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https://www.readbyqxmd.com/read/29627658/routine-chest-x-ray-is-unnecessary-after-ultrasound-guided-central-venous-line-placement-in-the-operating-room
#1
David C Woodland, C Randall Cooper, M Farzan Rashid, Vilma L Rosario, Paul David Weyker, Joshua Weintraub, Stuart Bentley-Hibbert, Michael D Kluger
BACKGROUND: Central venous catheters (CVC) can be useful for perioperative monitoring and insertion has low complication rates. However, routine post insertion chest X-rays have become standard of care and contribute to health care costs with limited impact on patient management. METHODS: 200 patient charts who underwent pancreaticoduodenectomy with central line placement and early line removal were reviewed for clinical complications related to central line placement as well as radiographic evidence of malpositioning...
March 28, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29627326/one-percent-chlorhexidine-alcohol-for-preventing-central-venous-catheter-related-infection-during-intensive-chemotherapy-for-patients-with-haematologic-malignancies
#2
Shimon Ohtake, Hiromichi Takahashi, Masaru Nakagawa, Yoshihito Uchino, Katsuhiro Miura, Noriyoshi Iriyama, Tomohiro Nakayama, Yoshihiro Hatta, Masami Takei
A central venous catheter (CVC) is a catheter placed into a large vein, and is used for chemotherapy administration. However, there is little confirmatory data on which antiseptic-such as chlorhexidine or povidone-iodine (PI) -is more protective against CVC-related infectious complications in patients receiving intensive chemotherapy. We aimed to compare the effectiveness of 1% chlorhexidine gluconate in 70% alcohol (CH) vs. PI for skin disinfection before CVC insertion in patients receiving intensive chemotherapy...
April 4, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29602709/comparative-study-on-fixation-of-central-venous-catheter-by-suture-versus-adhesive-device
#3
C S Molina-Mazón, X Martín-Cerezo, G Domene-Nieves de la Vega, S Asensio-Flores, J Adamuz-Tomás
OBJECTIVES: To assess the efficacy of a central venous catheter adhesive fixation device (CVC) to prevent associated complications. To establish the need for dressing changes, number of days' catheterization and reasons for catheter removal in both study groups. To assess the degree of satisfaction of personnel with the adhesive system. METHOD: A, randomized, prospective and open pilot study, of parallel groups, with comparative evaluation between CVC fixation with suture and with an adhesive safety system...
March 27, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29549061/impact-of-quickfish-in-addition-to-antimicrobial-stewardship-on-vancomycin-use-and-resource-utilization-in-cancer-patients-with-coagulase-negative-staphylococcal-blood-cultures
#4
Susan K Seo, Zivile Gedrimaite, Alla Paskovaty, Kenneth Seier, Sejal Morjaria, Nina Cohen, Elyn Riedel, Yi-Wei Tang, N Esther Babady
OBJECTIVE: To evaluate the impact of rapidly identifying coagulase-negative staphylococci (CoNS) from positive blood cultures (BC) combined with an established antimicrobial stewardship (AS) program at a tertiary cancer center. METHODS: Cancer patients >=18 years with >=1 positive CoNS BC identified by Staphylococcus QuickFISH®, a peptide nucleic acid fluorescence in situ hybridization assay, between 01/1/13 and 12/31/13 (QuickFISH) were compared to cancer patients >=18 years with CoNS identified via standard microbiologic techniques between 01/01/11 and 12/31/11 (baseline)...
March 13, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29512818/antibiotics-at-the-time-of-removal-of-central-venous-catheter-to-reduce-morbidity-and-mortality-in-newborn-infants
#5
REVIEW
Rowena L McMullan, Adrienne Gordon
BACKGROUND: Late-onset sepsis is associated with increased rates of mortality and morbidity in newborn infants, in addition to poorer long-term developmental outcomes and increased length of stay and hospital costs. Central line-associated blood stream infection (CLABSI) is the most common cause of late-onset sepsis in hospitalised infants, and prevention of CLABSI is a key objective in neonatal care. Increased frequency of CLABSI around the time of removal of central venous catheters (CVCs) has been reported, and use of antibiotics at the time of removal may reduce the incidence and impact of late-onset sepsis in vulnerable newborn infants...
March 7, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29456363/inadvertent-central-arterial-catheterization-an-unusual-cause-of-ischemic-stroke
#6
Nakul Katyal, Amanda Korzep, Christopher Newey
Central venous catheter (CVC) insertion is extensively utilized in Intensive Care Units for evaluation of hemodynamic status, administration of intravenous drugs, and for providing nutritional support in critically ill patients. Unfortunately, CVC use is associated with complications including lung injury, bleeding, infection, and thrombosis. We present a patient with an acute ischemic stroke from an inadvertently placed CVC into the right common carotid artery. A 57-year-old male presented to our institution for left hemiplegia and seizures 2 days after a CVC was placed...
January 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29434493/comparative-study-of-complications-in-cv-catheter-insertion-for-pediatric-patients-real-time-ultrasound-guided-versus-venography-guided-approach
#7
Shuichi Takano, Norio Shimizu, Naruo Tokuyasu, Teruhisa Sakamoto, Soichiro Honjo, Keigo Ashida, Hiroaki Saito, Yoshiyuki Fujiwara
Background: Tunneled central venous catheters (CVC), called Broviac/Hickman catheter, are widely used in the long-term treatment of pediatric patients. Recently, the percutaneous approach for CVC insertion has become dominant as a less invasive intervention. In this study, we reviewed the mechanical and delayed complications according to different procedures of CVC insertion and assessed the risk factors for complications in CVC insertions for pediatric patients. Methods: A total of 159 pediatric patients (85 males and 74 females) were included in this study...
December 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/29331162/unnecessary-removal-of-central-venous-catheters-in-cancer-patients-with-bloodstream-infections
#8
Anne Marie Chaftari, Ray Hachem, Sammy Raad, Ying Jiang, Elizabeth Natividad, Patrick Chaftari, Issam Raad
We evaluated the rate of central venous catheter (CVC) removal in 283 cancer patients with bloodstream infections (BSIs). Removal of CVCs occurred unnecessarily in 57% of patients with non-central-line-associated BSI (non-CLABSI), which was equivalent to the rate of CVC removal in patients with CLABSIs. Physician education and safe interventions to salvage the vascular access are warranted. Infect Control Hosp Epidemiol 2018;39:222-225.
February 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29330016/clinical-impact-of-delayed-catheter-removal-for-patients-with-central-venous-catheter-related-gram-negative-bacteraemia
#9
Y-M Lee, C Moon, Y J Kim, H J Lee, M S Lee, K-H Park
BACKGROUND: Gram-negative bacteria are increasingly the cause of catheter-related bloodstream infection (CRBSI), and the prevalence of multi-drug-resistant strains is rising rapidly. This study evaluated the impact of delayed central venous catheter (CVC) removal on clinical outcomes in patients with Gram-negative CRBSI. METHODS: Between January 2007 and December 2016, patients with Gram-negative bacteraemia and CVC placement, from two tertiary care hospitals, were included retrospectively...
May 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29325218/equal-candida-score-an-ecmm-score-derived-from-current-guidelines-to-measure-quality-of-clinical-candidaemia-management
#10
Sibylle C Mellinghoff, Martin Hoenigl, Philipp Koehler, Anil Kumar, Katrien Lagrou, Cornelia Lass-Flörl, Jacques F Meis, Vidya Menon, Riina Rautemaa-Richardson, Oliver A Cornely
Candida species frequently cause blood stream infections and are reported to be the third to tenth most commonly isolated pathogens. Guidelines and standardised treatment algorithms provided by professional organisations aim to facilitate decision-making regarding diagnosis, management and treatment of candidaemia. In routine clinical practise, however, it may be challenging to comply with these guidelines. The reasons include lack of familiarity or feasibility to adherence, but also their length and complexity...
January 11, 2018: Mycoses
https://www.readbyqxmd.com/read/29247720/voltage-gated-potassium-channels-and-nos-contribute-to-a-sustained-cutaneous-vasodilation-elicited-by-local-heating-in-an-interactive-manner-in-young-adults
#11
Naoto Fujii, Lyra Halili, Takeshi Nishiyasu, Glen P Kenny
Local skin heating to 42°C causes rapid increases in cutaneous perfusion (initial peak), followed by a brief nadir and subsequent sustained elevation (plateau). Several studies have demonstrated that nitric oxide synthase (NOS) largely contributes to the plateau response during local heating. In this study, we tested the hypothesis that voltage-gated potassium (Kv) channels contribute to the plateau of the cutaneous vasodilation during local heating through NOS-dependent mechanisms. Eleven young males (25±4years) participated in this study wherein cutaneous vascular conductance (CVC) was measured at four intradermal microdialysis sites that were continuously perfused with either 1) lactated Ringer (Control), 2) 10mM 4-aminopyridine (Kv channel blocker), 3) 10mM Nω-Nitro-L-arginine (NOS inhibitor), or 4) a combination of 4-aminopyridine and Nω-Nitro-L-arginine...
May 2018: Microvascular Research
https://www.readbyqxmd.com/read/29198897/the-idle-central-venous-catheter-in-the-nicu-when-should-it-be-removed
#12
Cristen N Litz, Jordan G Tropf, Paul D Danielson, Nicole M Chandler
PURPOSE: There is debate regarding the optimal timing of central line removal in the neonatal intensive care unit (NICU). The purpose was to evaluate outcomes of idle peripherally inserted central catheters (PICCs) and tunneled central venous catheters (TCVCs) and determine the incidence of line-related infections and replacements. METHODS: Patients in the NICU with T-CVCs placed between 11/2008 and 8/2015 (n=134) or PICCs placed between 7/2013 and 10/2015 (n=467) were included...
November 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29167141/impact-of-automatic-infectious-diseases-consultation-on-the-management-of-fungemia-at-a-large-academic-medical-center
#13
Travis M Jones, Richard H Drew, Dustin T Wilson, Christina Sarubbi, Deverick J Anderson
PURPOSE: The impact of automatic infectious diseases (ID) consultation for inpatients with fungemia at a large academic medical center was studied. METHODS: In this single-center, retrospective study, the time to appropriate antifungal therapy before and after implementing a policy requiring automatic ID consultation for the management of fungemia for all patients with an inpatient positive blood culture for fungus was examined. The rates of ID consultation; the likelihood of receiving appropriate antifungal therapy; central venous catheter (CVC) removal rates; performance of ophthalmologic examinations; infection-related length of stay (LOS); rates of all-cause inhospital mortality, death, or transfer to an intensive care unit within 7 days of first culture; and inpatient cost of antifungals were also evaluated...
December 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29156852/risk-factors-for-recurrent-central-line-associated-bloodstream-infections-in-a-pediatric-intensive-care-unit
#14
Rana İşgüder, İlker Devrim, Gökhan Ceylan, Ahu Kara, Gamze Gülfidan, Hasan Ağın
Background/aim: It is recommended that a central venous catheter (CVC) be removed if central line-associated bloodstream infection (CLABSI) has been diagnosed. The objective of this retrospective study was to evaluate the risk factors for recurrent CLABSI in reinserted catheters in a pediatric intensive care unit. Materials and methods: Patients with recurrent and nonrecurrent CLABSI were compared in terms of the catheter exchange interval, the interval between negative blood culture and reinsertion of the CVC, and the pre-/reinsertion treatment duration...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29148007/how-to-treat-arteriovenous-graft-infection-total-versus-partial-graft-excision
#15
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
November 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29133157/microbiologic-and-clinical-characteristics-of-biofilm-forming-candida-parapsilosis-isolates-associated-with-fungaemia-and-their-impact-on-mortality
#16
S Soldini, B Posteraro, A Vella, E De Carolis, E Borghi, M Falleni, A R Losito, G Maiuro, E M Trecarichi, M Sanguinetti, M Tumbarello
OBJECTIVES: Biofilm formation (BF) by fungal isolates may dramatically complicate infection. We determined the ability of Candida parapsilosis isolates from single fungaemia episodes to form biofilms and we analysed biofilm subgroups for antifungal susceptibility and pathogenic potential. We then correlated BF with clinical characteristics and outcomes of the episodes. METHODS: BF was measured using the crystal violet biomass assay. Antifungal susceptibility of preformed biofilms was assessed, and virulence was studied using the Galleria mellonella model...
November 10, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29045423/candidemia-in-non-icu-surgical-wards-comparison-with-medical-wards
#17
MULTICENTER STUDY
Antonio Vena, Emilio Bouza, Maricela Valerio, Belén Padilla, José Ramón Paño-Pardo, Mario Fernández-Ruiz, Ana Díaz Martín, Miguel Salavert, Alessandra Mularoni, Mireia Puig-Asensio, Patricia Muñoz
Candidemia acquired outside critical care or hematological areas has received much attention in recent years; however, data on candidemia in surgical departments are very scarce. Our objectives were to describe episodes of candidemia diagnosed in surgical wards and to compare them with episodes occurring in medical wards. We performed a post hoc analysis of a prospective, multicenter study implemented in Spain during 2010-2011 (CANDIPOP project). Of the 752 episodes of candidemia, 369 (49.1%) occurred in patients admitted to surgical wards (165, 21...
2017: PloS One
https://www.readbyqxmd.com/read/28966069/biotimer-assay-a-reliable-and-rapid-method-for-the-evaluation-of-central-venous-catheter-microbial-colonization
#18
Luigi Rosa, Antimo Cutone, Monica Coletti, Maria Stefania Lepanto, Mellani Scotti, Piera Valenti, Giammarco Raponi, Maria Cristina Ghezzi, Francesca Berlutti
Adherent bacteria and biofilm frequently colonize central venous catheters (CVCs). CVC colonization is correlated to infections and particularly to bloodstream ones. The classical microbiological methods to determine of CVC colonization are not fully reliable and are time-consuming. BioTimer Assay (BTA) is a biological method already used to count bacteria adherent to abiotic surfaces and biofilm without sample manipulation. BTA employs specific reagents whose color changed according to bacterial metabolism...
September 29, 2017: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/28948347/central-venous-catheter-salvage-in-children-with-staphylococcus-aureus-central-line-associated-bloodstream-infection
#19
Kristine S Corkum, Rachel E Jones, Caroline H Reuter, Larry K Kociolek, Elaine Morgan, Timothy B Lautz
BACKGROUND: Prompt central venous catheter (CVC) removal is currently recommended in children with Staphylococcus aureus central line-associated bloodstream infection (CLABSI). Our objective was to examine the outcome of attempted line salvage in children with S. aureus CLABSI and assess predictors of success. METHODS: A single-institution, retrospective cohort study was performed of all children with S. aureus CLABSI between 2012 and 2015. Patients with and without immediate CVC removal (≤ 2 days after first positive culture) were compared...
November 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28904468/gyriform-infarction-in-cerebral-air-embolism-imaging-mimicker-of-status-epilepticus
#20
Konark Malhotra, Appaji Rayi
Cerebral air embolism (CAE) is a potentially fatal iatrogenic complication related to common procedures including central venous catheter (CVC) removal. We report an interesting case of CAE related to CVC removal that was further complicated with status epilepticus. Neuroimaging of CAE and status epilepticus could pose diagnostic dilemmas and require consideration of wide diagnostic differentials. We discuss the clinical presentation, mechanism, and diagnostic approach, especially neuroimaging to differentiate various etiologies in CAE patients...
July 2017: Annals of Indian Academy of Neurology
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