Plasma N/OFQ concentrations were increased in critically ill patients with sepsis who had undergone major gastrointestinal surgery and in patients who subsequently died. Further work is required to clarify the significance of plasma N/OFQ concentrations in sepsis.

The data obtained by RIA show that smoking may increase plasma concentrations of UII with a more pronounced increase when a cigarette has been smoked recently. There was a complete lack of correlation between RIA and ILMA for the whole data set, which suggests that some of the variability in plasma UII reported in the literature may result from differences between assays.

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INTRODUCTION AND OBJECTIVES: Over 1 million CAUTIs occur annually among hospitalized U.S. patients receiving a Foley urinary catheter, accounting for over 13,000 deaths. CAUTI treatment requires antibiotics at a time when hospitals are expected to minimize avoidable antibiotic use. CAUTIs financially burden hospitals. The mean per-incident cost is estimated at $750-$4,823. One facility in this study found its net cost, including longer length of stay, to be $11,419 per case. Most payers do not reimburse these costs. The ACA penalizes hospitals for high CAUTI rates. Data was collected from multiple sites to assess whether an intervention using a novel, non-toxic skin care system/formulation for Foley insertion and maintenance could reduce CAUTI rates.METHODS: Approximately 25 hospitals using the formulation were asked to provide insertion and maintenance details on use, plus pre-and post-implementation CAUTI rates reported to the National Healthcare Safety Network. The formulation was used in high-risk ICU, Neuro, C-V and trauma patient populations with fecal and urinary incontinence, in its foam and moisture-impregnated-cloth forms. Both forms are safe for the perineal area, do not cause antibiotic resistance, and are not associated with adverse events. Clinical protocol was to apply the formulation to the meatus and surrounding tissue to establish a zone of protection, then re-establish after each incidence of fecal incontinence as a maintenance intervention.RESULTS: Ten hospitals provided pre-and post-intervention data (average time pre-intervention 21.2 months; average time postintervention 20 months). Eight reported CAUTI rate reductions, ranging from 22.47% to 100% (with two sites reporting elimination of CAUTI). Two other hospitals noted compliance issues that affected their results and made their data unreliable. One of those two reported no change in CAUTI rates and the other reported a 30.31% increase. The mean preimplementation CAUTI rate for the eight compliant hospitals was 3.65/ 1,000 catheter days. The mean post-implementation CAUTI rate for those same hospitals was 1.72/1,000 catheter days. The mean change was a reduction in CAUTI rates of 52.88%.CONCLUSIONS: Eight of 10 reporting sites found use of the skin care formulation was associated with lower CAUTI rates. Further study of the formulation's efficacy is warranted.