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Central venous catheter infections

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https://www.readbyqxmd.com/read/28323880/randomized-controlled-trials-in-central-vascular-access-devices-a-scoping-review
#1
Mari Takashima, Gillian Ray-Barruel, Amanda Ullman, Samantha Keogh, Claire M Rickard
BACKGROUND: Randomized controlled trials evaluate the effectiveness of interventions for central venous access devices, however, high complication rates remain. Scoping reviews map the available evidence and demonstrate evidence deficiencies to focus ongoing research priorities. METHOD: A scoping review (January 2006-December 2015) of randomized controlled trials evaluating the effectiveness of interventions to improve central venous access device outcomes; including peripherally inserted central catheters, non-tunneled, tunneled and totally implanted venous access catheters...
2017: PloS One
https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#2
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
March 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28297057/dialysis-access-issues-related-to-conversion-from-peritoneal-dialysis-to-hemodialysis-and-vice-versa
#3
Maurizio Gallieni, Antonino Giordano, Anna Ricchiuto, Davide Gobatti, Maurizio Cariati
ABSTRACTHemodialysis (HD) and peritoneal dialysis (PD) represent two complementary modalities of renal replacement therapy (RRT) for end-stage renal disease patients. Conversion between the two modalities is frequent and more likely to happen from PD to HD. Every year, 10% of PD patients convert to HD, suggesting the need for recommendations on how to proceed with the creation of a vascular access in these patients. Criteria for selecting patients who would likely fail PD, and therefore take advantage of a backup access, are undefined...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28289815/a-randomized-clinical-trial-of-ultrasound-guided-infra-clavicular-cannulation-of-the-subclavian-vein-in-cardiac-surgical-patients-short-axis-versus-long-axis-approach
#4
Antonella Vezzani, Tullio Manca, Claudia Brusasco, Gregorio Santori, Luca Cantadori, Andrea Ramelli, Gianluca Gonzi, Francesco Nicolini, Tiziano Gherli, Francesco Corradi
PURPOSE: The aim of this study was to compare the success rate and safety of short-axis versus long-axis approaches to ultrasound-guided subclavian vein cannulation. METHODS: A total of 190 patients requiring central venous cannulation following cardiac surgery were randomized to either short-axis or long-axis ultrasound-guided cannulation of the subclavian vein. Each cannulation was performed by anesthesiologists with at least 3 years' experience of ultrasound-guided central vein cannulation (>150 procedures/year, 50% short-axis and 50% long-axis)...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28286186/placement-of-upper-extremity-arteriovenous-access-in-patients-with-central-venous-occlusions-a-novel-technique
#5
Allen G Murga, Jason T Chiriano, Christian Bianchi, Neha Sheng, Sheela Patel, Ahmed M Abou-Zamzam, Theodore H Teruya
OBJECTIVE: Central venous occlusion is a common occurrence in patients with end stage renal disease. Placement of upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins is often not an option. Avoidance of lower extremity vascular access can decrease morbidity and infection. TECHNIQUE: The central venous lesions were crossed centrally via femoral access. The wire was retrieved in the neck extravascular. A HeRo catheter was then placed in the right atrium and completed with an arterial anastomosis...
March 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28279491/proposal-for-shorter-antibiotic-therapies
#6
C Wintenberger, B Guery, E Bonnet, B Castan, R Cohen, S Diamantis, P Lesprit, L Maulin, Y Péan, E Peju, L Piroth, J P Stahl, C Strady, E Varon, F Vuotto, R Gauzit
OBJECTIVES: Reducing antibiotic consumption has now become a major public health priority. Reducing treatment duration is one of the means to achieve this objective. Guidelines on the therapeutic management of the most frequent infections recommend ranges of treatment duration in the ratio of one to two. The Recommendation Group of the French Infectious Diseases Society (SPILF) was asked to collect literature data to then recommend the shortest treatment durations possible for various infections...
March 6, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28277833/capecitabine-in-locally-advanced-anal-cancer-do-we-need-randomised-evidence
#7
Li Chia Chong, Tabitha Healey, Tony Michele, Timothy J Price
Standard treatment for locally advanced anal cancer is chemoradiotherapy with mitomycin C and fluorouracil. However, infusional fluorouracil requires central venous catheter placement potentiating risk of infection and thrombosis. Capecitabine which is an oral tumor activated fluoropyrimidine carbamate is an established treatment alternative to infusional fluorouracil for patients with gastrointestinal cancers. Areas covered: This review examines and discusses the current evidence for substitution of Capecitabine for infusional fluorouracil in locally advanced anal cancer...
March 13, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#8
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28255132/extra-anatomical-veno-venous-surgical-bypass-for-central-vein-occlusion-in-patients-with-ipsilateral-arterio-venous-fistula-avf-for-haemodialysis-a-single-centre-experience
#9
K S Saravana, A A Zainal
OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face. MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28254252/improvement-in-the-diagnosis-of-catheter-related-bloodstream-infections-in-a-tertiary-cancer-center
#10
Patrick Chaftari, Anne-Marie Chaftari, Javier Adachi, Ray Hachem, Sammy Raad, Elizabeth Natividad, Nora Oliver, Bena Ellickalputhenpura, Ying Jiang, Jeffrey Tarrand, Issam Raad
BACKGROUND: Identifying a central venous catheter (CVC) as the source of bacteremia requires drawing simultaneous blood cultures (BCs) from the CVC and peripheral site and correct labeling of the BC source. In our emergency center (EC), 52% of BCs collected from febrile cancer patients lacked source information, making the diagnosis and management of catheter-related bloodstream infections (CRBSIs) challenging. METHODS: Between January 2015 and June 2015, we conducted a quality improvement project in our EC aiming to increase the occurrence of simultaneous BC drawing with accurate source labeling by 10%...
March 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28244579/prevention-of-healthcare-associated-infections-a-descriptive-study
#11
R Accardi, S Castaldi, A Marzullo, S Ronchi, D Laquintana, M Lusignani
BACKGROUND: This study aims to verify whether there are, and to which degree, knowledge and adherence to guidelines on the prevention and control of healthcare associated infections by nursing staff. Study design. A descriptive study was conducted on a sample of nurses in the areas of medicine, surgery, and its own specialties of the Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico in Milan from 1st December 2015 to 29th February 2016. METHODS: The knowledge of the nursing staff have been investigated through the use of questionnaires with anonymous self-reporting method; inspections in the wards using observational grids were carried out in order to verify adherence to best-practice principles...
March 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#12
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28224103/management-of-parenteral-nutrition-in-critically-ill-patients
#13
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/28218366/peripherally-inserted-central-catheter-related-complications-in-cancer-patients-a-prospective-study-of-over-50-000-catheter-days
#14
Junren Kang, Wei Chen, Wenyan Sun, Ruibin Ge, Hailong Li, Enling Ma, Qingxia Su, Fang Cheng, Jinhua Hong, Yuanjuan Zhang, Cheng Lei, Xinchuan Wang, Aiyun Jin, Wanli Liu
PURPOSE: To evaluate incidence and risk factors of peripherally inserted central catheter (PICC)-related complications in cancer patients. METHODS: A prospective, multicenter, cohort study of cancer patients with PICC insertion was performed from February 1, 2013 to April 24, 2014. All patients were monitored in clinic until PICCs were removed. The primary endpoint was PICC removal due to complications. Patient-, catheter- and insertion-related factors were analyzed in univariable and multivariable logistic regression analysis to identify significant independent risk factors for PICC-related complications...
February 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28218354/dialysis-access-infections-and-hospitalisations-in-unplanned-dialysis-start-patients-results-from-the-options-study
#15
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/28214161/human-factors-related-to-time-dependent-infection-control-measures-scrub-the-hub-for-venous-catheters-and-feeding-tubes
#16
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/28202886/totally-implantable-central-venous-device-associated-blood-stream-infection-in-elderly-malignant-disease-patients
#17
Yasuo Aota, Yuko Okuda, Tsubasa Watanabe, Keitaro Fujiwara, Itaru Nakamura, Tomohisa Yokoyama, Akihiko Gotoh, Michio Sakurai
AIM: We investigated the rate of bloodstream infections in elderly malignant disease patients whose totally implantable central venous device (CV ports) had been removed for any reason at our hospital. METHODS: We evaluated 22 elderly malignant disease patients who had had their CV ports removed for any reason between May 2014 to April 2015. RESULTS: The patients were 12 males and 10 females between 62 and 86 years of age with a median age of 75...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28202859/experience-of-peripherally-inserted-central-venous-catheter-in-patients-with-hematologic-diseases
#18
Yoshinori Hashimoto, Takanori Fukuta, Junko Maruyama, Hiromi Omura, Takayuki Tanaka
Objective Although use of the peripherally inserted central venous catheter (PICC) has become increasingly common, there are few reports of PICCs used for patients with hematologic diseases. In this study, we analyzed the safety of PICC placement in patients with hematologic diseases where PICCs had been placed to perform blood collection, blood transfusion, drug administration, and hematopoietic stem cell transplantation. Methods This study included 142 PICCs placed in 95 patients managed at our department from November 2013 to December 2015...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28198656/fungicidal-activity-and-pk-pd-of-caspofungin-as-tools-to-guide-antifungal-therapy-in-a-fluconazole-resistant-c-parapsilosis-candidemia
#19
Carlo Tascini, Emanuela Sozio, Antonello Di Paolo, Giancarlo Tintori, Alessandro Leonildi, Giacomo Bertolino, Franco Carmassi, Enrico Tagliaferri, Francesco Menichetti, Francesco Barchiesi
Candida parapsilosis may be responsible for bloodstream infections (BSI) and it is characterised by an increased incidence of fluconazole resistance. A 75-year old woman with severe comorbidities received the insertion of a peripherally inserted central venous catheter. Fluconazole did not prevent a C. parapsilosis BSI hence caspofungin was started after a nephrotoxic first-line treatment with amphotericin B. The ratio of peak plasma concentration over the minimum inhibitory concentration (Cmax/MIC) was adopted to maximise efficacy of caspofungin...
February 15, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28197350/disseminated-mycobacterium-interjectum-infection-with-bacteremia-hepatic-and-pulmonary-involvement-associated-with-a-long-term-catheter-infection
#20
David Sotello, D Jane Hata, Mohammed Reza, Raj Satyanarayana, Vichaya Arunthari, Wendelyn Bosch
We present a 49-year-old female with one year of intermittent fevers, chills, night sweats, and significant weight loss. Liver and lung biopsy showed evidence of a granulomatous process. Blood and liver biopsy cultures yielded growth of presumed Mycobacterium interjectum, thought to be related to a disseminated long-term central venous catheter infection. She successfully received one year of combined antimicrobial therapy after catheter removal without recurrence of disease. M. interjectum has been previously described as a cause of lymphadenitis in healthy children and associated with pulmonary disease in adults, although other localized infections have been reported...
2017: Case Reports in Infectious Diseases
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