Long-term indwelling catheters are utilised in people who are unable to use another bladder management method, for example the elderly and those with disability and/or severely restricted mobility that cannot use the bathroom or perform intermittent selfcatheterisation (Cottenden et al., 2009). Most users of long-term indwelling catheters have a disability such as spinal cord injury or

This study aims to compare the incidence of complications when using a new approach to secure an indwelling peripheral venous catheter (PVC), involving tying of the tube with a surgical knot at two places and several layers of elastic adhesive bandage, with a standard approach using sterile, transparent, and protective film. Methods: This study enrolled 311 consecutive adults undergoing thoracoscopic lobectomy under general anesthesia at Taizhou Hospital of Zhejiang Province between October 2017 and May 2018. Patients were randomized to experimental and control groups and were followed for up to 72 hours. The primary endpoint was dislodgement of the PVC. Secondary endpoints were blood in the catheter; analgesia pump obstruction alarm; time taken and cost of PVC replacement; replacement of securing materials and analgesia pump line; and time and cost of replacing them. All adverse events were recorded. Findings: Final analysis included 248 patients (experimental group: n ¼ 126; control group: n ¼ 122). PVC dislodgement was less frequent in the experimental group than in the control group. In the control group, 78.7% of patients required replacement of securing materials (costing 37 cents each time) and 13.1% required PVC replacement (costing 3.6 dollars each time), necessitating additional nursing time. No patients in the experimental group required replacement of the PVC or securing materials. Blisters were less common in the experimental group than in the control group (0% vs 9.84%, P < .001). No patients had limb edema. Conclusions: This new method of securing an analgesia pump line can reduce traction on the indwelling PVC, lowering the dislodgement rate.

Background: Patients with malignant pleural effusion (MPE) have a poor prognosis. Most patients are treated with tube thoracostomy and sclerotherapy but with a not satisfactory control rate of pleural effusion. This study aims to report the effect of intrapleural hyperthermic perfusion for MPE which is a standard practice at our center.Methods: This is a retrospective study of consecutive patients with MPE treated with hyperthermic perfusion from one single Institute. The procedure was done by perfusing the pleural cavity under video-assisted thoracoscope with 43.0°C distilled water using a standard extracorporeal circuit for 60 minutes. The efficacy of treatment was classified as follows: 1. complete response (CR; no re-accumulation of pleural effusion after IPH for at least four weeks); 2. partial response (PR; pleural effusion was reduced by 50% and this situation was sustained for four weeks; 3. no consequence (NC; pleural effusion was not reduced.Results: From January 2014 through December 2018, a total of 31 patients with MPE were treated using this technique. There were no serious reportable clinical complications associated with the procedures. The response rate was 100%, with 67.7% of PR and 32.3% of CR. The survival time ranged from 2 to 46 months, with a median survival of 12 months. The survival time of the patients received TKI treatment after IHP ranged from 13 to 45 months, with a median survival of 28 months. Multivariable analysis showed that TKI treatment (P=0.013) and male gender (P=0.004) were independent prognosis factors.Conclusions: Intrapleural hyperthermic perfusion is a feasible and safe strategy for patients with malignant pleural effusion.