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Vascular catheters induced infections

Nancy E Epstein
Background: The risk of spinal cord injury (SCI) due to decreased cord perfusion following thoracic/thoracoabdominal aneurysm surgery (T/TL-AAA) and thoracic endovascular aneurysm repair (TEVAR) ranges up to 20%. For decades, therefore, many vascular surgeons have utilized cerebrospinal fluid drainage (CSFD) to decrease intraspinal pressure and increase blood flow to the spinal cord, thus reducing the risk of SCI/ischemia. Methods: Multiple studies previously recommend utilizing CSFD following T/TL-AAA/TEVAR surgery to treat SCI by increasing spinal cord blood flow...
2018: Surgical Neurology International
Sowmya Nanjappa, Matthew Snyder, John N Greene
<p>Extravasation of medications can manifest as tenderness, pain, tissue necrosis, and thrombophlebitis and lead to infection and severe long-term complications. Risk factors for leakage of medications include mechanical and pharmacologic mechanisms such as cannulation technique, vasoconstriction, and cytotoxicity. Well-known vesicants like anthracyclines, vinca alkaloids, and vasopressors are usually administered with proper caution. Often overlooked are many antimicrobial agents, which typically act via differences in osmolality and pH...
November 1, 2017: Journal of Drugs in Dermatology: JDD
Tamara Yawno, Tharani Sabaretnam, Jingang Li, Courtney McDonald, Rebecca Lim, Graham Jenkin, Euan M Wallace, Suzanne L Miller
Intrauterine inflammation is a significant cause of injury to the developing fetal brain. Using a preterm fetal sheep model of in utero infection, we asked whether human amnion epithelial cells (hAECs) were able to reduce inflammation-induced fetal brain injury. Surgery was undertaken on pregnant sheep at ∼105 days gestation (term is 147 days) for implantation of vascular catheters. Lipopolysaccharide (LPS; 150 ng/kg bolus) or saline was administered IV at 109, 110, and 111 days. Sixty million fluorescent-labeled hAECs were administered at 110, 111, and 112 days gestation via the brachial artery catheter...
April 13, 2017: Cell Transplantation
Marijke Peetermans, Peter Verhamme, Thomas Vanassche
Staphylococcus aureus is a leading cause of skin and soft tissue infections, foreign body infections, and infective endocarditis. In case of endovascular infection with S. aureus, higher rates of cardiac valve destruction, embolic complications, severe sepsis, and death occur. The unique capacity of S. aureus to induce clotting has been known for over a century; however, its role in virulence has long been controversial. S. aureus secretes two coagulases, staphylocoagulase and von Willebrand factor binding protein that both activate prothrombin to generate fibrin...
June 2015: Seminars in Thrombosis and Hemostasis
Helena Ahtinen, Julia Kulkova, Laura Lindholm, Erkki Eerola, Antti J Hakanen, Niko Moritz, Mirva Söderström, Tiina Saanijoki, Sirpa Jalkanen, Anne Roivainen, Hannu T Aro
BACKGROUND: Staphylococcus epidermidis (S. epidermidis) has emerged as one of the leading pathogens of biomaterial-related infections. Vascular adhesion protein-1 (VAP-1) is an inflammation-inducible endothelial molecule controlling extravasation of leukocytes. Sialic acid-binding immunoglobulin-like lectin 9 (Siglec-9) is a leukocyte ligand of VAP-1. We hypothesized that (68)Ga-labeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-conjugated Siglec-9 motif containing peptide ((68)Ga-DOTA-Siglec-9) could detect inflammatory response due to S...
2014: EJNMMI Research
Tomoyuki Shimokaze, Kazuhiro Akaba, Emi Saito
Heparin may cause hyperkalemia by blocking aldosterone biosynthesis in the adrenal gland. Dizygotic twin sisters were born by Cesarean section at 25 weeks' gestation. The younger sister developed acute hyperkalemia (7.4 mEq/L) at 10 days of age. At the time of the development of the hyperkalemia, there were no signs of systemic infection, cardiac or renal failure, adrenal insufficiency, or sudden anemia. She was receiving no medication other than heparin to maintain the vascular catheter. Heparin was changed to dalteparin at 12 days of age...
2014: Journal of Clinical Research in Pediatric Endocrinology
Rebekah Beyers, Michael Baldwin, Sevilay Dalabih, Abdallah Dalabih
Clostridium sordellii is a toxin producing ubiquitous gram-positive anaerobe, mainly associated with trauma, soft tissue skin infections, and gynecologic infection. We report a unique case of a new strain of Clostridium sordellii (not present in the Center for Disease Control (CDC) database) infection induced toxic shock syndrome in a previously healthy two-year-old male with colitis-related hemolytic uremic syndrome (HUS). The patient presented with dehydration, vomiting, and bloody diarrhea. He was transferred to the pediatric critical care unit (PICU) for initiation of peritoneal dialysis (PD)...
2014: Case Reports in Pediatrics
Ryoji Yanagisawa, Masaharu Kataoka, Takumi Inami, Nobuhiko Shimura, Haruhisa Ishiguro, Keiichi Fukuda, Hideaki Yoshino, Toru Satoh
BACKGROUND: Percutaneous transluminal pulmonary angioplasty (PTPA) is a recently developed catheter-based therapy for chronic thromboembolic pulmonary hypertension (CTEPH). The aim of the present study was to investigate the safety and efficacy of PTPA in elderly patients with CTEPH. METHODS: In all, 257 PTPA sessions in 70 patients (median age 63 years) were analyzed. Patients were divided into two groups according to age: (i) a younger group (<65 years; n=39); and (ii) an elderly group (≥65 years; n=31)...
August 1, 2014: International Journal of Cardiology
U Teichgräber, S N Nagel, S Kausche
PURPOSE: Evaluation of correlations between underlying disease and port complications. MATERIALS AND METHODS: Retrospective analysis of a data set of 3160 port systems, which had been interventionally implanted over a period of 10 years. Of these, 1393 were included in the final evaluation. The 7 most common underlying diseases and port-induced complications were considered. Port-related thrombotic events, port pocket infections as well as the port-induced sepsis were evaluated and classified as either early or late complications...
May 2014: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Peter F Lawrence, Michael P Harlander-Locke, Gustavo S Oderich, Misty D Humphries, Gregory J Landry, Jeffrey L Ballard, Christopher J Abularrage
BACKGROUND: Previous studies have combined anastomotic, catheter-induced, and atherosclerotic isolated femoral artery aneurysms (FAAs) to achieve adequate numbers for analysis and have recommended repair of asymptomatic FAAs with diameters ≥2.5 cm and all symptomatic FAAs. This study evaluated the contemporary management of isolated FAAs. METHODS: Patients with FAAs were evaluated using a standardized, prospectively maintained database by a research consortium...
February 2014: Journal of Vascular Surgery
Gernot Schilcher, Axel Schlagenhauf, Daniel Schneditz, Hubert Scharnagl, Werner Ribitsch, Robert Krause, Alexander R Rosenkranz, Tatjana Stojakovic, Joerg H Horina
OBJECTIVE: The ethanol lock technique has shown great potential to eradicate organisms in biofilms and to treat or prevent central venous catheter related infections. Following instillation of ethanol lock solution, however, the inherent density gradient between blood and ethanol causes gravity induced seepage of ethanol out of the catheter and blood influx into the catheter. Plasma proteins so are exposed to highly concentrated ethanol, which is a classic agent for protein precipitation...
2013: PloS One
Rafat Mosalli, Mohamed Elbaz, Bosco Paes
Arterial cannulation in neonates is usually performed for frequent blood pressure monitoring and blood sampling. The procedure, while easily executed by skilled neonatal staff, can be associated with serious complications such as vasospasm, thrombosis, embolism, hematoma, infection, peripheral nerve damage, ischemia, and tissue necrosis. Several treatment options are available to reverse vascular induced ischemia and tissue damage. Applied interventions depend on the extent of tissue involvement and whether the condition is progressive and deemed life threatening...
2013: Case Reports in Pediatrics
Karan Garg, Brittny Williams Howell, Stephanie S Saltzberg, Todd L Berland, Firas F Mussa, Thomas S Maldonado, Caron B Rockman
BACKGROUND: Cannulation of the radial artery is frequently performed for invasive hemodynamic monitoring. Complications arising from indwelling catheters have been described in small case series; however, their surgical management is not well described. Understanding the presentation and management of such complications is imperative to offer optimal treatment, particularly because the radial artery is increasingly accessed for percutaneous coronary interventions. METHODS: We conducted a retrospective review to identify patients who underwent surgical intervention for complications arising from indwelling radial artery catheters from 1997 to 2011...
November 2013: Journal of Vascular Surgery
Manila Gaddh, Ana Antun, Kei Yamada, Pooja Gupta, Ha Tran, Fuad El Rassi, Hyun S Kim, Hanna Jean Khoury
Patients with cancer are at high risk for developing venous thromboembolism (VTE), and the presence of a central venous catheter (CVC) further increases this risk. CVC-related VTE has serious implications related to the loss of vascular access, development of pulmonary embolism, recurrent VTE, infections and post-thrombotic syndrome. The pathogenesis of CVC-related VTE is complex and multifactorial, with risk factors associated with the catheter, the vessel selected for insertion and the underlying cancer as well as the anti-cancer therapy...
March 2014: Leukemia & Lymphoma
Roger S Smith, Zheng Zhang, Michael Bouchard, Jun Li, Heather S Lapp, Gregory R Brotske, David L Lucchino, Douglas Weaver, Laurence A Roth, Arthur Coury, John Biggerstaff, Sivaprasad Sukavaneshvar, Robert Langer, Christopher Loose
Adherence of proteins, cells, and microorganisms to the surface of venous catheters contributes to catheter occlusion, venous thrombosis, thrombotic embolism, and infections. These complications lengthen hospital stays and increase patient morbidity and mortality. Current technologies for inhibiting these complications are limited in duration of efficacy and may induce adverse side effects. To prevent complications over the life span of a device without using active drugs, we modified a catheter with the nonleaching polymeric sulfobetaine (polySB), which coordinates water molecules to the catheter surface...
September 26, 2012: Science Translational Medicine
Salvatore Mandolfo
The permanent central venous catheter (CVCp) for vascular access is increasingly common in patients on hemodialysis. The main problem related to CVCp is the biofilm, which leads to malfunction and an increased risk of infections. In recent years lock solutions for the CVCp have become popular. Heparin should be abandoned because it induces rapid biofilm development and exposes the patient to the risk of bleeding due to overspill of heparin into the bloodstream. Citrate solution (3.8%) is associated with the best risk/benefit ratio for CVC functioning but offers no advantages in terms of reducing infections...
May 2012: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Marilyn E Schallom, Donna Prentice, Carrie Sona, Scott T Micek, Lee P Skrupky
OBJECTIVE: To compare heparin (3 mL, 10 units/mL) and 0.9% sodium chloride (NaCl, 10 mL) flush solutions with respect to central venous catheter lumen patency. DESIGN: Single-center, randomized, open label trial. SETTING: Medical intensive care unit and Surgical/Burn/Trauma intensive care unit at Barnes-Jewish Hospital, St. Louis, MO. PATIENTS: Three hundred forty-one patients with multilumen central venous catheters...
June 2012: Critical Care Medicine
Andre Kaplan
In general, therapeutic apheresis is a relatively safe procedure with the most commonly seen complications caused by citrate-induced hypocalcemia and urticarial reactions to the protein-containing replacement fluid. Depletion coagulopathy and immunoglobulin depletion must be anticipated when albumin is used as the replacement fluid and becomes more profound as the number of treatment increases. The most serious complications are seen when there is an anaphylactoid reaction to the multiple units of fresh frozen plasma required when used as the replacement fluid...
March 2012: Seminars in Dialysis
Mala Sachdeva, Adriana Hung, Oleksandr Kovalchuk, Markus Bitzer, Michele H Mokrzycki
Background. The contribution of the hemodialysis (HD) vascular access type to inflammation is unclear. Methods. We conducted a prospective observational study in an incident HD population. C-reactive protein (CRP), interleukin-6 (IL-6), and interferon-γ-induced protein (IP-10) were measured before and at 6-time points after access placement for 1 year. Results. Sixty-four incident HD patients were included (tunneled catheter (TC), n = 40, arteriovenous fistula (AVF), n = 14, and arteriovenous graft (AVG), n = 10)...
2012: International Journal of Nephrology
Brian M Ilfeld
A continuous peripheral nerve block, also termed "perineural local anesthetic infusion," involves the percutaneous insertion of a catheter adjacent to a peripheral nerve, followed by local anesthetic administration via the catheter, providing anesthesia/analgesia for multiple days or even months. Continuous peripheral nerve blocks may be provided in the hospital setting, but the use of lightweight, portable pumps permits ambulatory infusion as well. This technique's most common application is providing analgesia after surgical procedures...
October 2011: Anesthesia and Analgesia
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