Summary of recommendations: Guidelines for the Prevention of Intravascular Catheter-related Infections.
Naomi P. O'Grady,Mary Alexander,Lillian A. Burns,E. Patchen Dellinger,Jeffrey Garland,Stephen O. Heard,Pamela A. Lipsett,Henry Masur,Leonard A. Mermel,Michele L. Pearson,Issam I Raad,Adrienne G. Randolph,Mark E. Rupp,Sanjay Saint +13 more
TLDR
These guidelines have been developed for healthcare personnel who insert intravascular catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home healthcare settings.Abstract:
These guidelines have been developed for healthcare personnel who insert intravascular catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home healthcare settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, healthcare infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The working group was led by the Society of Critical Care Medicineread more
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Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012
R. Phillip Dellinger,Mitchell M. Levy,Andrew Rhodes,Djillali Annane,Herwig Gerlach,Steven M. Opal,Jonathan E. Sevransky,Charles L. Sprung,Ivor S. Douglas,Roman Jaeschke,Tiffany M. Osborn,Mark E. Nunnally,Sean R. Townsend,Konrad Reinhart,Ruth M. Kleinpell,Derek C. Angus,Clifford S. Deutschman,Flávia Ribeiro Machado,Gordon D. Rubenfeld,Steven A R Webb,Richard Beale,Jean Louis Vincent,Rui Moreno +22 more
TL;DR: A consensus committee of 68 international experts representing 30 international organizations was convened in 2008 to provide an update to the "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock".
Journal ArticleDOI
KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update.
Charmaine E. Lok,Thomas S. Huber,Timmy Lee,Surendra Shenoy,Alexander S. Yevzlin,Kenneth Abreo,Michael Allon,Arif Asif,Brad C. Astor,Marc H. Glickman,Janet Graham,Louise Moist,Dheeraj K. Rajan,Cynthia Roberts,Tushar J. Vachharajani,Rudolph P. Valentini +15 more
TL;DR: The 2019 update to the KDOQI Clinical Practice Guideline for Vascular Access is a comprehensive document intended to assist multidisciplinary practitioners care for chronic kidney disease patients and their vascular access.
The role of understaffing in central venous catheter-associated bloodstream infections [see comments]
S. Fridkin,SM Pear +1 more
Abstract: OBJECTIVE
To determine risk factors for central venous catheter-associated bloodstream infections (CVC-BSI) during a protracted outbreak.
DESIGN
Case-control and cohort studies of surgical intensive care unit (SICU) patients.
SETTING
A university-affiliated Veterans Affairs medical center.
PATIENTS
Case-control study: all patients who developed a CVC-BSI during the outbreak period (January 1992 through September 1993) and randomly selected controls. Cohort study: all SICU patients during the study period (January 1991 through September 1993).
MEASUREMENTS
CVC-BSI or site infection rates, SICU patient clinical data, and average monthly SICU patient-to-nurse ratio.
RESULTS
When analyzed by hospital location and site, only CVC-BSI in the SICU had increased significantly in the outbreak period compared to the previous year (January 1991 through December 1991: pre-outbreak period). In SICU patients, CVC-BSI were associated with receipt of total parenteral nutrition [TPN]; odds ratio, 16; 95% confidence interval, 4 to 73). When we controlled for TPN use, CVC-BSI were associated with increasing severity of illness and days on assisted ventilation. SICU patients in the outbreak period had shorter SICU and hospital stays, were younger, and had similar mortality rates, but received more TPN compared with patients in the pre-outbreak period. Furthermore, the patient-to-nurse ratio significantly increased in the outbreak compared with the pre-outbreak period. When we controlled for TPN use, assisted ventilation, and the period of hospitalization, the patient-to-nurse ratio was an independent risk factor for CVC-BSI in SICU patients.
CONCLUSIONS
Nursing staff reductions below a critical level, during a period of increased TPN use, may have contributed to the increase in CVC-BSI in the SICU by making adequate catheter care difficult. During healthcare reforms and hospital downsizing, the effect of staffing reductions on patient outcome (i.e., nosocomial infection) needs to be critically assessed.
Journal ArticleDOI
The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results From a Multispecialty Panel Using the RAND/UCLA Appropriateness Method
Vineet Chopra,Scott A. Flanders,Sanjay Saint,Scott C. Woller,Naomi P. O'Grady,Nasia Safdar,Scott O. Trerotola,Rajiv Saran,Nancy Moureau,Stephen Wiseman,Mauro Pittiruti,Elie A. Akl,Agnes Y.Y. Lee,Anthony Courey,Lakshmi Swaminathan,Jack LeDonne,Carol Becker,Sarah L. Krein,Steven J. Bernstein +18 more
TL;DR: A multidisciplinary meeting of national and international experts was organized and conducted to develop appropriateness criteria for use, care, and management of PICCs and related VADs in hospitalized patients.
Journal ArticleDOI
Critical care management of severe traumatic brain injury in adults
Samir Haddad,Yaseen M. Arabi +1 more
TL;DR: The critical care management of severe TBI will be discussed with focus on monitoring, avoidance and minimization of secondary brain insults, and optimization of cerebral oxygenation and CPP.
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