In situ bacteriologic diagnosis of total parenteral nutrition catheter infection.

An evaluation of the in situ bacteriologic status of a total parenteral nutrition (TPN) catheter, when the patient is pyretic but the cause of infection is not obvious, permits continued use of the catheter if the result is negative, as opposed to removal of the suspected catheter. To find a predictive value for the infection of the catheter, semiquantitative blood cultures taken through the TPN catheter were examined during the pyretic episodes. A total of 227 catheters from 204 patients were studied. Of these 149 were investigated during pyretic episodes. Twenty TPN catheters were removed because their semiquantitative blood cultures were positive, and in all cases the clinical conditions of the patients improved after removal of the catheters. The remaining 129 catheters investigated showed negative results and had predictive values of 100%. These catheters were left in place and all subsequently proved to be sterile on their removal at the end of the TPN. Thus 87% of the 149 suspected catheters were saved.

Detection of central venous catheter-associated sepsis.

To determine whether contamination of the catheter was the cause of pyrexis in patients receiving total parenteral nutrition through central venous catheters, semiquantitative culture of blood drawn through the line kept in place was performed. Eighty-three catheters from 75 patients were studied. The predictive value of a negative culture using this method was greater than 97%.

Has droperidol an atropinic effect?

The action of droperidol on the tachycardia produced by atropine and on the serum concentration of cholinesterases was observed during balanced anaesthesia. Without atropine, the mean heart rates of patients who received fentanyl plus droperidol were similar. Atropine increased heart rate only in the presence of droperidol (P less than 0.001) (fentanyl v. fentanyl plus droperidol: P less than 0.05). Droperidol inhibited serum cholinesterases (P less than 0.05); this effect was independent of atropine.

Dose-related tachycardia induced by pancuronium during balanced anaesthesia with and without droperidol.

Pancuronium 0.02--0.08 mg kg-1 induced a dose-related increase of heart rate in patients anaesthetized with nitrous oxide supplemented with either fentanyl 0.003 mg kg-1 or fentanyl 0.003 mg kg-1 plus droperidol 0.15 mg kg-1. The tachycardia was more marked following the administration of droperidol.