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Early removal of urinary catheter after surgery requiring thoracic epidural: a prospective trial.
Hu, Yinin; Craig, Sarah J; Rowlingson, John C; Morton, Steve P; Thomas, Christopher J; Persinger, Matthew B; Isbell, James; Lau, Christine L; Kozower, Benjamin D.
  • Hu Y; Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA.
  • Craig SJ; Department of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, VA.
  • Rowlingson JC; Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA.
  • Morton SP; Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA.
  • Thomas CJ; Department of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, VA.
  • Persinger MB; Department of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, VA.
  • Isbell J; Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA; Department of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, VA.
  • Lau CL; Department of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, VA.
  • Kozower BD; Department of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, VA. Electronic address: bdk8g@virginia.edu.
J Cardiothorac Vasc Anesth ; 28(5): 1302-6, 2014 Oct.
Article en En | MEDLINE | ID: mdl-25281046
ABSTRACT

OBJECTIVES:

To prevent urinary retention, urinary catheters commonly are removed only after thoracic epidural discontinuation after thoracotomy. However, prolonged catheterization increases the risk of infection. The purpose of this study was to determine the rates of urinary retention and catheter-associated infection after early catheter removal.

DESIGN:

This study described a prospective trial instituting an early urinary catheter removal protocol compared with a historic control group of patients.

SETTING:

The protocol was instituted at a single, academic thoracic surgery unit.

PARTICIPANTS:

The study group was comprised of patients undergoing surgery requiring thoracotomy who received an intraoperative epidural for postoperative pain control.

INTERVENTIONS:

An early urinary catheter removal protocol was instituted prospectively, with all catheters removed on or before postoperative day 2. Urinary retention was determined by bladder ultrasound and treated with recatheterization. MEASUREMENTS AND MAIN

RESULTS:

The primary outcomes were urinary retention rate, defined as bladder volume>400 mL, and urinary tract infection rate. Results were compared with a retrospective cohort of 210 consecutive patients who underwent surgery before protocol initiation. Among the 101 prospectively enrolled patients, urinary retention rate was higher (26.7% v 12.4%, p = 0.003), while urinary tract infection rate improved moderately (1% v 3.8%, p = 0.280).

CONCLUSIONS:

Early removal of urinary catheters with thoracic epidurals in place is associated with a high incidence of urinary retention. However, an early catheter removal protocol may play a role in a multifaceted approach to reducing the incidence of catheter-associated urinary tract infections.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Toracotomía / Analgesia Epidural / Remoción de Dispositivos / Catéteres Urinarios Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2014 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Toracotomía / Analgesia Epidural / Remoción de Dispositivos / Catéteres Urinarios Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2014 Tipo del documento: Article