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"Central Line" OR "Central Venous Line"

Weihang Lu, Wei Guo, Jie Liu, Yangyang Ge, Dan Rong, Bai He, Jianfei Dong, Xin Jia
OBJECTIVE: Successful endovascular repair of thoracic aorta for type B aortic dissection requires correct stent-graft sizing, particularly of distal landing zone which is mainly based on operator experience. The present study aimed to quantitatively define proximal-to-distal tapering of descending thoracic aortic diameter and its consistency. METHODS: The novel parameter HDP (Hundred times Distance accounts for Percentage: distance [from distal end of left subclavian artery to each level along aortic central line] / length [from distal end of left subclavian artery to proximal end of celiac artery along aortic central line] *100) was calculated per 1% unit of descending thoracic aorta based on 3mensio software-derived measurements from 281 consecutive individuals who had undergone enhanced chest computer tomography scanning...
February 12, 2019: Annals of Vascular Surgery
Edward K Len, Ritesh Akkisetty, Sandia Royal, Maryanne Brooks, Susette Coyle, Rajan Gupta, Matthew Lissauer
BACKGROUND: Hospital over-capacity often forces boarding patients outside of their designated intensive care unit (ICU). Anecdotal evidence suggested medical intensive care unit (MICU) patients boarding in the surgical intensive care unit (SICU) were responsible for increases in healthcare-associated infection (HAI) rates. We studied the effect of ICU boarding on rates of SICU HAIs. METHODS: This single-center, retrospective two-year database study compared primary SICU patients (Home) to MICU patients boarding in the SICU (Boarders)...
February 15, 2019: Surgical Infections
Nguyen Tien Son, Pontus Stenberg, Valdas Jokubavicius, Takeshi Ohshima, Jawad Ul Hassan, Ivan Gueorguiev Ivanov
The negative silicon vacancy (V_Si^-) in SiC has recently emerged as a promising defect for quantum bits and room-temperature quantum sensing. However, its electronic structure is still not well characterized. While the isolated Si vacancy is expected to give rise to only two paramagnetic centers corresponding to two inequivalent lattice sites in 4H-SiC, there have been five electron paramagnetic resonance (EPR) centers assigned to V_Si^- in the past: the so-called isolated no-zero-field splitting (ZFS) V_Si^- center and another four axial configurations with small ZFS: TV1a, TV2a, TV1b, and TV2b...
February 14, 2019: Journal of Physics. Condensed Matter: An Institute of Physics Journal
John Kleinman, Kenji Inaba, Emily Pott, Kazuhide Matsushima, Demetrios Demetriades, Aaron Strumwasser
Focused assessment with Sonography for trauma (FAST) examination is essential to trauma triage. We sought to determine whether FASTs completed early in sequencing portend worse outcomes. A two-year review (2014-2015) of all trauma activations at our Level I trauma center was performed. Patients were matched at baseline and FAST times were compared. Outcomes included resuscitation time (RESUS-h), ventilation days (d), hospital length of stay (HLOS-d), ICU length of stay (LOS-d), survival (%), nosocomial infection rate (%), and venous thromboembolism complication rate (%)...
October 1, 2018: American Surgeon
Joshua Tseng, Harry C Sax, Rodrigo F Alban
Charge markups for health care are variable and inflated several times beyond cost. Using the 2015 Medicare Provider Fee-For-Service Utilization and Payment Data file, we identified providers who billed for critical care hours and related procedures, including CPR, EKG interpretation, central line placement, arterial line placement, chest tube/thoracentesis, and emergent endotracheal intubation. Markup ratios (MRs), defined as the amount charged divided by the amount allowable, were calculated and compared; 42...
October 1, 2018: American Surgeon
Elhaam Mesghali, Scott Fitter, Khaled Bahjri, Kayvan Moussavi
BACKGROUND: Hypertonic saline (HTS) and mannitol are frequently utilized in the emergency department (ED) to manage elevations in intracranial pressure (ICP). OBJECTIVE: The objective of this study was to compare the incidence of extravasation injury when HTS or mannitol was administered via peripheral i.v. line (PIV). METHODS: This retrospective cohort study evaluated adult and pediatric patients given either 3% HTS or mannitol via PIV while in the ED...
February 8, 2019: Journal of Emergency Medicine
Kamal Sharma, Andre Raszynski, Balagangadhar R Totapally
Introduction: Obesity is associated with poor health outcomes but may be protective in intensive care unit patients. The objective of this study is to describe the characteristics of underweight, normal weight, and obese children, and to compare their length of stay, resource utilization, and mortality. Methods: The charts of 1447 patients who were admitted to a tertiary-level pediatric intensive care unit during 1 calendar year were reviewed. Patients were divided into three groups: underweight (<5th percentile), normal (5th-95th percentiles), and obese (>95th percentile)...
2019: SAGE Open Medicine
Mary Lyn Stein, Luis G Quinonez, James A DiNardo, Morgan L Brown
Neonates undergoing congenital heart surgery require central venous access for diagnostic information and medication administration. There are multiple options for central access including peripherally inserted central catheters, umbilical, central venous, and transthoracic intracardiac lines. We retrospectively identified all patients younger than 30 days who underwent cardiac surgery in a 1-year period. Data were collected on demographic and medical characteristics, adverse events, pre-emptive transfusion of blood products prior to line removal, and transfusion of blood products following removal of transthoracic intracardiac lines and central venous lines...
January 30, 2019: Pediatric Cardiology
Ketan Desai, Anshu C Warade, Ashish K Jha, Sanjeev Pattankar
Objective: A retrospective analysis of surgically treated 354 cases of injection-related iatrogenic peripheral nerve injuries was performed. The purpose of this clinical study was to present our experience in the management of various types of injection-related peripheral nerve injuries and discuss various issues that are associated with this subset of peripheral nerve injuries. Methods: Over a 17-year period, 354 cases of injection-related iatrogenic peripheral nerve injuries were managed surgically at the Department of Neurosurgery at P...
January 2019: Neurology India
Jinhua Ren, Qiaoxian Lin, Weimin Chen, Congmeng Lin, Yuxin Zhang, Cunrong Chen, Shaozhen Chen, Xiaohong Yuan, Ping Chen, Xiaofeng Luo, Yun Lin, Lvying Shen, Mengxian Guo, Qiuru Chen, Min Xiao, Yongquan Chen, Xueqiong Wu, Yanling Zeng, Zhizhe Chen, Xudong Ma, Jianda Hu, Ting Yang
A multicenter retrospective study in 131 patients (44 females/87 males) with hematological disorders who underwent G-CSF-primed/haplo-identical (Haplo-ID) (n = 76) or HLA-identical (HLA-ID) HSCT (n = 55) from February 2013 to February 2016 was conducted to compare the incidence and risk factors for pre-engraftment bloodstream infection (PE-BSI). In the Haplo-ID group, 71/76 patients with high-risk (n = 28) or relapsed/refractory hematological malignancies (n = 43) received FA5-BUCY conditioning (NCT02328950)...
January 26, 2019: European Journal of Clinical Microbiology & Infectious Diseases
Hongyu Li, Goro Honda, Yusuke Ome, Manami Doi, Jun Yamamoto, Jun Muto
BACKGROUND: Laparoscopic hepatectomy for segment (S) 7 is classified as one of the most difficult procedures to perform.1 Here, we report a standardized method with the caudate lobe first approach2,3 which may benefit such difficult procedures. METHODS: A 76-year-old woman was diagnosed with multiple liver metastases after sigmoid colon cancer resection. Her liver function was normal. Abdominal CT showed multiple small tumors located in S3 (two), S7 (two), and S8 (two)...
January 25, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Rebecca D Suttle, Heather M Buffington, Wendy T Madden, Martha A Dawson
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are associated with an increased risk of mortality, prolonged hospitalizations, and inflated cost of care. Patients in the hematology-oncology specialty unit are at greater risk of developing CLABSIs because of their immunocompromised state and high number of central line (CL) days. OBJECTIVES: The aim of the EPIC2 project was to reduce CLABSI rates on a hematology-oncology specialty unit with historically high CLABSI rates despite prior quality improvement efforts...
February 1, 2019: Clinical Journal of Oncology Nursing
Fabiola Peixoto Ferreira La Torre, Gabriel Baldanzi, Eduardo Juan Troster
OBJECTIVES: To determine the risk factors for acquiring central line-associated blood stream infections (CLABSI) in pediatric intensive care units and to investigate the incidence and etiology of CLABSI in pediatric intensive care units with different profiles. METHODS: The study was a prospective cohort study in three hospitals. One of the hospitals is a large metropolitan public hospital with two pediatric intensive care units and a total of nineteen pediatric intensive care unit beds, another is a regional hospital with eight pediatric intensive care unit beds, and the third is a private hospital with fifteen beds...
October 2018: Revista Brasileira de Terapia Intensiva
Jason B Fischer, Julie Sturza, Zio Kim, M James Lopez, Alexander J Rogers
OBJECTIVES: This study aimed to describe demographic, clinical, and laboratory values in febrile pediatric intestinal failure patients with indwelling central venous catheters presenting to the emergency department to determine if there are low-risk features predictive of negative blood cultures that could help identify a subset that do not need hospitalization and/or broad-spectrum antibiotics. METHODS: We conducted a retrospective cohort study of febrile patients younger than 18 years with diagnosis of intestinal failure requiring a central venous catheter for home parenteral nutrition to identify factors associated with normal blood cultures to identify a low-risk subset...
January 21, 2019: Pediatric Emergency Care
A Adjowa Walker, Conrad R Cole
PURPOSE OF REVIEW: Ultra-short bowel syndrome is relatively rare and has not yet been extensively reported. In ultra-short bowel syndrome, poor absorption of nutrients and dysmotility, interfere with fluid, energy, electrolyte and micronutrient balance. Patients with this disorder are managed through prolonged parenteral nutrition with the ultimate goal of achieving enteral autonomy. Overall outcomes of these patients are dependent on postsurgical bowel anatomy (residual length, intact colon, ostomy closure timing), incidence of sepsis, and care by a multidisciplinary specialized team...
January 21, 2019: Current Opinion in Pediatrics
H Thabrew, A Nagahawatte, G B Wijayaratne
Introduction: The ability to predict candidaemia gives a significant advantage to the clinician by enabling pre-emptive treatment to reduce mortality. Objectives: To identify the prevalence, risk factors, and to validate candida colonization index (CI), candida score (CS) to reliably predict the development of candidaemia in the identified study sample. Methods: Cross sectional analytical study of consecutive admissions fulfilling inclusion criteria to intensive care units (ICUs) of Teaching Hospital Karapitiya from 1st December 2015 to 30th March 2016...
December 31, 2018: Ceylon Medical Journal
Jie Hu, Qian Wang, Zhirong Tong, Juanya Shen, Jinlong Liu, Yanjun Sun, Haibo Zhang
BACKGROUND:  The desirable distance, defined as offset, between the central line of the superior vena cava (SVC) and the intra-atrial conduit after an intra-atrial conduit (IAC) Fontan's procedure remained unclear. We compared the hemodynamic features using virtual surgery with different offset designs in our study. METHODS:  Three-dimensional models of IAC Fontan's procedure were reconstructed according to the magnetic resonance imagings (MRIs) of three patients, then four models for each patient with different offsets equaling 100, 67, 33, and 0% of the diameter of the IVC were reconstructed...
January 22, 2019: Thoracic and Cardiovascular Surgeon
Pranita D Tamma, Anna T Conley, Sara E Cosgrove, Anthony D Harris, Ebbing Lautenbach, Joe Amoah, Edina Avdic, Pam Tolomeo, Jacqueleen Wise, Sonia Subudhi, Jennifer H Han
Importance: Conversion to oral therapy for Enterobacteriaceae bacteremia has the potential to improve the quality of life of patients by improving mobility, eliminating catheter-associated discomfort, decreasing the risk for noninfectious and infectious catheter-associated adverse events, and decreasing health care costs. Objective: To compare the association of 30-day mortality with early oral step-down therapy vs continued parenteral therapy for the treatment of Enterobacteriaceae bloodstream infections...
January 22, 2019: JAMA Internal Medicine
Sanjay Kumar Gupta, Fahd Khaleefah Al Khaleefah, Ibrahim Saifi Al Harbi, Fiaz Ahmed, Sinimol Jabar, Marilou Andal Torre, Sunitha Lorin Mathias
Introduction: Healthcare-associated infections (HAIs) are an infection that patients acquire during receiving treatment and care for the medical or surgical problem. Objective: The objective of this study is to find the patterns of HAIs cases in the hospital and to know the impact of the intervention on prevention and control of health care associated infection. Methodology: This was prospective interventional study. Results: The majority of cases of HAIs was reported from intensive care unit 47%...
December 2018: Indian Journal of Critical Care Medicine
S Christopher Derderian, Ryan Good, Raphael N Vuille-Dit-Bille, Todd Carpenter, Denis D Bensard
BACKGROUND: Central venous catheters (CVC) are vital to the management of critically ill children. Despite efforts to minimize complications, central line associated bloodstream infection (CLABSI) and venous thromboembolisms (VTE) still occur. METHODS: We performed a retrospective review of a prospectively collected database for children admitted to the pediatric intensive care unit (PICU) between November 2013 and December 2016. RESULTS: In total, 2714 CVC were in place, 979 of which were percutaneous CVC...
December 27, 2018: Journal of Pediatric Surgery
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