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Internal jugular vein variability predicts fluid responsiveness in cardiac surgical patients

infusion

To evaluate the efficacy of using internal jugular vein variability (IJVV) as an index of fluid responsiveness in mechanically ventilated patients after cardiac surgery” Ma et al (2018). Abstract Background: To evaluate the efficacy of using internal jugular vein variability (IJVV) as an index of fluid responsiveness in mechanically ventilated patients after cardiac surgery. [ctt […]

Patient outcomes in hemodialysis at a tertiary care hospital in China

dialysis

The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center in China” Zhang et al (2018). Abstract: Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center […]

Introducing a quality improvement pediatric IV infiltration prevention bundle

intravenous cannulation

This quality improvement project sought to decrease the incidence of infiltration by creating an educational awareness program for both staff nurses and families using the S.T.I.C.K. mnemonic bundle” Watterson et al (2018). Abstract: Peripheral intravenous (PIV) catheters are commonly used in pediatric medical-surgical orthopedic and neurology populations but are at risk of dislodgement with subsequent […]

Incidence of Teicoplanin anaphylaxis associated with surgical prophylaxis

glass particles

This is the first study to calculate a rate of IgE mediated anaphylaxis to teicoplanin in clinical practice” Azamgarhi et al (2018). Abstract: BACKGROUND: The rate of true anaphylaxis to teicoplanin is currently unknown. METHODS: A case-series including all suspected anaphylactic reactions attributed to teicoplanin anaphylaxis within a single institution over a 29-month period were […]

Evaluation of the time-dependent inflammatory response to steel and Teflon insulin infusion catheters

Long peripheral IV

Therefore, we systematically assessed and quantified the inflammatory tissue response to steel versus Teflon CSII catheters over a maximum wear-time of 7 days in swine” Hauzenberger et al (2018). Abstract: Continuous subcutaneous insulin infusion (CSII) catheters are considered the weak link of insulin pump therapy. Wear-time considerably varies between patients and the choice of catheter […]

Prevention of blood culture contamination and associated adverse health care events

antibiofilm cvc coating

The findings of a national infection prevention survey of blood culture practices and related interventions in hospitals support the need for infection preventionists to expand their participation in the review of topics related to the ordering and collection of blood for culture” Garcia et al (2018). Abstract: The scientific literature indicates that blood culture contamination […]

Evaluation of quality indicators in an Indian intensive care unit

infusion nurses

The purpose of this study is to report QIs in an Indian ICU using this database” Gudivada et al (2017). Abstract: BACKGROUND: Quality indicators (QIs) are essential for maintaining quality of care in the critically ill. The Indian Society of Critical Care Medicine proposed benchmarks and enabled Indian Intensive Care Units (ICUs) to capture data […]

Accidental central venous administation of 0.1 % chlorhexidine mouthwash

extravasation

We describe a case of central venous administration of 0.1% CHX mouthwash, its potential complications and possibilities of treatment” Ploner et al (2018). Abstract: Medication errors are frequent and a serious safety concern. Chlorhexidine (CHX) is used daily in healthcare as a disinfectant. Its accidental intravascular injection is scarcely described. Serious complications, such as acute […]

Complications associated with implantable port use in infants

child iv

To evaluate technical success and the incidences of, and risk factors for, mechanical and infectious complications of venous port placement in infants” Acord et al (2018). Abstract: PURPOSE: To evaluate technical success and the incidences of, and risk factors for, mechanical and infectious complications of venous port placement in infants. [ctt link=”f4H3e” template=”1″]ReTweet if useful… […]

Totally implantable central venous access devices in elderly patients

marsi

The need for totally implantable central venous access devices (TICVADs) has increased with increased opportunities in the use of chemotherapy and parenteral nutrition. This study aimed to determine the outcomes of TICVAD implantation and use in patients aged ≥85 years” Imaoka et al (2018). Abstract: BACKGROUND/AIMS: The need for totally implantable central venous access devices […]

Anaphylaxis and other serious hypersensitivity reactions to rolapitant injectable emulsion

picc line prevalence

Varubi (rolapitant) Injectable Emulsion: Health Care Provider Letter – Anaphylaxis and Other Serious Hypersensitivity Reactions Anaphylaxis, anaphylactic shock and other serious hypersensitivity reactions have been reported in the postmarketing setting, some requiring hospitalization. These reactions have occurred during or soon after the infusion of Varubi (rolapitant) injectable emulsion. Most reactions have occurred within the first […]

Unnecessary removal of central venous catheters in cancer patients with bloodstream infections

clabsi

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” Chaftari et al (2018). Abstract: We evaluated the rate of central venous catheter (CVC) removal in 283 cancer patients with bloodstream infections (BSIs). Removal of CVCs occurred unnecessarily in […]

Employing adult PICCs as tunnelled central venous catheters in children

central catheter

Using a PICC device as a TCVC in small children appears to be a safe technique, with an acceptable complication profile” Lawson and Zealley (2018). Abstract: PURPOSE: Central venous access in children, in particular small children and infants, is challenging. We have developed a technique employing adult peripherally inserted central venous catheters (PICCs) as tunnelled […]

Anticoagulation protocol for patients undergoing ECMO based on thromboelastography

io infusion

This study aims to assess the safety and feasibility of an anticoagulation protocol for patients undergoing ECMO based on thromboelastography (TEG) as opposed to an activated partial thromboplastin time (aPTT)-based protocol” Panigada et al (2018). Abstract Background: There is no consensus on the management of anticoagulation during extracorporeal membrane oxygenation (ECMO). ECMO is currently burdened […]

Maximizing the safety of central venous lines for neonates

central venous catheter

We describe a strategy aimed at maximizing the safety and minimizing the thrombogenicity of central venous lines for neonates with congenital heart defects” Raees et al (2018). Abstract: 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 […]

Case study of a misguided right internal jugular triple lumen venous catheter

picc tip

A right internal jugular triple lumen venous catheter insertion was attempted for medication administration, and to provide access for continuous renal replacement therapy” Chamarthi and Koratala (2017). Extract: “A 47-year-old man with a history of end-stage renal disease, chronic heart failure, hypertension and diabetes mellitus was brought to the emergency department for dizziness and respiratory […]

What are the expected arterial catheter outcomes in children?

central line insertion training

To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease” Adler et al (2018). Abstract: OBJECTIVES: To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease. [ctt link=”gUDH5″ template=”1″]ReTweet if useful… What are the expected arterial catheter outcomes in children? https://ctt.ec/gUDH5+ […]

Emergency department resuscitation of pediatric trauma patients in Iraq and Afghanistan

intraosseous infusion sites

Pediatric subjects accounted for a notable portion of care delivered in theater emergency departments during the study period. Vascular access and fluid administration were the most frequently performed interventions. Pediatric-specific training is needed as a part of deployment medicine operations” Schauer et al (2018). Abstract: BACKGROUND: Military hospital healthcare providers treated children during the recent […]

Review of clinical effectiveness and safety of central venous access devices

intravenous fluids

This Rapid Response report is an update of the previous CADTH reports which found no difference in terms of frequency of occlusion in patients who had a valved versus a non-valved PICCs, and similar patency between heparin and saline use for CVCs” Ho and Spry (2017). Excerpt: Central venous access devices (CVADs) or central venous […]

Authors describe optimization of the blood culture pathway

blood culture contamination

By siting our blood culture analyser in the Blood Sciences laboratory and optimizing the pre-analytical and analytic phases of blood culture management we reduced the time taken to detect most blood culture isolates to <12 hours” Weinbren et al (2018). Summary: Laboratory processing of blood cultures has remained static over the past 30 years despite […]

Pattern of causative micro-organisms in catheter related blood stream infections

clabsi rca

Gram negative microorganisms were more commonly responsible for CRBSI in our settings” Mohsin (2017). Abstract: BACKGROUND: Catheter related blood stream infections (CRBSI) are the leading cause of morbidity in HD patients. The majority of these infections relate to haemodialysis catheters. There is a paucity of local data on microbial agents responsible for CRBSI in our […]

Point-of-care ultrasound education to improve care of dialysis patients

ultrasound training

In this narrative review, we will provide an overview of selected POCUS techniques, highlight potential uses of POCUS in routine nephrology practice, and describe a new curriculum implemented at Johns Hopkins University School of Medicine to teach diagnostic POCUS skills to nephrology fellows” Mullangi et al (2018). Abstract: Point-of-care ultrasound (POCUS) is rapidly emerging as […]

Converting the easy internal jugular access into a central venous access device

icu clabsi

The purpose of this letter is to inform your readers that the Easy IJ can be converted into a multi-lumen central venous catheter or even an introducer catheter” Moayedi and Witting (2018). Abstract: Placement of an 18-gauge, 48-mm single lumen intravenous catheter under ultrasound guidance into the internal jugular (IJ) vein, termed the “Easy IJ,” […]

Risk factors of vasopressor-induced symmetrical peripheral gangrene

IV Infusion

Symmetrical peripheral gangrene (SPG) is an uncommon syndrome showing symmetrical gangrene in acral regions without evidence of large-vessel occlusion or vasculitis. Intravenous vasopressors are frequently used to manage hemodynamically unstable patients. There have been few reports about SPG after using inotropics” Kwon et al (2018). Abstract: BACKGROUND: Symmetrical peripheral gangrene (SPG) is an uncommon syndrome […]

Chylothorax related to central line associated thrombosis

picc tip

Central vein thrombosis as a cause of chylothorax is uncommon, and in a few cases in the literature was related to thrombotic complications of central venous access devices (CVAD)” Spiwak et al (2018). Abstract: Central vein thrombosis as a cause of chylothorax is uncommon, and in a few cases in the literature was related to […]

Effectiveness of ultrasound-guided peripheral intravenous cannulation in pediatric patients

Ultrasound

The objective of this systematic review is to identify, evaluate and synthesize evidence of effectiveness on ultrasound-guided peripheral intravenous cannulation in pediatric patients aged under three years” Yamagami et al (2018). Abstract: The objective of this systematic review is to identify, evaluate and synthesize evidence of effectiveness on ultrasound-guided peripheral intravenous cannulation in pediatric patients […]

Cerebral oxygenation during umbilical arterial blood sampling in very low birth weight neonates

neonatal io access

Umbilical arterial blood sampling (UABS) has been associated with cerebral oxygen saturation (CrSO2) decrements in very low birth weight (VLBW) neonates. We sought to determine patient- and UABS procedure-related factors contributing to this effect” Mintzer and Messina (2018). Abstract: Objective: Umbilical arterial blood sampling (UABS) has been associated with cerebral oxygen saturation (CrSO2) decrements in […]

Epidemiology of health-care associated infections in pediatric intensive care units

zero clabsi

We provide comprehensive multicenter benchmark data regarding rates of HAI within dedicated pediatric CICUs. We confirm that while rare, HAIs of all types are associated with significant resource utilization and mortality” Alten et al (2017). Abstract: BACKGROUND: Health-care associated infections (HAI) represent serious complications for patients within pediatric cardiac intensive care units (CICU). HAI are […]