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https://www.readbyqxmd.com/read/28079867/reducing-peripherally-inserted-central-catheters-in-the-neonatal-intensive-care-unit
#1
A J Vachharajani, N A Vachharajani, H Morris, A Niesen, A Elward, D A Linck, A M Mathur
OBJECTIVE: Our objective was to safely reduce the number of peripherally inserted central catheters (PICCs) inserted in infants with umbilical venous catheter using quality improvement methods. STUDY DESIGN: In a tertiary neonatal intensive care unit, a questionnaire designed to prompt critical thinking around the decision to place a PICC, along with an updated standardized feeding guideline was introduced. PICC insertion in 86 infants with umbilical venous catheter (pre intervention) with birth weight 1000-1500 g were compared with 115 infants (post intervention) using Fisher's exact test...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28079740/venous-thromboembolism-among-pediatric-orthopedic-trauma-patients-a-database-analysis
#2
Daniel Guzman, Samir Sabharwal, Caixia Zhao, Sanjeev Sabharwal
Using the 2012 Kids Inpatient Database, we assessed records of pediatric patients (<21 years old) with fractures of the upper limb, lower limb, spine, pelvis, and multiple locations and calculated the overall prevalence of venous thromboembolism (VTE) and associated potential risk factors. 387 (0.68%) of 57 183 patients with one or more fractures were diagnosed with VTE. Children sustaining fractures of the axial skeleton and those with multiple fractures had a higher prevalence of VTE than those with isolated extremity fractures...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#3
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28077611/umbilical-venous-catheter-versus-peripherally-inserted-central-catheter-in-neonates-a-randomized-controlled-trial
#4
By Ashish R Dongara, Dipen V Patel, Somashekhar M Nimbalkar, Nirav Potana, Archana S Nimbalkar
: Peripherally inserted central catheter (PICC) and umbilical venous catheter (UVC) in terms of success rate, complications, cost and time of insertion in neonatal intensive care were compared. Neonates requiring vascular access for minimum 7 days were included. Sample size of 72 per group was determined. Trial was registered at Clinical Trials Registry of India (CTRI/2015/02/005529). Success rates of the UVC and PICC were 68.1% and 65.3%, respectively (p = 0.724). Mean (SD) time needed for PICC and UVC insertion was 34...
January 10, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28076593/brachial-insertion-of-fully-implantable-venous-catheters-for-chemotherapy-complications-and-quality-of-life-assessment-in-35-patients
#5
Igor Yoshio Imagawa Fonseca, Mariana Krutman, Kenji Nishinari, Guilherme Yazbek, Marcelo Passos Teivelis, Guilherme André Zottele Bomfim, Rafael Noronha Cavalcante, Nelson Wolosker
Objective: To prospectively evaluate the perioperative safety, early complications and satisfaction of patients who underwent the implantation of central catheters peripherally inserted via basilic vein. Methods: Thirty-five consecutive patients with active oncologic disease requiring chemotherapy were prospectively followed up after undergoing peripheral implantation of indwelling venous catheters, between November 2013 and June 2014. The procedures were performed in the operating room by the same team of three vascular surgeons...
October 2016: Einstein
https://www.readbyqxmd.com/read/28075624/use-of-preprocedural-mdct-for-cardiac-implantable-electric-device-lead-extraction-frequency-of-findings-that-change-management
#6
Wendy L Ehieli, Daniel T Boll, Daniele Marin, Robert Lewis, Jonathan P Piccini, Lynne M Hurwitz
OBJECTIVE: Five percent of cardiac implantable electric devices (CIEDs) are removed each year. Percutaneous extraction is preferred but can be complicated if the leads adhere to the vasculature or perforate. The goal of this study is to assess the frequency of findings on dedicated MDCT that alter preprocedural planning for percutaneous CIED extraction. MATERIALS AND METHODS: One hundred patients with CIEDs who underwent MDCT before percutaneous lead extraction were analyzed...
January 11, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28075612/comparison-of-mechanical-versus-hand-administration-of-iv-contrast-agents-for-pediatric-pulmonary-ct-angiography
#7
Matthew A Zapala, David Zurakowski, Edward Y Lee
OBJECTIVE: The purpose of this study was to assess the difference between mechanical versus hand administration of IV contrast agents on the diagnostic quality of pediatric pulmonary CT angiography (CTA). MATERIALS AND METHODS: A retrospective review of the medical records was performed to detect pediatric patients (≤ 18 years) with pulmonary CTA performed between September 2012 and March 2015. Patients were placed into two cohorts on the basis of the method of contrast administration (mechanical vs hand)...
January 11, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28075214/intralipid-vehicle-does-not-interfere-with-the-efficacy-of-progesterone-in-attenuating-edema-following-tbi
#8
Bushra Wali, Donald Stein, Iqbal Sayeed
The recent disappointing results of Phase 3 trials for progesterone (PROG) in traumatic brain injury (TBI) have triggered speculation about reasons for the negative outcomes. One confounding factor may have been the vehicle used to administer PROG. Virtually all of the many preclinical experiments informing the clinical trials and reporting beneficial PROG effects used more soluble 2-hydroxypropyl-b-cyclodextrin (HBC) as a vehicle given intraperitoneally or subcutaneously rather than a lipid formulation given intravenously (i...
January 11, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28073314/safety-of-the-peripheral-administration-of-vasopressor-agents
#9
Tyler Lewis, Cristian Merchan, Diana Altshuler, John Papadopoulos
Vasopressors are an integral component of the management of septic shock and are traditionally given via a central venous catheter (CVC) due to the risk of tissue injury and necrosis if extravasated. However, the need for a CVC for the management of septic shock has been questioned, and the risk of extravasation and incidence of severe injury when vasopressors are given via a peripheral venous line (PVL) remains poorly defined. We performed a retrospective chart review of 202 patients who received vasopressors through a PVL...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28072922/the-relationship-between-parenteral-nutrition-and-central-line-associated-bloodstream-infections
#10
Gabriela Fonseca, Marissa Burgermaster, Elaine Larson, David S Seres
BACKGROUND: Parenteral nutrition (PN) administered via central venous catheter has been identified as an independent risk factor for central line-associated bloodstream infections (CLABSIs). The aim of this study was to provide an updated description of the relationship between PN and CLABSI and assess temporal trends in CLABSI rates for individuals who received PN from 2009-2014, after the Centers for Medicare & Medicaid declared CLABSI a "never event." METHODS: Using data obtained from all adult patient discharges between January 1, 2009, and December 31, 2014, from 2 affiliated hospitals in a large health system in New York City, univariate and multivariate analyses were performed to examine the relationship between PN and CLABSIs as well as temporal trends...
January 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28068924/de-implementation-strategy-to-reduce-the-inappropriate-use-of-urinary-and-intravenous-catheters-study-protocol-for-the-ricat-study
#11
Bart J Laan, Ingrid J B Spijkerman, Mieke H Godfried, Berend C Pasmooij, Jolanda M Maaskant, Marjon J Borgert, Brent C Opmeer, Margreet C Vos, Suzanne E Geerlings
BACKGROUND: Urinary and (peripheral and central) intravenous catheters are widely used in hospitalized patients. However, up to 56% of the catheters do not have an appropriate indication and some serious complications with the use of these catheters can occur. The main objective of our quality improvement project is to reduce the use of catheters without an appropriate indication by 25-50%, and to evaluate the affecting factors of our de-implementation strategy. METHODS: In a multicenter, prospective interrupted time series analysis, several interventions to avoid inappropriate use of catheters will be conducted in seven hospitals in the Netherlands...
January 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28065517/peritoneal-macrophage-heterogeneity-is-associated-with-different-peritoneal-dialysis-outcomes
#12
Chia-Te Liao, Robert Andrews, Leah E Wallace, Mohd Wajid A Khan, Ann Kift-Morgan, Nicholas Topley, Donald J Fraser, Philip R Taylor
Peritonitis remains the major obstacle for the maintenance of long-term peritoneal dialysis and dysregulated host peritoneal immune responses may compromise local anti-infectious defense, leading to treatment failure. Whilst, tissue mononuclear phagocytes, comprising macrophages and dendritic cells, are central to a host response to pathogens and the development of adaptive immune responses, they are poorly characterized in the human peritoneum. Combining flow cytometry with global transcriptome analysis, the phenotypic features and lineage identity of the major CD14(+) macrophage and CD1c(+) dendritic cell subsets in dialysis effluent were defined...
January 5, 2017: Kidney International
https://www.readbyqxmd.com/read/28063456/normal-saline-versus-heparin-for-patency-of-central-venous-catheters-in-adult-patients-a-systematic-review-and-meta-analysis
#13
Lei Zhong, Hai-Li Wang, Bo Xu, Yao Yuan, Xin Wang, Ying-Ying Zhang, Li Ji, Zi-Mu Pan, Zhan-Sheng Hu
BACKGROUND: Heparin saline (HS) is theoretically superior to normal saline (NS) for maintaining the patency of central venous catheters (CVCs), but the comparative efficacy of them remains controversial. The aim of this systematic review and meta-analysis was to assess the efficacy of NS versus HS in the maintenance of the patency of CVCs in adult patients. METHODS: We searched PubMed, Embase and the Cochrane library databases. Randomized controlled trials (RCTs) evaluating the use of NS vs...
January 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28055065/effect-of-fish-oil-supplementation-and-aspirin-use-on-arteriovenous-fistula-failure-in-patients-requiring-hemodialysis-a-randomized-clinical-trial
#14
Ashley B Irish, Andrea K Viecelli, Carmel M Hawley, Lai-Seong Hooi, Elaine M Pascoe, Peta-Anne Paul-Brent, Sunil V Badve, Trevor A Mori, Alan Cass, Peter G Kerr, David Voss, Loke-Meng Ong, Kevan R Polkinghorne
Importance: Vascular access dysfunction is a leading cause of morbidity and mortality in patients requiring hemodialysis. Arteriovenous fistulae are preferred over synthetic grafts and central venous catheters due to superior long-term outcomes and lower health care costs, but increasing their use is limited by early thrombosis and maturation failure. ω-3 Polyunsaturated fatty acids (fish oils) have pleiotropic effects on vascular biology and inflammation and aspirin impairs platelet aggregation, which may reduce access failure...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28054365/mapping-for-acute-transvenous-phrenic-nerve-stimulation-study-maps-study
#15
Lukas R C Dekker, Bart Gerritse, Avram Scheiner, Lilian Kornet
AIMS: Central Sleep Apnea Syndrome, correlated with the occurrence of heart failure, is characterized by periods of insufficient ventilation during sleep. This acute study in 15 patients aims to map the venous system and determine, if diaphragmatic movement can be achieved by phrenic nerve stimulation at various locations within the venous system. METHODS: Subjects underwent a scheduled catheter ablation procedure. During the procedural waiting time, one multi-electrode EP catheter was subsequently placed at the the superior and inferior vena cava and the junctions of the left jugular and left brachiocephalic vein and right jugular and right brachiocephalic vein, for phrenic nerve stimulation (1-2 seconds ON / 2-3 seconds OFF, 40 Hz, pulse width 210 μs)...
January 5, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28050444/review-of-the-management-of-peroral-extrusion-of-ventriculoperitoneal-shunt-catheter
#16
REVIEW
Rajendra Kumar Ghritlaharey
INTRODUCTION: Peroral extrusion of peritoneal part of Ventriculoperitoneal Shunt (VPS) catheter is an extremely rare complication following VPS implantation. AIM: To review the options available for the management of peroral extrusion of VPS catheter. MATERIALS AND METHODS: PubMed, Medline, PMC (PubMed Central), Embase, Google scholar databases search was performed to retrieve the published/available data relating to the peroral extrusion of VPS catheter...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049359/iranian-low-dose-escalating-prophylaxis-regimen-in-children-with-severe-hemophilia-a-and-b
#17
Peyman Eshghi, Elham Sadeghi, S Zahra Tara, Behnaz Habibpanah, Razieh Hantooshzadeh
Establishing an appropriate prophylaxis regimen for children with hemophilia is a critical challenge in developing countries. Barriers including availability and affordability, catheter-related complications, and inhibitor development risks have led to the introduction of new tailored prophylaxis regimens in different countries. This study emphasizes on the benefits of the Iranian low-dose escalating prophylaxis regimen in a Hemophilia Comprehensive Care Center in Iran. Referred patients with hemophilia less than 15 years of age, who were subject to prophylaxis regimen, are studied retrospectively...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28049254/peripherally-inserted-central-venous-catheter-associated-complications-exert-negative-effects-on-body-weight-gain-in-neonatal-intensive-care-units
#18
Jie Wen, Qun Yu, Haiyan Chen, Niannian Chen, Shourong Huang, Wei Cai
BACKGROUND AND OBJECTIVES: The placement of a peripherally inserted central venous catheter (PICC) is an essential procedure in neonatal intensive care units (NICU). The aim of this study was to determine the risk of PICC complications in NICU, and further identify the effects of PICC complications on body weight gain in premature infants. METHODS AND STUDY DESIGN: A total of 304 premature infants who had a PICC inserted in NICU were enrolled in this study. The weight-for-age z-score (WAZ) at the time of PICC insertion and removal were calculated, and changes of WAZ in different groups were compared using a t-test...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28048492/th-cd-206-07-determination-of-patient-specific-myocardial-mass-at-risk-using-computed-tomography-angiography
#19
L Hubbard, B Ziemer, S Malkasian, J Lipinski, B Sadeghi, H Javan, B Dertli, E Groves, S Molloi
PURPOSE: To evaluate the accuracy of a patient-specific coronary perfusion territory assignment algorithm that uses CT angiography (CTA) and a minimum-cost-path approach to assign coronary perfusion territories on a voxel-by-voxel basis for determination of myocardial mass at risk. METHODS: Intravenous (IV) contrast (370 mg/mL iodine, 25 mL, 7 mL/s) was injected centrally into five swine (35-45 kg) and CTA was performed using a 320-slice CT scanner at 100 kVp and 200 mA...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047506/su-g-201-17-verification-of-dose-distributions-from-high-dose-rate-brachytherapy-ir-192-source-using-a-multiple-array-diode-detector-mapcheck2
#20
K Harpool, T De La Fuente Herman, S Ahmad, I Ali
PURPOSE: To investigate quantitatively the accuracy of dose distributions for the Ir-192 high-dose-rate (HDR) brachytherapy source calculated by the Brachytherapy-Planning system (BPS) and measured using a multiple-array-diode-detector in a heterogeneous medium. METHODS: A two-dimensional diode-array-detector system (MapCheck2) was scanned with a catheter and the CT-images were loaded into the Varian-Brachytherapy-Planning which uses TG-43-formalism for dose calculation...
June 2016: Medical Physics
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