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https://www.readbyqxmd.com/read/29341466/effects-of-intravenous-home-dobutamine-in-palliative-end-stage-heart-failure-on-quality-of-life-heart-failure-hospitalization-and-cost-expenditure
#1
Pieter Martens, Jan Vercammen, Wendy Ceyssens, Linda Jacobs, Evert Luwel, Herwig Van Aerde, Peter Potargent, Monique Renaers, Matthias Dupont, Wilfried Mullens
AIMS: In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. METHODS AND RESULTS: All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed...
January 17, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29340799/fully-automated-life-support-an-implementation-and-feasibility-pilot-study-in-healthy-pigs
#2
Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer, Martin Schenk
BACKGROUND: Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lacking in the medical sector. With respect to workload and safety, especially, the intensive care unit appears to be an important and challenging application field. Whereas many closed-loop subsystems for single applications already exist, no comprehensive system covering multiple therapeutic aspects and interactions is available yet...
January 16, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29340455/central-venous-catheter-related-infections-in-patients-receiving-short-term-hemodialysis-therapy-incidence-associated-factors-and-microbiological-aspects
#3
Mayra Gonçalves Menegueti, Natália Cristina Betoni, Fernando Bellissimo-Rodrigues, Elen Almeida Romão
INTRODUCTION: Bloodstream infections are the second most common cause of death among patients on hemodialysis. This study aimed to evaluate the incidence of and risk factors associated with central venous catheter-related infections in patients undergoing hemodialysis, and to identify and characterize the type and antimicrobial susceptibility profiles of the primary microorganisms isolated during one year of follow-up. METHODS: A prospective cohort study was conducted in 2014 in a hemodialysis referral center...
November 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/29340341/credentialing-of-hospitalists-in-ultrasound-guided-bedside-procedures-a-position-statement-of-the-society-of-hospital-medicine
#4
Brian P Lucas, David M Tierney, Trevor P Jensen, Ria Dancel, Joel Cho, Mahmoud El-Barbary, Ricardo Franco-Sadud, Nilam Soni
Ultrasound guidance is used increasingly to perform the following 6 bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis. Yet most hospitalists have not been certified to perform these procedures, whether using ultrasound guidance or not, by specialty boards or other institutions extramural to their own hospitals. Instead, hospital privileging committees often ask hospitalist group leaders to make ad hoc intramural certification assessments as part of credentialing...
January 18, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29338079/nutrition-delivery-and-growth-outcomes-in-infants-with-gastroschisis
#5
Charles R Hong, David Zurakowski, Brenna S Fullerton, Katelyn Ariagno, Tom Jaksic, Nilesh M Mehta
BACKGROUND: We aimed to describe nutrient intake and growth in infants with gastroschisis and identify factors associated with impaired growth. METHODS: Retrospective study of neonates who underwent gastroschisis repair from 2010 to 2015. Nutrient intake and weight-for-age z scores (WAZ) were recorded. RESULTS: Data from 60 eligible infants with median (Q1, Q3) gestational age of 36 weeks (35, 37) and birth weight 2418 g (2098, 2665) were analyzed...
January 8, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29333796/upper-extremity-deep-vein-thrombosis-symptoms-diagnosis-and-treatment
#6
REVIEW
Jaber Mustafa, Ilan Asher, Zev Sthoeger
Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Clinical suspicion should be confirmed by diagnostic imaging procedures such as duplex ultrasound, computed tomography scan, or magnetic resonance imaging...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29331162/unnecessary-removal-of-central-venous-catheters-in-cancer-patients-with-bloodstream-infections
#7
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;1-4.
January 14, 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-bacteremia
#8
Yu-Mi Lee, Chisook Moon, Young Jin Kim, Hee-Joo Lee, Mi Suk Lee, Ki-Ho Park
BACKGROUND: Gram-negative bacteria are increasingly the cause of catheter-related bloodstream infections (CRBSI), which show a rapidly rising prevalence of multidrug-resistant strains. We 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 bacteremia and CVC placement, from two tertiary care hospitals, were retrospectively included...
January 9, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29329067/case-report-iatrogenic-brachial-artery-dissection-with-complete-anterograde-occlusion-during-elective-arterial-line-placement
#9
Laurence Weinberg, Diana Abu-Ssaydeh, Manfred Spanger, Patrick Lu, Michael H-G Li
INTRODUCTION: Brachial arterial catheters provide a more accurate reflection of central aortic arterial pressure compared to their radial counterparts. Although brachial arterial line complications are uncommon, we report a case of a rare iatrogenic brachial artery dissection with complete anterograde occlusion from elective arterial line placement. PRESENTATION OF CASE: A 41-year-old female presented for a right upper and middle lobe resection of a large neuroendocrine lung cancer...
December 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29322352/supraclavicular-catheterization-of-the-brachiocephalic-vein-a-way-to-prevent-or-reduce-catheter-maintenance-related-complications-in-children
#10
Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie
Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015)...
January 10, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29319771/peritoneal-dialysis-as-the-first-dialysis-treatment-option-initially-unplanned
#11
Marcela Lara Mendes, Camila Albuquerque Alves, Edwa Maria Bucuvic, Dayana Bitencourt Dias, Daniela Ponce
Most patients with stage 5 CKD start RRT of unplanned manner. Unplanned dialysis, also known as urgent start, may be defined as hemodialysis (HD) started without permanent vascular access, i.e., using a central venous catheter (CVC), or as peritoneal dialysis (PD) started within seven days after implantation of the catheter, without family training. Although few studies have evaluated the PD as an immediate treatment option for patients starting urgent RRT, theirs results suggest that it is a feasible and safe alternative, with infectious complications and survival similar to patients treated with unplanned HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29317911/a-quality-assurance-investigation-of-clabsi-events-are-there-exceptions-to-never
#12
Samantha Strickler, Rohit R Gupta, John T Doucette, Roopa Kohli-Seth
Background: In the USA, central line associated blood stream infections (CLABSIs) have been designated as 'never events', prompting initiatives towards a 'zero CLABSIs' standard. We propose that there are cascading risk factors predisposing certain patient cohorts to higher CLABSIs rates. Methods: A retrospective review of all CLABSI infections over a 12-month period was undertaken. Risk factors examined included catheter type, insertion site and parenteral nutrition (PN) status...
January 2018: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29314087/ultrasonographic-assessment-of-the-internal-jugular-vein-for-the-estimation-of-central-venous-pressure-in-hemodialysis-patients-a-preliminary-study
#13
Basile Kerleroux, Jeremy Pasco, Mathieu Dupuis, Marine Eustache, Ahmed Lemrabott, Charlotte Jouzel, Catherine Albert, Kevin Janot, Baptiste Morel, André Pruna
PURPOSE: To investigate a new noninvasive method to assess central venous pressure (CVP) in hemodialysis patients, based on the ultrasonographic measurement of the collapsing point of the internal jugular vein (CVPni). MATERIALS AND METHODS: In this preliminary, noninterventional, single center study, we enrolled 22 dialyzed patients with an indwelling jugular catheter. CVPni was compared to the gold-standard invasive measurement of CVP using the central venous catheter (CVPi)...
January 4, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29311539/tolvaptan-for-fluid-management-in-living-donor-liver-transplant-recipients
#14
Shunichi Imai, Masahiro Shinoda, Hideaki Obara, Minoru Kitago, Taizo Hibi, Yuta Abe, Hiroshi Yagi, Kentaro Matsubara, Hisanobu Higashi, Osamu Itano, Yuko Kitagawa
BACKGROUND Tolvaptan, an antagonist of the vasopressin V2 receptor is a novel oral diuretic that promotes water excretion selectively. We have used furosemide as a primary diuretic and added human atrial natriuretic peptide (hANP) if necessary for fluid management postoperatively in living-donor liver transplantation (LDLT) recipients. Recently we introduced tolvaptan and used both tolvaptan and furosemide as primary diuretics. MATERIAL AND METHODS Clinical outcomes were compared between LDLT recipients whose postoperative fluid management was performed before (control group, n=10) and after (tolvaptan group, n=16) introduction of tolvaptan...
January 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29310557/a-medium-term-venous-access-alternative-for-infants-undergoing-congenital-heart-surgery
#15
Muhammad Aanish Raees, Paul V Dubar, David P Bichell
We describe a strategy aimed at maximizing the safety and minimizing the thrombogenicity of central venous lines for neonates with congenital heart defects. Our method involves the use of a tunneled technique to place a 4.2 Fr single-lumen (Broviac) catheter in the subpericardial space, with minimal intravascular course and a tip placed in the lower right atrium. Using this technique, we potentially eliminated the requirement for percutaneous placement of central venous lines postoperatively as well as potentially decreased the risk of intrapericardial bleeding associated with transthoracic lines...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29307014/stenotrophomonas-maltophilia-bacteremia-and-pneumonia-at-a-tertiary-care-oncology-center-a-review-of-16%C3%A2-years
#16
Consuelo Velázquez-Acosta, Sugehily Zarco-Márquez, Mari Carmen Jiménez-Andrade, Patricia Volkow-Fernández, Patricia Cornejo-Juárez
PURPOSE: The aim of this study was to describe the clinical characteristics and antimicrobial patterns of Stenotrophomonas maltophilia bloodstream infections (BSI) and pneumonia episodes in patients with cancer. METHODS: Patients with S. maltophilia BSI or pneumonia admitted from 1 Jan. 2000 to 31 Dec. 2016 were identified at the Instituto Nacional de Cancerología (INCan), a tertiary-care oncology hospital in Mexico City. RESULTS: During the study period, there were 171 isolates identified...
January 7, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29303459/multimodal-treatment-approach-in-a-patient-with-multiple-intracranial-myxomatous-aneurysms
#17
David L Penn, Arianna B Lanpher, Jennifer M Klein, Harry P W Kozakewich, Kristopher T Kahle, Edward R Smith, Darren B Orbach
The most common primary cardiac tumor is myxoma, typically originating in the left atrium. Emboli to the central nervous system can cause cerebral infarction or, rarely, seed tumor growth within vessel walls, causing myxomatous aneurysms. Fewer than 60 myxomatous aneurysms have been reported, including 2 cases in children. Here, the authors describe 2 different growing myxomatous aneurysms in a child successfully managed using a combined multidisciplinary approach. A 12-year-old boy developed a sudden headache, diplopia, gait instability, and speech difficulty...
January 5, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29303020/risk-factors-outcomes-and-genotypes-of-carbapenem-nonsusceptible-klebsiella-pneumoniae-bloodstream-infection-a-three-year-retrospective-study-in-a-large-tertiary-hospital-in-northern-china
#18
Si-Han Zheng, Sheng-Ji Cao, Hui Xu, Dan Feng, Li-Ping Wan, Guang-Jie Wang, Xiao-Guang Xiao
OBJECTIVE: To investigate the independent risk factors, outcomes and genotypes associated with carbapenem-non-susceptible K. pneumoniae bloodstream infections (BSIs) in northern China from 2014 to 2016. METHODS: Over a three-year period, a total of 289 K. pneumoniae BSI patients were identified. Medical records were extracted to obtain the clinical information. Polymerase chain reactions (PCRs) were performed to analyse the multilocus sequence typing (MLST) types, Klebsiella pneumoniae carbapenemase (KPC) and metallo-β-lactamases (MBL) genes, for replicon typing of the 10 randomly selected carbapenem-non-susceptible K...
January 5, 2018: Infectious Diseases
https://www.readbyqxmd.com/read/29301821/tale-of-a-misguided-central-venous-catheter
#19
Gajapathiraju Chamarthi, Abhilash Koratala
No abstract text is available yet for this article.
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29300286/medical-adhesive-related-skin-injury-prevalence-at-the-peripherally-inserted-central-catheter-insertion-site-a-cross-sectional-multiple-center-study
#20
Huihan Zhao, Yu He, Qin Wei, Yanping Ying
PURPOSE: We examined prevalence and associated risk factors of medical adhesive-related skin injury (MARSI) at the peripherally inserted central catheter (PICC) insertion site in hospitalized oncology patients in Guangxi, China. DESIGN: A cross-sectional, multiple-center epidemiological study. SUBJECTS AND SETTING: The sample comprised 697 adult inpatients at 4 tertiary hospitals (3 general hospitals and 1 oncology hospital). The facilities are located in the western China...
January 2018: Journal of Wound, Ostomy, and Continence Nursing
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