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1.
Crit Care ; 24(1): 109, 2020 03 18.
Artículo en Inglés | MEDLINE | ID: mdl-32188500

RESUMEN

BACKGROUND: Candidemia is an opportunistic infection associated with high morbidity and mortality in patients hospitalized both inside and outside intensive care units (ICUs). Identification of patients at risk is crucial to ensure prompt antifungal therapy. We sought to assess risk factors for candidemia and death, both outside and inside ICUs. METHODS: This prospective multicenter matched case-control study involved six teaching hospitals in Switzerland and France. Cases were defined by positive blood cultures for Candida sp. Controls were matched to cases using the following criteria: age, hospitalization ward, hospitalization duration, and, when applicable, type of surgery. One to three controls were enrolled by case. Risk factors were analyzed by univariate and multivariate conditional regression models, as a basis for a new scoring system to predict candidemia. RESULTS: One hundred ninety-two candidemic patients and 411 matched controls were included. Forty-four percent of included patients were hospitalized in ICUs, and 56% were hospitalized outside ICUs. Independent risk factors for candidemia in the ICU population included total parenteral nutrition, acute kidney injury, heart disease, prior septic shock, and exposure to aminoglycoside antibiotics. Independent risk factors for candidemia in the non-ICU population included central venous catheter, total parenteral nutrition, and exposure to glycopeptides and nitroimidazoles. The accuracy of the scores based on these risk factors is better in the ICU than in the non-ICU population. Independent risk factors for death in candidemic patients included septic shock, acute kidney injury, and the number of antibiotics to which patients were exposed before candidemia. DISCUSSION: While this study shows a role for known and novel risk factors for candidemia, it specifically highlights important differences in their distribution according to the hospital setting (ICU versus non-ICU). CONCLUSION: This study provides novel risk scores for candidemia accounting for the hospital setting and recent progress in patients' management strategies and fungal epidemiology.


Asunto(s)
Antifúngicos/uso terapéutico , Candidemia/mortalidad , Unidades de Cuidados Intensivos/estadística & datos numéricos , Anciano , Estudios de Casos y Controles , Catéteres Venosos Centrales , Infección Hospitalaria , Femenino , Francia , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Suiza
2.
Br J Nurs ; 29(3): S25-S29, 2020 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-32053448

RESUMEN

Demand for vascular access devices to meet the clinical needs of patients has increased dramatically in recent years, with a disproportionate increase in the numbers of individuals requiring a central venous access device (CVAD). With this increasing number of patients becoming recipients of CVADs globally each year, the associated incidence of catheter-related bloodstream infections (CRBSIs) is also increasing. In addition, there is strong evidence to demonstrate that antimicrobial resistance is a global challenge. There is a need to change the approach to CVAD management and get back to basics through a clearer understanding of how the incidence of CRBSIs can be reduced. This includes the role of biofilm and how its development can be inhibited through the use of an effective lock solution, and the avoidance of antibiotics.


Asunto(s)
Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/instrumentación , Infección Hospitalaria/prevención & control , Biopelículas , Infecciones Relacionadas con Catéteres/epidemiología , Cateterismo Venoso Central/efectos adversos , Catéteres Venosos Centrales/efectos adversos , Infección Hospitalaria/epidemiología , Diseño de Equipo , Humanos , Incidencia
5.
J Vasc Access ; 21(1): 116-119, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31232149

RESUMEN

BACKGROUND: Central venous catheters are extensively used in critical care units and in dialysis centres to gain access to the blood stream for the purpose of invasive monitoring, drug administration, parenteral nutrition and to perform renal replacement therapy. One of the common areas of central venous catheter insertion is right internal jugular vein due to its anatomical continuity with the superior vena cava. The complication rates of central venous catheter insertion can be more than 15%, including early and late complications. CASE REPORT: We present an unusual complication of recurrent laryngeal nerve palsy, leading to right vocal fold paralysis, following insertion of a right internal jugular tunnelled dialysis catheter. The vocal fold paralysis improved over next 8 months with conservative management alone. CONCLUSION: This case illustrates an unusual complication of central venous catheter insertion and the importance of recognizing the possibility of such complications, to prevent them from happening and also to manage them appropriately.


Asunto(s)
Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/instrumentación , Catéteres de Permanencia , Catéteres Venosos Centrales , Venas Yugulares , Parálisis de los Pliegues Vocales/etiología , Anciano , Tratamiento Conservador , Diseño de Equipo , Femenino , Ronquera/etiología , Humanos , Resultado del Tratamiento , Parálisis de los Pliegues Vocales/diagnóstico , Parálisis de los Pliegues Vocales/terapia
6.
J Vasc Access ; 21(1): 45-54, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31177939

RESUMEN

BACKGROUND: Technical factors at the moment of catheter insertion might have a role in peripherally inserted central catheter-related thrombotic risk. We performed a systematic review and meta-analysis to define the actual rate of peripherally inserted central catheter-related symptomatic deep vein thrombosis in patients in whom catheter insertion was performed according to ultrasound guidance, appropriate catheter size choice, and proper verification of tip location. METHODS: We searched Medline, Embase, and Cochrane Library. Only prospective observational studies published in peer-reviewed journals after 2010 up to November 2018 reporting peripherally inserted central catheter-related deep vein thrombosis rate were included. All studies were of adult patients who underwent peripherally inserted central catheter insertion. Results were restricted to those studies which included in their methods ultrasound guidance for venipuncture, catheter tip location, and a catheter size selection strategy. Random-effect meta-analyses and arcsine transformation for binomial data were performed to pool deep vein thrombosis weighted frequencies. RESULTS: Of the 1441 studies identified, 15 studies involving 5420 patients and 5914 peripherally inserted central catheters fulfilled our inclusion criteria. The weighted frequency of peripherally inserted central catheter-related deep vein thrombosis was 2.4% (95% confidence interval = 1.5-3.3) and remained low in oncologic patients (2.2%, 95% confidence interval = 0.6-3.9). Thrombotic rate was higher in onco-hematologic patients (5.9%, 95% confidence interval = 1.2-10). Considerable heterogeneity (I2 = 74.9) was observed and all studies were considered at high risk of attrition bias. CONCLUSIONS: A proper technique is crucial at the moment of peripherally inserted central catheter insertion. Peripherally inserted central catheter-related deep vein thrombosis rate appears to be low when evidence-based technical factors are taken into consideration during the insertion procedure.


Asunto(s)
Obstrucción del Catéter/etiología , Cateterismo Venoso Central/efectos adversos , Cateterismo Periférico/efectos adversos , Trombosis de la Vena/etiología , Cateterismo Venoso Central/instrumentación , Cateterismo Periférico/instrumentación , Catéteres de Permanencia , Catéteres Venosos Centrales , Diseño de Equipo , Humanos , Medición de Riesgo , Factores de Riesgo , Ultrasonografía Intervencional , Trombosis de la Vena/diagnóstico por imagen
7.
J Vasc Access ; 21(1): 86-91, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31328625

RESUMEN

PURPOSE: In an effort to reduce catheter-related bloodstream infection's incidence rates in an intensive care unit, several evidence-based procedures recommended by the Centers for Disease Control and Prevention for centrally inserted central catheters were implemented. A failure to fully comply with the recommendation for prompt removal of the centrally inserted central catheters was attributed, mainly to the difficulties and inadequacies raised from establishing peripheral venous access. METHODS: The ultrasound-guided peripheral venous cannulation method as a supplementary intervention to the Centers for Disease Control and Prevention's recommendations was incorporated and examined during the subsequent year. RESULTS: A significant reduction on catheter-related bloodstream infection incidence rates out of the expected range was found. Centrally inserted central catheters utilization ratios were reduced by 10.7% (p < 0.05; 58%-47%) and the catheter-related bloodstream infection incidence rate was reduced by 11.7 per thousand device-days (15.9-4.16/1000 centrally inserted central catheters days (2015-2016 group, respectively)). CONCLUSION: The reduction of catheter-related bloodstream infection was higher than that described in the published literature. This probably shows that the combination of the five evidence-based procedures recommended by the Centers for Disease Control and Prevention together with that of ultrasound-guided peripheral venous cannulation method can increase the compliance with the Category IA recommendation for removal or avoidance of unnecessary placement of centrally inserted central catheters and decrease the catheter-related bloodstream infections in a more effective way, by affecting the patients' centrally inserted central catheter exposure.


Asunto(s)
Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/instrumentación , Cateterismo Periférico/instrumentación , Catéteres de Permanencia , Catéteres Venosos Centrales , Remoción de Dispositivos , Ultrasonografía Intervencional , Anciano , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/microbiología , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/normas , Cateterismo Periférico/efectos adversos , Cateterismo Periférico/normas , Chipre/epidemiología , Remoción de Dispositivos/efectos adversos , Remoción de Dispositivos/normas , Diseño de Equipo , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Tiempo de Tratamiento , Resultado del Tratamiento , Ultrasonografía Intervencional/normas , Estados Unidos
8.
J Vasc Access ; 21(1): 33-38, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31159638

RESUMEN

The Infusional Services Team at a large cancer centre in Belfast, Northern Ireland, performed a cross-sectional analysis of two catheter securement technologies to address an area of frequent, but underestimated concern - peripherally inserted central catheter migration and dislodgement. Healthcare practitioner and patient feedback, along with economic impact, were assessed. The costs associated with catheter replacement during the adhesive device group study period were calculated using an average cost per insertion, based on material costs required for the procedure. Other factors were the replacement cost of the adhesive engineered securement device with each dressing change. In the subcutaneous securement group, the material costs were adjusted for use of the subcutaneous device as it remained in situ for the duration of the catheters' dwell time. This review found that subcutaneous securement offers both patient and facilities a safe, effective and economical alternative for device securement with patients who are unable to tolerate or have successful securement with adhesive securement devices. The use of subcutaneous devices provided for reduced risks for peripherally inserted central catheters in terms of dislodgement, migration or malposition, alleviating the potential risks to develop catheter-related thrombosis and device-related infection.


Asunto(s)
Cateterismo Venoso Central/instrumentación , Cateterismo Periférico/instrumentación , Catéteres de Permanencia , Catéteres Venosos Centrales , Migración de Cuerpo Extraño/prevención & control , Adhesivos Tisulares/uso terapéutico , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/economía , Cateterismo Periférico/efectos adversos , Cateterismo Periférico/economía , Catéteres de Permanencia/economía , Catéteres Venosos Centrales/economía , Investigación sobre la Eficacia Comparativa , Análisis Costo-Beneficio , Estudios Transversales , Diseño de Equipo , Migración de Cuerpo Extraño/economía , Migración de Cuerpo Extraño/etiología , Costos de la Atención en Salud , Humanos , Irlanda del Norte , Factores de Tiempo , Adhesivos Tisulares/efectos adversos , Adhesivos Tisulares/economía , Resultado del Tratamiento
9.
Radiol Clin North Am ; 58(1): 105-117, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31731895

RESUMEN

Central venous catheters (CVCs) are commonly used in patients in a variety of clinical settings, including the intensive care unit, general ward, and outpatient settings. After placement, the radiologist is frequently requested to evaluate the location of CVCs and deem them suitable for use. An understanding of the ideal location of catheter tips as well as the approach to identifying malpositioned catheter tips is essential to prevent improper use, recognize and/or prevent further injury, and direct potential lifesaving care. An approach to CVC placement based on tip location can be helpful in localization and guiding management.


Asunto(s)
Catéteres Venosos Centrales , Venas Yugulares/diagnóstico por imagen , Errores Médicos , Radiografía Torácica/métodos , Vena Subclavia/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Humanos
10.
Vasc Endovascular Surg ; 54(1): 65-68, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31500541

RESUMEN

Central venous catheter (CVC) insertion with ultrasound guidance is routine clinical practice in the critically ill patient. Arterial malposition is serious and may lead to severe complications such as hemorrhage, stroke, or death. We describe a bail-out technique for removal of right-sided CVC that was mispositioned into the brachiocephalic trunk (BCT) at the origin of the right common carotid artery (CCA). Covered stenting of the BCT extending into the CCA in combination with plug embolization of the right subclavian artery was utilized.


Asunto(s)
Tronco Braquiocefálico/diagnóstico por imagen , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/instrumentación , Catéteres Venosos Centrales , Remoción de Dispositivos/instrumentación , Procedimientos Endovasculares/instrumentación , Stents , Anciano , Remoción de Dispositivos/métodos , Embolización Terapéutica , Humanos , Masculino , Resultado del Tratamiento
13.
Support Care Cancer ; 28(1): 361-372, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31044308

RESUMEN

OBJECTIVE: This systematic review and meta-analysis aimed to provide evidence-based guidance to better understand the risk of central line-associated bloodstream infection (CLABSI) in cancer patients who received totally implantable venous access ports (TIVAPs) compared with those who received external central venous catheters (CVCs). METHODS: A systematic search of PubMed, Web of science, Embase, and the Cochrane Library was carried out from inception through Oct 2018, with no language restrictions. Trials examining the risk of CLABSI in cancer patients who received TIVAPs compared with those who received external CVCs were included. Two reviewers independently reviewed, extracted data, and assessed the risk of bias of each study. A random-effect model was used to estimate relative risks (RRs) with 95% CIs. RESULTS: In all, 26 studies involving 27 cohorts and 5575 patients reporting the incidence of CLABSI in patients with TIVAPs compared with external CVCs were included. Pooled meta-analysis of these trials revealed that TIVAPs were associated with a significant lower risk of CLABSI than were external CVCs (relative risk [RR], 0.44; 95% confidence interval [CI], 0.31-0.62; P < 0.00001), which was confirmed by trial sequential analysis for the cumulative z curve entered the futility area. Subgroup analyses demonstrated that CLABSI reduction was greatest in adult patients (RR [95% CI], 0.35 [0.22-0.56]) compared with pediatric patients who received TIVAPs (RR [95% CI], 0.55 [0.38-0.79]). CONCLUSIONS: TIVAP can significantly reduce the risk of CLABSI compared with external CVCs.


Asunto(s)
Bacteriemia/epidemiología , Bacteriemia/etiología , Infecciones Relacionadas con Catéteres/epidemiología , Catéteres Venosos Centrales/efectos adversos , Neoplasias/epidemiología , Adulto , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/estadística & datos numéricos , Catéteres Venosos Centrales/microbiología , Catéteres Venosos Centrales/estadística & datos numéricos , Humanos , Incidencia , Neoplasias/terapia , Factores de Riesgo
14.
Khirurgiia (Mosk) ; (12): 13-17, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31825338

RESUMEN

OBJECTIVE: To analyze postoperative complications of totally implantable central venous port system (TIPCVP) deployment and develop methods of their prevention. MATERIAL AND METHODS: The study involved 43 patients who underwent TIPCVP implantation through right-sided jugular access and 3 patients with migration of the catheter transferred to the Domodedovo Central City Hospital. RESULTS: There were four perioperative and one early postoperative complication. None of the complications was the reason for removal of TIPCVP. Pinch-off syndrome occurred in two patients who were operated in other hospitals and a catheter was inserted through the right subclavian vein. CONCLUSION: Injury of the carotid artery and pneumothorax can be avoided by ultrasound navigation during internal jugular vein puncture. Catheterization of the internal jugular vein is useful to avoid pinch-off syndrome. Migration of the catheter is successfully cured by endovascular methods.


Asunto(s)
Cateterismo Venoso Central/efectos adversos , Neumotórax/prevención & control , Cateterismo Venoso Central/métodos , Catéteres de Permanencia/efectos adversos , Catéteres Venosos Centrales/efectos adversos , Remoción de Dispositivos , Migración de Cuerpo Extraño/etiología , Migración de Cuerpo Extraño/terapia , Humanos , Venas Yugulares/diagnóstico por imagen , Venas Yugulares/lesiones , Neumotórax/etiología , Vena Subclavia/diagnóstico por imagen , Ultrasonografía Intervencional
15.
Enferm. intensiva (Ed. impr.) ; 30(4): 170-180, oct.-dic. 2019. tab
Artículo en Español | IBECS | ID: ibc-184481

RESUMEN

Introducción: Los catéteres centrales de inserción periférica se han convertido en una prioridad en los neonatos que necesitan terapia intravenosa de larga duración, pero su uso no está exento de riesgos. Objetivo: Describir la aparición de eventos adversos en neonatos portadores de catéteres venosos centrales de inserción periférica y determinar factores de riesgo asociados a ellos. Métodos: Se llevó a cabo un estudio descriptivo transversal en el que se incluyeron la totalidad de neonatos portadores de catéteres venosos centrales de inserción periférica desde el 1 de octubre de 2014 hasta el 30 de septiembre de 2015. Se registraron los eventos adversos y variables sociodemográficas y clínicas relacionadas con los neonatos y los catéteres analizados. Resultados: Se incluyeron en el estudio un total de 116 neonatos y 140 catéteres. Se registraron eventos adversos en el 16,4% de ellos: bacteriemia asociada al catéter (5,7%), obstrucción (5,7%), extravasación (2,1%) y flebitis (2,1%). Los factores asociados a bacteriemia con el odds de prevalencia corresponde a neonatos: < 27 semanas de gestación (OR = 1,2; p = 0,02), con peso < 1.000 g (OR = 6,7; p = 0,02), portadores de catéter > 1 semana (OR = 9,8; p = 0,02) y con perfusión de antibióticos por catéter (OR = 1,3; p < 0,01). La flebitis se asocia con la inserción del catéter en miembros inferiores y cabeza (OR = 1,1; p = 0,03). Los factores asociados a bacteriemia con odds de prevalencia ajustada corresponde a neonatos de peso extremo (OR = 6,38; p = 0,03) y portadores del catéter > 7 días (OR = 9,41; p = 0,04). Conclusiones: La evaluación periódica de eventos adversos relacionados con catéteres es de gran utilidad para elaborar planes de mejora. Esto permitirá extremar la seguridad en los RN más vulnerables, en especial los neonatos con extremo bajo peso que precisan tratamientos muy prolongados


Background: Peripherally inserted central catheters have become a priority in infants who require long-term intravenous therapy, but their use involves certain risks. Objective: The aim of the study was to describe the occurrence of adverse events in newborns with peripherally inserted central catheters and to determine the risk factors associated with them. Methods: A descriptive cross-sectional study was designed and performed. All neonates with peripherally inserted central catheters from October 1st, 2014 to September 30 th, 2015 were included. The adverse events and sociodemographic and clinical variables related to neonates and analyzed catheters were recorded. Results: A total of 140 catheters were placed in 116 infants. All of them were analyzed. Adverse events occurred in 16.4%: catheter-associated bacteraemia (5.7%), obstruction (5.7%), extravasation (2.1%) and phlebitis (2.1%), < 27 weeks of pregnancy (OR = 1.2, P = .02), birth weight < 1000 g (OR = 6.7, P = .02), with catheters in situ for longer than one week (OR = 9.8, P = .02) and with perfusion of antibiotics per catheter (OR = 1.3, P < .01). Phlebitis is associated with the insertion of the catheter in LL and head (OR = 1.1, P = .03). Factors associated with bacteraemia risk with adjusted prevalence odds ratio are extremely low birth weight neonates (OR = 6.38; P = .03) and with a catheter in situ for longer than one week (OR = 9.41; P = .04). Conclusions: The periodic evaluation of catheter-related adverse events is very useful to prepare improvement plans. This will maximize safety for the most vulnerable newborns, especially those of extremely low birth weight that require very long treatments


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Catéteres Venosos Centrales/efectos adversos , Factores de Riesgo , Unidades de Cuidado Intensivo Neonatal/tendencias , Cuidados Críticos/métodos , Epidemiología Descriptiva , Bacteriemia/complicaciones , Bacteriemia/prevención & control , Flebitis/prevención & control , Intervalos de Confianza
17.
Nephrol Nurs J ; 46(6): 587-590, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31872988

RESUMEN

Central venous catheter (CVC) vascular access is common among patients on hemodialysis. CVC use carries a substantial risk of central line-associated bloodstream infections (CLABSIs), costly events that place patients at a high risk of mortality. Our hospital and dialysis organization developed a cooperative strategy to reduce the rate of CLABSI among hospitalized patients on hemodialysis with a CVC. The program included the use of training and reporting tools to guide hospital staff with CLABSI prevention, as well as leadership committees to oversee the process. Fourteen CLABSIs were reported in the 17-month period prior to the implementation of the program, while no new CLABSIs occurred in the 30 months following implementation of the program. This prevention program effectively reduced the frequency of CLABSIs. Broader implementation of such programs may result in better outcomes and lower costs for hospitalized patients on hemodialysis.


Asunto(s)
Bacteriemia , Infecciones Relacionadas con Catéteres , Cateterismo Venoso Central , Catéteres Venosos Centrales , Bacteriemia/prevención & control , Infecciones Relacionadas con Catéteres/prevención & control , Humanos , Diálisis Renal
18.
Rev Chilena Infectol ; 36(4): 414-420, 2019 Aug.
Artículo en Español | MEDLINE | ID: mdl-31859763

RESUMEN

Taurolidine is a broad-spectrum antiseptic used as lock therapy solution in adult and pediatric patients with long term central venous catheters (CVC) for the prevention of catheter related bloodstream infections (CRBSI). Taurolidine doesn't induce the resistant development and has only minor and brief side effects, which makes it an alternative both as a lock therapy and for the prevention of CRBSI in this group of patients.


Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Infecciones Relacionadas con Catéteres/prevención & control , Catéteres Venosos Centrales/efectos adversos , Taurina/análogos & derivados , Tiadiazinas/administración & dosificación , Humanos , Taurina/administración & dosificación
19.
PLoS One ; 14(12): e0226641, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31856186

RESUMEN

BACKGROUND: It remains unclear whether the use of central venous catheters (CVC) improves a patient's clinical outcome after elective intracranial supratentorial procedures. METHODS: This two-armed, single-center retrospective study sought to compare patients undergoing elective intracranial surgery with and without CVCs. Standard anaesthesia procedures were modified during the study period resulting in the termination of obligatory CVC instrumentation for supratentorial procedures. Peri-operative adverse events (AEs) were evaluated as primary endpoint. RESULTS: The data of 621 patients in total was analysed in this study (301 with and 320 without CVC). Patient characteristics and surgical procedures were comparable between both study groups. A total of 132 peri-operative AEs (81 in the group with CVC vs. 51 in the group without CVC) regarding neurological, neurosurgical, cardiovascular events and death were observed. CVC patients suffer from AEs almost twice as often as non CVC patients (ORadjusted = 1.98; 95%CI[1.28-3.06]; p = 0.002). Complications related to catheter placement (pneumothorax and arterial malpuncture) were observed in 1.0% of the cases. The ICU treatment period in patients with CVC was 22 (19;24) vs. 21 (19;24) hours (p = 0.413). The duration of hospital stay was also similar between groups (9 (7;13) vs. 8 (7;11) days, p = 0.210). The total time of ventilation (350 (300;440) vs. 335 (281;405) min, p = 0.003) and induction time (40 (35;50) vs. 30 (25;35) min, p<0.001) was found to be prolonged significantly in the group with CVCs. There were no differences found in post-operative inflammatory markers as well as antibiotic treatment. CONCLUSION: The data of our retrospective study suggests that patients undergoing elective neurosurgical procedures with CVCs do not demonstrate any additional benefits in comparison to patients without a CVC.


Asunto(s)
Catéteres Venosos Centrales/efectos adversos , Revascularización Cerebral/efectos adversos , Procedimientos Quirúrgicos Electivos/efectos adversos , Complicaciones Posoperatorias/epidemiología , Anciano , Revascularización Cerebral/instrumentación , Revascularización Cerebral/métodos , Procedimientos Quirúrgicos Electivos/instrumentación , Procedimientos Quirúrgicos Electivos/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología
20.
BMJ ; 367: l4993, 2019 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-31685481

RESUMEN

The studyGilbert R, Brown M, Rainford N et al. Antimicrobial-impregnated central venous catheters for prevention of neonatal bloodstream infection (PREVAIL): an open-label, parallel-group, pragmatic, randomised controlled trial. Lancet Child Adolesc Health 2019;3:381-90.The study was funded by the NIHR Health Technology Assessment programme (project number 12/167/02).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000782/antimicrobial-central-venous-catheters-for-pre-term-babies-do-not-reduce-infections.


Asunto(s)
Antiinfecciosos , Bacteriemia , Catéteres Venosos Centrales , Antibacterianos , Niño , Humanos , Lactante , Recién Nacido , Evaluación de la Tecnología Biomédica
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