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https://www.readbyqxmd.com/read/28818852/accuracy-of-11-formulae-to-guide-umbilical-arterial-catheter-tip-placement-in-newborn-infants
#1
Wei Ling Lean, Jennifer A Dawson, Peter G Davis, Christiane Theda, Marta Thio
BACKGROUND: Umbilical arterial catheter (UAC) insertion is a common procedure in the neonatal intensive care unit (NICU). Correct placement of the tip of the UAC at first attempt minimises handling of the infant and reduces the risk of infection and complications. We aimed to determine the accuracy of 11 published formulae to guide UAC placement. METHODS: This was a one-year prospective observational study in a tertiary NICU. Clinicians used their preferred formula for UAC insertion, with X-rays performed immediately post-procedure to check the tip position...
August 17, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28818213/the-natural-history-and-outcomes-of-line-associated-upper-extremity-deep-venous-thromboses-in-critically-ill-patients
#2
Joshua Underhill, Matthew A Sherman, Ryan Howard, Anthony Hage, Andrea Obi, Lena Napolitano, Dawn M Coleman
OBJECTIVE: Anticoagulation remains the standard of care for line-associated upper extremity deep venous thrombosis (UEDVT). This treatment carries the risk of hemorrhagic complications, possibly more so in surgical patients. Considering the low-risk profile of UEDVT-which is associated with fewer, less severe pulmonary emboli than lower extremity deep venous thrombosis-current UEDVT treatment guidelines may be overly aggressive. The goal of this study was to review outcomes of line-associated UEDVT in critically ill patients and to define the efficacy of current treatment protocols in pulmonary embolism (PE) prevention while avoiding hemorrhagic complications...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28797911/a-prospective-evaluation-of-radiation-free-direct-solitary-cholangioscopy-for-the-management-of-choledocholithiasis
#3
Monique T Barakat, Mohit Girotra, Abhishek Choudhary, Robert J Huang, Saurabh Sethi, Subhas Banerjee
BACKGROUND AND AIMS: Endoscopy has replaced many radiological studies for the GI tract. However, ERCP remains a hybrid endoscopic-fluoroscopic procedure, which limits its portable delivery, creates delays due to fluoroscopy room unavailability and exposes patients/providers to radiation. We evaluated fluoroscopy/radiation-free management of patients with non-complex choledocholithiasis using direct solitary cholangioscopy (DSC). METHODS: Patients underwent fluoroscopy-free biliary cannulation, sphincterotomy then cholangioscopy to establish location, number/size of stones and document distance from ampulla to bifurcation to guide balloon advancement...
August 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28793102/deaths-among-the-elderly-with-icu-infections
#4
Álvaro Francisco Lopes de Sousa, Artur Acelino Francisco Luz Nunes Queiroz, Layze Braz de Oliveira, Luana Kelle Batista Moura, Denise de Andrade, Evandro Watanabe, Maria Eliete Batista Moura
Objective: to evaluate the clinical outcome of elderly patients admitted to intensive care units who had nosocomial infection, correlating the findings with sociodemographic and clinical variables. Method: descriptive research, performed with 308 elderly patients. The collection was made from medical records and covers the years 2012 to 2015. Uni-/bivariate analyses were performed. Results: a statistical association was found between the clinical outcome types and the variables age, length of stay, presence of previous comorbidities, main diagnosis, respiratory and urinary tract infections, use of central venous and indwelling urinary catheters, mechanical ventilation, and tracheostomy...
July 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28792258/utilization-of-intravenous-catheters-by-prehospital-providers-during-pediatric-transports
#5
Timothy VanderKooy, Kelsey Spaur, Lina Brou, Sean Caffrey, Kathleen M Adelgais
INTRODUCTION: Prehospital intravenous (IV) access in children may be difficult and time-consuming. Emergency Medical Service (EMS) protocols often dictate IV placement; however, some IV catheters may not be needed. The scene and transport time associated with attempting IV access in children is unknown. The objective of this study is to examine differences in scene and transport times associated with prehospital IV catheter attempt and utilization patterns of these catheters during pediatric prehospital encounters...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28790779/device-associated-healthcare-associated-infections-da-hai-and-the-caveat-of-multiresistance-in-a-multidisciplinary-intensive-care-unit
#6
Inam Danish Khan, Atoshi Basu, Sheshadri Kiran, Shaleen Trivedi, Priyanka Pandit, Anupam Chattoraj
BACKGROUND: Device-Associated Healthcare-Associated Infections (DA-HAI), including Ventilator-Associated Pneumonia (VAP), Central-Line-Associated Blood Stream Infection (CLABSI), and Catheter-Related Urinary Tract Infection (CAUTI), are considered as principal contributors to healthcare hazard and threat to patient safety as they can cause prolonged hospital stay, sepsis, and mortality in the ICU. The study intends to characterize DA-HAI in a tertiary care multidisciplinary ICU of a teaching hospital in eastern India...
July 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28790011/management-of-septic-shock-in-an-intermediate-care-unit
#7
Eric Meaudre, Cédric Nguyen, Claire Contargyris, Ambroise Montcriol, Erwan d'Aranda, Pierre Esnault, Mourad Bensalah, Bertrand Prunet, Julien Bordes, Philippe Goutorbe
BACKGROUND: While guidelines advocate goal-directed resuscitation based on timed bundles, the management of SS outside an ICU setting has been poorly studied in intermediate care units (IMCU). PATIENTS AND METHOD: We reviewed all cases of septic shock patients admitted to our IMCU between January 2013 and June 2014. The characteristics of sepsis, compliance of bundles, and outcomes were collected. The IMCU population was compared with the SS patients admitted to the ICU during the same period...
August 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28777405/bursting-pressure-of-triple-lumen-central-venous-catheters-under-static-and-dynamic-loads
#8
Tim Beckingham, Andy Roberts, Alana St John, Gerry O'Callaghan
INTRODUCTION: Central venous catheter (CVC) access is commonplace in intensive care units. Patients undergoing computed tomographic angiography require injection of contrast at high flow rates (4.5 mL/s), often CVC access is not used due to safety concerns. The CVC might rupture at high flow rates, resulting in CVC fragmentation and embolization or contrast extravasation.The objective of this study is to determine the pressure required to burst a CVC under static load and compare this to the pressure generated by injection of contrast at high flow rates (dynamic load) through the distal (16-g) lumen of a triple-lumen CVC...
August 3, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28777198/nosocomial-infections-during-extracorporeal-membrane-oxygenation-incidence-etiology-and-impacton-patients-outcome
#9
Giacomo Grasselli, Vittorio Scaravilli, Stefano Di Bella, Stefano Biffi, Michela Bombino, Nicolò Patroniti, Luca Bisi, Anna Maria Peri, Antonio Pesenti, Andrea Gori, Laura Alagna
OBJECTIVE: To study incidence, type, etiology, risk factors, and impact on outcome of nosocomial infections during extracorporeal membrane oxygenation. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Italian tertiary referral center medical-surgical ICU. PATIENTS: One hundred five consecutive patients who were treated with extracorporeal membrane oxygenation from January 2010 to November 2015...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28765996/non-central-peripherally-inserted-central-catheters-in-neonatal-intensive-care-complication-rates-and-longevity-of-catheters-relative-to-tip-position
#10
Bernard Goldwasser, Catalina Baia, Mimi Kim, Benjamin H Taragin, Robert M Angert
BACKGROUND: Peripherally inserted central catheters (PICCs) represent a mainstay of intravascular access in the neonatal intensive care setting when long-term vascular access is needed. Ideally, PICCs should be inserted and maintained in a central position with the tip ending in the superior or inferior vena cava. This is not always achievable, and sometimes the tip remains in a peripheral location. Higher complication rates have been reported with non-central PICCs; however these findings have not been confirmed in a solely neonatal series and PICCs with tips in peripheral veins have not been studied...
August 1, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28762227/-chlorhexidine-bed-bath-improves-clabsi-a-meta-analysis
#11
Shu-Cing Lin, Chair-Hua Lin, Chin-Ching Yu
BACKGROUND: Central catheters are used primarily in ICU settings. Bloodstream infections in the central line of central catheters have been shown to cause longer hospital stays for patients and result in higher medical costs. PURPOSE: The present study applies a systematic review and meta-analysis to assess the effect of a 2% chlorhexidine (CHG) bed-bath on the risk of central line-associated bloodstream infections (CLABSI). METHODS: The Public Health Resource Unit of England issued the Critical Appraisal Skills Programme and evaluated the standardized crucial appraisal tools from the Joanna Briggs Institute that are used to assess methodological quality...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28750921/the-methodology-of-surveillance-for-antimicrobial-resistance-and-healthcare-associated-infections-in-europe-suspire-a-systematic-review-of-publicly-available-information
#12
REVIEW
María Núñez-Núñez, María Dolores Navarro, Virginia Palomo, Nithya Babu Rajendran, María Dolores Del Toro, Andreas Voss, Mike Sharland, Frangiscos Sifakis, Evelina Tacconelli, Jesús Rodríguez-Baño
OBJECTIVES: Surveillance is a key component of any control strategy for health-care associated infections (HAIs) and antimicrobial resistance (AMR), and public availability of methodological aspects is crucial for the interpretation of the data. We sought to systematically review publicly available information for HAIs and/or AMR surveillance systems organised by public institutions or scientific societies in European countries. METHODS: A systematic review of scientific and grey literature following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was performed...
July 24, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28750885/regional-cerebral-saturation-monitoring-during-withdrawal-of-life-support-until-death
#13
Cornelia Genbrugge, Ward Eertmans, Frank Jans, Willem Boer, Jo Dens, Cathy De Deyne
AIMS: The aim of this pilot study was to explore the regional cerebral oxygen saturation (rSO2) during the process of dying in Intensive Care Unit (ICU) patients in whom it was decided to withdraw life support. METHODS: Regional cerebral saturation was measured from the moment active treatment was stopped until the moment of death, defined as the onset of asystole. Simultaneously, heart rate and arterial blood pressure were recorded using a radial arterial catheter...
July 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28749853/the-icu-is-becoming-a-main-battlefield-for-severe-maternal-rescue-in-china-an-8-year-single-center-clinical-experience
#14
Liu Yuqi, Guoliang Tan, Shang Chengming, Sun Xuri
OBJECTIVES: To review the characteristics of and to identify the reasons for severe maternal admissions to the ICU. DESIGN: This was an analytical, observational, open, and retrospective study. SETTING: In our ICU. PATIENTS: A total of 487 severe maternal cases were reviewed during the 8-year study period of January 2009 to December 2016. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 487 severe maternal cases (12...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28749714/risk-factors-for-carbapenem-resistant-klebsiella-pneumoniae-infection-a-meta-analysis
#15
Pin Liu, Xuan Li, Mei Luo, Xuan Xu, Kewen Su, Shuai Chen, Ying Qing, Yingli Li, Jingfu Qiu
AIMS: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has been rapidly emerging as a life-threatening nosocomial disease in many countries. However, studies on the corresponding risk factors of CRKP infection showed inconsistent results. To resolve these inconsistencies, we conducted a meta-analysis of previous studies on the potential risk factors of CRKP infection. The results of this study could be used to develop CRKP infection prevention strategies. METHODS: Relevant works were systematically searched from five electronic databases up to September 2016...
July 27, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/28749401/use-of-real-time-ultrasound-for-locating-tip-position-in-neonates-undergoing-peripherally-inserted-central-catheter-insertion-a-pilot-study
#16
Nagsen Telang, Deepak Sharma, Oleti Tejo Pratap, Hemasree Kandraju, Srinivas Murki
BACKGROUND & OBJECTIVES: Securing long-term venous access is an essential part of sick newborn care. The malposition of central line tip leads to several complications. There is a need for an easily available bedside investigating tool to diagnose these malpositions. This study was done to compare the effectiveness of real-time ultrasound (RTUS) with X-ray in identifying the peripherally inserted central catheter (PICC) line tip. METHODS: This pilot observational study was conducted in a level III Neonatal Intensive Care Unit of a tertiary care hospital in India, from June 2012 to June 2013...
March 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28745959/closed-arterial-lab-sampling-devices-a-study-of-compliance-and-best-practice
#17
Ann Benedict, Adam Mayer, Heather Craven
As the quality of patient care continues to improve, nursing professionals are continuously tasked with researching, implementing, and evaluating best practices. The practice of obtaining blood samples from paediatric patients, using a conventional three-way stopcock method, has been associated with peripheral arterial catheter intraluminal contamination and catheter-related bloodstream infections. A paediatric cardiac intensive care unit (PCICU), in a large medical centre in the USA, set an objective to mitigate the risk of possible contamination by implementing the use of closed arterial lab sampling devices...
July 27, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28733213/risk-factors-for-the-infection-and-or-colonization-of-extended-spectrum-beta-lactamase-producing-bacteria-in-a-neonatal-intensive-care-unit-a-meta-analysis
#18
REVIEW
Xuan Li, Xuan Xu, Xianxian Yang, Mei Luo, Pin Liu, Kewen Su, Ying Qing, Shuai Chen, Jingfu Qiu, Yingli Li
BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing bacteria are the important causes of healthcare associated infection in the neonatal intensive care unit (NICU). This study performed a meta-analysis to identify the risk factors associated with infection and/or colonization of ESBL-producing bacteria in the NICU. METHODS: Relevant studies in the literature published from January 1, 2000 to July 1, 2016 were searched in the electronic databases. The literature was screened and data were extracted according to the inclusion and exclusion criteria...
July 18, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28721223/atrial-fibrillation-in-a-preterm-newborn-with-structurally-normal-heart
#19
Pier Paolo Bassareo, Andrea Raffaele Marras, Mariangela Marras, Silvia Marras, Giuseppe Mercuro
Atrial fibrillation (AF) is a really uncommon arrhythmia in newborns. Here, we report the case of a 1-day-old infant who was recovered in Neonatal Intensive Care Unit for a twin-to-twin transfusion. The appearance of an unexpected AF was registered at his continuous electrocardiographic monitoring. Both chest X-ray and echocardiographic examination revealed the anomalous insertion of the tip of a central venous catheter (CVC) into the heart ('umbilical artery → inferior vena cava → right atrium → patent foramen ovale → left atrium')...
March 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28716670/nationwide-study-on-peripheral-venous-catheter-associated-bloodstream-infections-in-internal-medicine-departments
#20
María Guembe, María Jesús Pérez-Granda, José Antonio Capdevila, José Barberán, Blanca Pinilla, Pablo Martín-Rabadán, Emilio Bouza
BACKGROUND: The use of peripheral venous catheters (PVCs) has increased outside the intensive care unit, as have rates of peripheral venous catheter associated-bloodstream infection (PVC-BSI). The internal medicine department (IMD) is one of the main wards where PVCs are widely used. However, data on the incidence of PVC-BSI and its characteristics in the IMD are scarce. AIM: Our objective was to assess the incidence of PVC-BSI episodes detected in IMDs in Spain...
July 14, 2017: Journal of Hospital Infection
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