Antibiotic lock technique reduces the incidence of temporary catheter-related infections.

BACKGROUND: In the hemodialytic population, infections are the second leading cause of death; access infections account for a large proportion of this mortality. The antibiotic lock technique has been applied to infected tunneled catheters as rescue or prophylaxis medication to reduce infection rates. In addition, application of topical antibiotic ointments to tunneled and non-tunneled catheters also prevents exit site infections. METHODS: 17 patients with 25 catheters participated in our study from March 2004 - February 2005. The catheter lock comprised of mixed cefazolin (5 mg/dl) with heparin (2,500 IU/ml) and mupirocin was topically applied to the area (2 x 2 cm) surrounding the catheter exit site. RESULTS: The catheter infection rate was reduced from 12.7 times/1,000 catheter days to 5.02 times/1,000 catheter days in patients with jugular vein catheters. The total catheter-related infection rate was 14.9 times/1,000 catheter days in the control group and 4.1 times/1,000 catheter days in the study group. The reduction in catheter infections was more evident in a subgroup of non-diabetic patients, and in those with femoral catheters. CONCLUSION: The use of antibiotic lock and topical antibiotics significantly reduces the incidence of temporary catheter-related infections, especially in non-diabetic patients and in those with femoral catheters.

Transfer function analysis of the ventricular function: a new method for calculating right ventricular ejection fraction.

The relationship between the ventricular transfer function and ejection fraction has been investigated by the routine procedure of first-pass radionuclide angiocardiography. Ejection fraction has been shown to equal 1-e(-b), where b is the ratio of the R-R interval over the mean transit time difference between ventricular and atrial time-activity curves. To evaluate the effect of region of interest (ROI) on the right ventricular ejection fraction (RVEF), the results of the transfer function analysis (TFA) technique using precise ROI, TFA using rectangular ROI, and the routine method were compared. Regression analyses among RVEFs obtained from the above ROI methods yielded good correlations. Reliable RVEFs have been obtained even in the case of an improper bolus injection. Thus, the TFA technique is a new, simple, and reliable method for calculating RVEF without needing to outline the right ventricle precisely.