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Rectal Trumpet-Associated Hemorrhage in the Intensive Care Unit: A Quality Improvement Initiative.
Glass, Daniel; Huang, David T; Dugum, Mohannad; Chintamaneni, Preethi; Cua, Sarah; Saul, Melissa; Marsh, Wallis; Al-Khafaji, Ali.
Affiliation
  • Glass D; Daniel Glass, MD, Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. David T. Huang, MD, MPH, Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and The CRISMA (Clinical Research, Investigation and Systems Modeling of Acute Illness) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Mohannad Dugum, MD, Department of Gastroen
J Wound Ostomy Continence Nurs ; 45(6): 516-520, 2018.
Article in En | MEDLINE | ID: mdl-30395128
The rectal trumpet (RT) is a nasopharyngeal airway device that is inserted into the rectum for management of fecal incontinence. No published data exist on adverse events caused by the use of an RT. The purpose of this quality improvement project was to determine the rate of RT-associated hemorrhage among patients treated with an RT in our transplant intensive care unit (TICU). This quality improvement initiative and retrospective medical record review included all patients (N = 3933) cared for in a single specialty intensive care unit at a tertiary academic medical center between January 1, 2014, and May 31, 2016. We estimate that approximately 400 patients were treated with an RT. We found 3 possible and 9 probable cases of RT-associated hemorrhage, resulting in an estimated incident rate of 3% among RT-treated patients. All of these patients underwent invasive procedures for hemostasis. They received a mean of 4.9 units of packed red blood cell transfusions, and 9 experienced hypotension. Eight out of the 9 probable RT-associated hemorrhage patients experienced hemorrhage only after greater than 7 days of treatment with an RT. Following this initiative, RT use was banned in our TICU. The use of RTs can cause hemorrhage with clinically significant consequences.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Rectum / Catheterization / Fecal Incontinence / Quality Improvement / Hemorrhage Type of study: Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: J Wound Ostomy Continence Nurs Journal subject: ENFERMAGEM Year: 2018 Document type: Article Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Rectum / Catheterization / Fecal Incontinence / Quality Improvement / Hemorrhage Type of study: Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: J Wound Ostomy Continence Nurs Journal subject: ENFERMAGEM Year: 2018 Document type: Article Country of publication: