Of 368 eligible patients discharged from 2 academic hospitals to home with peripherally inserted central catheters and tunneled CVCs, 222 consented...
October 4, 2016: Infection Control and Hospital Epidemiology
Arunangshu Chakraborty, Sanjit Agrawal, Taniya Datta, Suparna Mitra, Rakhi Khemka
Chemotherapy in children suffering from cancer usually requires placement of an indwelling central venous catheter (CVC). A child may need to undergo repeated procedures because of infection and occlusion of previous access devices. We present a case of CVC insertion in a child suffering from acute lymphoblastic leukemia where an innovative technique was employed.
October 2016: Journal of Indian Association of Pediatric Surgeons
Andrew S Griffin, Shawn M Gage, Jeffrey H Lawson, Charles Y Kim
OBJECTIVE: This study evaluated whether the use of a staged Hemodialysis Reliable Outflow (HeRO; Merit Medical, South Jordan, Utah) implantation strategy incurs increased early infection risk compared with conventional primary HeRO implantation. METHODS: A retrospective review was performed of 192 hemodialysis patients who underwent HeRO graft implantation: 105 patients underwent primary HeRO implantation in the operating room, and 87 underwent a staged implantation where a previously inserted tunneled central venous catheter was used for guidewire access for the venous outflow component...
September 26, 2016: Journal of Vascular Surgery
Sheila L Robbins Tighe
Patients with intestinal failure have an increased risk for catheter-related bloodstream infections that can necessitate central venous line replacement and result in morbidity, prolonged hospitalization, or mortality. For pediatric patients with intestinal failure, the severe loss of intestinal absorptive ability leads to reliance on parenteral nutrition to meet minimal needs required for growth and development. Reliance on parenteral nutrition, in turn, forces dependency on central venous lines. Recent research concentrating on the pediatric population with intestinal failure indicates that prophylactic ethanol lock therapy can reduce the rate of catheter-related bloodstream infections and decrease central venous line removal rates in this high-risk population...
September 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
Adam D Jakes, Poonam Jani, Victoria Allgar, Archie Lamplugh, Ahmed Zeidan, Sunil Bhandari
BACKGROUND: Dialysis in elderly patients (>80-years-old) carries a poor prognosis, but little is known about the most effective vascular access method in this age group. An arteriovenous fistula (AVF) is both time-consuming and initially expensive, requiring surgical insertion. A central venous catheter (CVC) is initially a cheaper alternative, but carries a higher risk of infection. We examined whether vascular access affected 1-year and 2-year mortality in elderly patients commencing haemodialysis...
2016: PloS One
Michelle Ribeiro Viana Taveira, Luciana Santana Lima, Cláudia Corrêa de Araújo, Maria Júlia Gonçalves de Mello
BACKGROUND: Totally implantable venous access ports (TIVAPs) are used for prolonged central venous access, allowing the infusion of chemotherapy and other fluids and improving the quality of life of children with cancer. TIVAPs were developed to reduce the infection rates associated with central venous catheters; however, infectious events remain common and have not been fully investigated in pediatric oncology patients. PROCEDURE: A retrospective cohort was formed to investigate risk factors for central line-associated bloodstream infection (CLABSI) in pediatric cancer patients...
September 26, 2016: Pediatric Blood & Cancer
Aurelia B Fu, Erica I Hodgman, Lorraine S Burkhalter, Rachel Renkes, Tamra Slone, Adam C Alder
BACKGROUND: Central venous access devices (CVADs) play an important role in the management of pediatric oncology patients; unfortunately, they are also associated with potentially serious complication rates. We hypothesized that, despite the significantly different disease courses typical of acute lymphoblastic leukemia and acute myelogenous leukemia, there would be identifiable risk factors for premature CVAD removal. METHODS: We retrospectively studied clinical characteristics and procedure records for all patients admitted with a leukemia diagnosis at our institution from May 2009 to July 2014...
October 2016: Journal of Surgical Research
Michael Stenger, Kasper Klein, Rasmus B Grønnemose, Janne K Klitgaard, Hans J Kolmos, Jes S Lindholt, Martin Alm, Peter Thomsen, Thomas E Andersen
Approximately half of all nosocomial bloodstream infections are caused by bacterial colonization of vascular catheters. Attempts have been made to improve devices using anti-adhesive or antimicrobial coatings; however, it is often difficult to bind coatings stably to catheter materials, and the low amounts of drug in thin-film coatings limit effective long-term release. Interpenetrating polymer networks (IPNs) are polymer hybrid materials with unique drug release properties. While IPNs have been extensively investigated for use in tablet- or capsule-based drug delivery systems, the potential for use of IPNs in drug release medical devices remains largely unexplored...
November 10, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Mario Abinun, Jonathan P Lane, Mark Wood, Mark Friswell, Terence J Flood, Helen E Foster
Severe infections are emerging as major risk factors for death among children with juvenile idiopathic arthritis (JIA). In particular, children with refractory JIA treated with long-term, multiple, and often combined immunosuppressive and antiinflammatory agents, including the new biological disease-modifying antirheumatic drugs (DMARDs), are at increased risk for severe infections and death. We investigated 4 persons with JIA who died during 1994-2013, three of overwhelming central venous catheter-related bacterial sepsis caused by coagulase-negative Staphylococus or α-hemolytic Streptococcus infection and 1 of disseminated adenovirus and Epstein-Barr virus infection)...
October 2016: Emerging Infectious Diseases
İlker Devrim, Rana İşgüder, Hasan Ağın, Gökhan Ceylan, Yüce Ayhan, Özlem Sara Sandal, Ferhat Sarı, Ahu Kara, Mine Düzgöl, Gamze Gülfidan, Nuri Bayram
BACKGROUND: We aimed to evaluate the correlation of caspofungin E-tests with the prognosis and response to caspofungin therapy of Candida parapsilosis complex bloodstream infections in children hospitalized in a pediatric intensive care unit. METHODS: All children who had C. parapsilosis complex bloodstream infections and who were treated with caspofungin were included in this retrospective study. For each patient, the following parameters, including all consecutive blood and central venous catheter (CVC) cultures, the duration between diagnosis and CVC removal, mortality rate, relapses of the C...
2016: Mediterranean Journal of Hematology and Infectious Diseases
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