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Central venous Catheter guidelines

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https://www.readbyqxmd.com/read/29211195/impact-of-two-bundles-on-central-catheter-related-bloodstream-infection-in-critically-ill-patients
#1
Cristobal Felipe Padilla Fortunatti
OBJECTIVE: To evaluate the impact of the implementation of insertion and maintenance bundles on the rates of catheter-related bloodstream infection in an intensive care unit. METHOD: This is a quasi-experimental, before-and-after study with a non-equivalent control group. During a six-month period, insertion and maintenance bundles for the central venous catheters were implemented. Supervision guidelines were developed to assess compliance with the bundle and catheter characteristics...
December 4, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29210814/caregiver-education-reduces-the-incidence-of-community-acquired-clabsis-in-the-pediatric-patient-with-intestinal-failure
#2
Barbie Drews, Michelle Macaluso, Hannah Piper, Nandini Channabasappa
Pediatric patients with intestinal failure often require central venous catheters for extended periods of time for parenteral nutrition, blood sampling, and medication administration, increasing morbidity, mortality, and costs. In 2007, we reported a central line-associated bloodstream infection rate of 7.0 per 1,000 catheter line-days in our pediatric patients with intestinal failure. On the basis of this high rate of catheter-associated infections, we developed and implemented a central line care curriculum for patients/family caregivers and home health nurses...
November 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/29203044/-new-international-guidelines-for-curative-treatment-and-prophylaxis-for-venous-thromboembolism-vte-in-cancer-patients-and-the-dedicated-smartphone-application
#3
I Benzidia, J Connault, A Solanilla, U Michon-Pasturel, M Jamelot, M K Nguessan, A Hij, C Le Maignan, D Farge, C Frère
Venous thromboembolism (VTE) is a frequent and serious complication in cancer patients, and the second leading cause of death in this setting. Cancer patients are also more likely to present recurrent VTE and major bleeding while taking anticoagulants. Management of VTE in these patients is always challenging and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME) released international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis, based on a systematic review of the literature ranked according to the Grading of Recommendations Assessment, Development, and Evaluation scale...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29198897/the-idle-central-venous-catheter-in-the-nicu-when-should-it-be-removed
#4
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/29167220/iatrogenic-injury-of-vertebral-artery-resulting-in-stroke-after-central-venous-line-insertion
#5
Vindya Abeysinghe, Jie Hua Xu, Kishore Sieunarine
There are many complications of central venous catheter insertion. Iatrogenic injury of the vertebral artery is a rare complication that can result in severe morbidity and mortality. The case presented describes the complication of an acute ischaemic stroke after cannulation of the vertebral artery. There are various techniques when obtaining central access, however the best practice as described by the evidence based guidelines produced by the American Society of Anesthesiologists utilises real-time ultrasound guidance to minimise adverse events...
November 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29160517/prevalence-and-antibiogram-of-methicillin-resistant-staphylococcus-aureus-isolated-from-medical-device-related-infections-a-retrospective-study-in-lahore-pakistan
#6
Muhammad Sohail, Zakia Latif
INTRODUCTION: With the advancement of medicine and surgery, various types of medical devices have become part of treatment strategies. METHODS: Identification and antimicrobial sensitivity testing were done according to CLSI guidelines following standard microbiological practices. RESULTS: Urinary catheter infections (31%) were most frequent followed by central venous catheter (18%) and orthopedic implants (15%). Methicillin resistant Staphylococcus aureus (MRSA) was a major cause of device-related infection after Escherichia coli (21%); other pathogens were Klebsiella pneumoniae (14%), Pseudomonas spp...
September 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#7
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29125332/abo-blood-group-related-venous-thrombosis-risk-in-patients-with-peripherally-inserted-central-catheters
#8
Chung Mo Koo, Ravi Vissapragada, Rebecca Sharp, Phi Nguyen, Thomas Ung, Chrismin Solanki, Adrian Esterman
OBJECTIVE: To investigate the association between ABO blood group and venous thrombosis (VT) risk in patients with peripherally inserted central catheters (PICC). METHODS: Single centre retrospective cohort study. A cohort of patients who underwent PICC insertion from September 2010 to August 2014 were followed up for symptomatic VT presentations diagnosed by ultrasound. Blood group status was identified from hospital information systems. RESULTS: 2270 participants had 3020 PICCs inserted...
November 10, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29101989/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-central-venous-access
#9
Colette M Shaw, Shrenik Shah, Baljendra S Kapoor, Thomas R Cain, Drew M Caplin, Khashayar Farsad, M-Grace Knuttinen, Margaret H Lee, Joseph J McBride, Jeet Minocha, Elizabeth V Robilotti, Paul J Rochon, Richard Strax, Elrond Y L Teo, Jonathan M Lorenz
Obtaining central venous access is one of the most commonly performed procedures in hospital settings. Multiple devices such as peripherally inserted central venous catheters, tunneled central venous catheters (eg, Hohn catheter, Hickman catheter, C. R. Bard, Inc, Salt Lake City UT), and implantable ports are available for this purpose. The device selected for central venous access depends on the clinical indication, duration of the treatment, and associated comorbidities. It is important for health care providers to familiarize themselves with the types of central venous catheters available, including information about their indications, contraindications, and potential complications, especially the management of catheters in the setting of catheter-related bloodstream infections...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29098715/central-venous-catheters-for-chronic-hemodialysis-is-last-choice-never-the-right-choice
#10
EDITORIAL
Chance S Dumaine, Robert S Brown, Jennifer M MacRae, Matthew J Oliver, Pietro Ravani, Robert R Quinn
Since the publication of the first vascular access clinical practice guidelines in 1997, the global nephrology community has dedicated significant time and resources toward increasing the prevalence of arteriovenous fistulas and decreasing the prevalence of central venous catheters for hemodialysis. These efforts have been bolstered by observational studies showing an association between catheter use and increased patient morbidity and mortality. To date, however, no randomized comparisons of the outcomes of different forms of vascular access have been conducted...
November 2, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29044814/determination-of-the-optimal-depth-of-a-left-internal-jugular-venous-catheter-in-infants-a-prospective-observational-study
#11
Ji-Hyun Lee, Hyo-Jin Byon, Yoon-Hyeong Choi, In-Kyung Song, Jin-Tae Kim, Hee-Soo Kim
BACKGROUND: Few reports exist regarding the optimal depth of a left-sided central venous catheter in pediatric patients. We aimed to provide a guideline for the optimal depth of central venous catheters at the left internal jugular vein in infants, using anatomical landmarks, age, height, and weight. METHODS: A two-stage study was conducted. In the first observational study, infants aged ≤1 year and scheduled for elective surgery requiring a central venous catheter were enrolled...
October 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29026535/clinical-and-molecular-characteristics-risk-factors-and-outcomes-of-carbapenem-resistant-klebsiella-pneumoniae-bloodstream-infections-in-the-intensive-care-unit
#12
Xia Zheng, Jian-Feng Wang, Wang-Lan Xu, Jun Xu, Juan Hu
BACKGROUND: To analyze the clinical characteristics and outcomes of carbapenem-resistant Klebsiella pneumoniae (CRKp) and carbapenem-susceptible K. pneumoniae (CSKp) bloodstream infections (BSIs), and to study the risk factors for development of CRKp BSI and K. pneumoniae BSI-related mortality. METHODS: A retrospective case control study of patients with K. pneumoniae BSI was conducted in the intensive care unit of the First Affiliated Hospital, Medical of College, Zhejiang University from January 2013 to December 2014...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28874131/a-chronic-hemodialysis-patient-with-isolated-pulmonary-valve-infective-endocarditis-caused-by-non-albicans-candida-a-rare-case-and-literature-review
#13
Chih-Hao Chang, Myo-Ming Huang, Dong-Feng Yeih, Kuo-Cheng Lu, Yi-Chou Hou
BACKGROUND: Isolated pulmonary valve infective endocarditis caused by Candida is rare in chronic hemodialysis patients. The 2009 Infectious Diseases Society of America guidelines suggest the combined use of surgery and antibiotics to treat candidiasis; however, successful nonsurgical treatment of Candida endocarditis has been reported. CASE PRESENTATION: A 63-year-old woman with end-stage kidney disease was admitted to our hospital after experiencing disorientation for 5 days...
September 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28864367/thromboprophylaxis-failure-in-the-adult-medical-inpatient
#14
REVIEW
Amanda Northup, Susan Wilcox
Venous thromboembolism (VTE), a leading cause of morbidity and mortality among hospitalized patients, is often due to prophylaxis failure rather than omission, but few studies have identified the risk factors for failure. Risk factors for thromboprophylaxis failure include personal or family history of VTE, use of vasopressors or inotropes, increased body mass index, cranial surgery, intensive care patient, leukocytosis, indwelling central venous catheter and admission from a long-term care facility. Identifying patients at risk for thromboprophylaxis failure should prompt close observation during hospitalization for signs of VTE, close observation after discharge and potentially more aggressive prophylaxis strategies, although no specific guidelines exist for medical patients at this time...
August 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28844205/ultrasound-guided-central-venous-catheter-placement-a-structured-review-and-recommendations-for-clinical-practice
#15
REVIEW
Bernd Saugel, Thomas W L Scheeren, Jean-Louis Teboul
The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In this review, we describe the rationale for the use of US during CVC placement, the basic principles of this technique, and the current evidence and existing guidelines for its use. In addition, we recommend a structured approach for US-guided central venous access for clinical practice. Static and real-time US can be used to visualize the anatomy and patency of the target vein in a short-axis and a long-axis view...
August 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28790011/management-of-septic-shock-in-intermediate-care-unit
#16
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 septic shock (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/28782178/staphylococcal-biofilm-gene-expression-on-biomaterials-a-methodological-study
#17
Annika Juhlin, Sara Svensson, Peter Thomsen, Margarita Trobos
The combination of increased healthcare access, universal aging, and infallible therapy demands, synergistically drive the need for the development of biomaterial technologies that mitigate the challenge of biomaterial-associated infections (BAI). Staphylococcus epidermidis and Staphylococcus aureus account for the majority of BAI due to their ability to accumulate in adherent multilayered biofilm. This investigation details the development of gene expression assays to evaluate the genetic processes of attachment, accumulation, maturation, and dispersal phases of biofilms on biomaterials in vitro, while abiding by the Minimum Information for Publication of Quantitative Real-Time PCR Experiments (MIQE) guidelines...
December 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28731490/lancisi-s-sign-and-central-venous-catheter-tip-position-a-case-report
#18
Valentina Vigo, Piero Lisi, Giuseppe Galgano, Carlo Lomonte
INTRODUCTION: Valvular disease and pulmonary hypertension are common conditions in haemodialysis patients. In presence of tricuspid regurgitation, an increased retrograde blood flow into the right atrium during ventricle systole results in a typical modification of the normal venous waveform, creating a giant c-v wave. This condition clinically appears as a venous palpable pulsation within the internal jugular vein, also known as Lancisi's sign. CASE REPORT: An 83-year-old woman underwent haemodialysis for 9 years...
July 19, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#19
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
September 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28687213/prevention-of-central-line-associated-bloodstream-infections
#20
REVIEW
Taison Bell, Naomi P O'Grady
Central venous catheters (CVCs) are commonly used in critically ill patients and offer several advantages to peripheral intravenous access. However, indwelling CVCs have the potential to lead to bloodstream infections, with the risk increasing with an array of characteristics, such as catheter choice, catheter location, insertion technique, and catheter maintenance. Evidence-based guidelines have led to a significant reduction in the incidence of bloodstream infections associated with CVCs. The combination of guideline implementation and newer technologies has the potential to further reduce morbidity and mortality from infections related to CVCs...
September 2017: Infectious Disease Clinics of North America
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