Case report: Treatment of congenital lobar emphysema with lung lobectomy in a puppy.

An 11-week-old, sexually intact female Catahoula Leopard dog was evaluated for a multiple-week history of exercise intolerance and intermittent periods of respiratory distress. Thoracic radiographs revealed a markedly hyperinflated right lung field, with compression of the surrounding lung lobes. Thoracic computed tomography further localized the hyperinflation to the right middle lung lobe, with suspicion of congenital lobar emphysema. A right intercostal thoracotomy with right middle lung lobectomy was performed successfully. Histopathology results confirmed bronchial cartilage hypoplasia with marked emphysema and pleural fibrosis. The puppy recovered from surgery uneventfully and was discharged from the hospital without any postoperative complications. At 18 months postoperatively, the dog was clinically normal with no return of respiratory distress. This case report describes successful surgical treatment of a large breed puppy with the uncommonly reported condition of congenital lobar emphysema.

A mixed-methods evaluation on the efficacy and perceptions of needleless connector disinfectants.

OBJECTIVE: Optimizing needleless connector hub disinfection practice is a key strategy in central-line-associated bloodstream infection (CLABSI) prevention. In this mixed-methods evaluation, 3 products with varying scrub times were tested for experimental disinfection followed by a qualitative nursing assessment of each. METHODS: Needleless connectors were inoculated with varying concentrations of Staphylococcus epidermidis, Pseudomonas aeruginosa, and Staphylococcus aureus followed by disinfection with a 70% isopropyl alcohol (IPA) wipe (a 15-second scrub time and a 15-second dry time), a 70% IPA cap (a 10-second scrub time and a 5-second dry time), or a 3.15% chlorhexidine gluconate with 70% IPA (CHG/IPA) wipe (a 5-second scrub time and a 5-second dry time). Cultures of needleless connectors were obtained after disinfection to quantify bacterial reduction. This was followed by surveying a convenience sample of nursing staff with intensive care unit assignments at an academic tertiary hospital on use of each product. RESULTS: All products reduced overall bacterial burden when compared to sterile water controls, however the IPA and CHG/IPA wipes were superior to the IPA caps when product efficacy was compared. Nursing staff noted improved compliance with CHG/IPA wipes compared with the IPA wipes and the IPA caps, with many preferring the lesser scrub and dry times required for disinfection. CONCLUSION: Achieving adequate bacterial disinfection of needleless connectors while maximizing healthcare staff compliance with scrub and dry times may be best achieved with a combination CHG/IPA wipe.