Central Venous Catheter‐Related Infection in Severe Trauma Patients

Youn, Seok Hwa; Lee, John Cook-Jong; Kim, Young‐Hwan; Moon, Jonghwan; Choi, Younghwa; Jung, Kyoungwon

doi:10.1007/s00268-015-3137-y

Cited by 12 publications

(7 citation statements)

References 42 publications

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“…SHPT disturbs the levels of serum calcium, phosphorus, and ALP. In recent years, large clinical studies, such as the DOPPs and CORES studies, have shown that high or low levels of serum calcium and phosphorus may increase all-cause mortality and cardiovascular mortality in CKD patients and lower their quality of life [22][23][24]. These findings indicate that it is crucial to control SHPT.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of laboratory parameters and symptoms after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

et al. 2019

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Objectives: The aim of the study was to evaluate the laboratory parameters and symptoms after parathyroidectomy (PTX) in dialysis patients with secondary hyperparathyroidism (SHPT), and to briefly analyze the different therapeutic effects of the three surgical methods. Methods: A total of 182 dialysis patients who underwent PTX between February 2012 and January 2018 at the Second Affiliated Hospital of Soochow University were included in this study and followed for 12 months. Laboratory parameters such as calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and intact parathyroid hormone (iPTH) were measured before and after operation. According to the follow-up time and type of operation, we calculated the percentage of laboratory indicators reaching the recommended range of the KDIGO guidelines after surgery. We also analyzed the improvement of bone pain and pruritus, as well as surgical complications. Results: After the operation, the levels of iPTH, Ca, and P decreased significantly at each time point. ALP increased at the first postoperative week and gradually decreased to normal range after 3 months. Symptoms, such as bone pain and pruritus, were significantly relieved. According to the follow-up time and three surgical methods (subtotal parathyroidectomy, total parathyroidectomy, total parathyroidectomy plus autologous transplantation), we found that the ratio of each laboratory parameter reaching the recommended range of KDIGO guidelines was significantly different. Conclusion: PTX is a safe and effective therapy for treating SHPT that is refractory to medical therapies and accompanied by related signs and symptoms in dialysis patients. All three operative techniques were effective in controlling SHPT.

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Section: Discussionmentioning

confidence: 99%

Evaluation of laboratory parameters and symptoms after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

et al. 2019

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“…Methods for reducing complications from intravenous access, such as the use of bundles to reduce infection, have been outlined and could be applied if we recognised unwanted complications from our project. 22 23 However, these balancing measures were not adequately documented, and we could not effectively determine the rates before or after the intervention. Ensuring thorough documentation of fluid resuscitation related-volumes, complications and intravenous access attempts would allow a better understanding of some balancing measures to ensure that there were no negative outcomes resulting from this quality improvement initiative.…”

Section: Discussionmentioning

confidence: 99%

Ensuring adequate vascular access in patients with major trauma: a quality improvement initiative

et al. 2018

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Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital. Background data were supported with a formal root cause analysis to outline the problems and generate plan, do, study and act (PDSA) rapid change cycles. These PDSA cycles were then implemented over the course of 2 months to alter system and personnel barriers to care, thereby ensuring that patients with major trauma received adequate vascular access for fluid resuscitation. This was followed by a 6-month sustainability assessment. The percentage of patients with major trauma who received adequate fluid access went from a mean of 55.5% to >90% in 2 months and was sustained at or greater than 90% for 6 consecutive months. The formal application of quality improvement processes is uncommon in trauma care but is much needed to ensure success and sustainability of quality initiatives. Planning including engagement and prechange awareness is crucial to staff engagement, change, and sustainment. Formal quality improvement and change management techniques can elicit rapid and sustainable changes in trauma care. We provide a framework for change to increase compliance with fluid access in patients with major trauma.

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“… 18 The degree of complications depends on catheter material, location, length of catheterization, conditions of surgery, and patient‐related circumstances. Among these complications, CVC‐related infections are the most important one, which might affect the hospitalization time, duration of the stay in the intensive care unit, the cost of treatment, and mortality rates 19 . The cost of treatment for HD catheter complications is about $1 billion per year in the United States 20 …”

Section: Introductionmentioning

confidence: 99%

“…Among these complications, CVC-related infections are the most important one, which might affect the hospitalization time, duration of the stay in the intensive care unit, the cost of treatment, and mortality rates. 19 The cost of treatment for HD catheter complications is about $1 billion per year in the United States. 20 F I G U R E 1 Types of vascular access devices for hemodialysis therapy: (a) arteriovenous fistula; (b) arteriovenous graft; (c) central venous catheter…”

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confidence: 99%

Surface modification strategies for hemodialysis catheters to prevent catheter‐related infections: A review

et al. 2020

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Insertion of a central venous catheter is one of the most common invasive procedures applied in hemodialysis therapy for end‐stage renal disease. The most important complication of a central venous catheter is catheter‐related infections that increase hospitalization and duration of intensive care unit stay, cost of treatment, mortality, and morbidity rates. Pathogenic microorganisms, such as, bacteria and fungi, enter the body from the catheter insertion site and the surface of the catheter can become colonized. The exopolysaccharide‐based biofilms from bacterial colonies on the surface are the main challenge in the treatment of infections. Catheter lock solutions and systemic antibiotic treatment, which are commonly used in the treatment of hemodialysis catheter‐related infections, are insufficient to prevent and terminate the infections and eventually the catheter needs to be replaced. The inadequacy of these approaches in termination and prevention of infection revealed the necessity of coating of hemodialysis catheters with bactericidal and/or antiadhesive agents. Silver compounds and nanoparticles, anticoagulants (e.g., heparin), antibiotics (e.g., gentamicin and chlorhexidine) are some of the agents used for this purpose. The effectiveness of few commercial hemodialysis catheters that were coated with antibacterial agents has been tested in clinical trials against catheter‐related infections of pathogenic bacteria, such as Staphylococcus aureus and Staphylococcus epidermidis with promising results. Novel biomedical materials and engineering techniques, such as, surface micro/nano patterning and the conjugation of antimicrobial peptides, enzymes, metallic cations, and hydrophilic polymers (e.g., poly [ethylene glycol]) on the surface, has been suggested recently.

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Central Venous Catheter‐Related Infection in Severe Trauma Patients

Cited by 12 publications

References 42 publications

Evaluation of laboratory parameters and symptoms after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

Evaluation of laboratory parameters and symptoms after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

Ensuring adequate vascular access in patients with major trauma: a quality improvement initiative

Surface modification strategies for hemodialysis catheters to prevent catheter‐related infections: A review

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