Pregnancy outcome in late-onset severe OHSS patients following different ascetic fluid drainage and comparison with the non-OHSS IVF patients

Abstract Introduction Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic serious complication of controlled ovarian stimulation during assisted reproductive technology, the aim of our research is to explore the differences of pregnancy outcome between severe OHSS patients and the non-OHSS IVF patients, and also compare the pregnancy ourtome of different ascites drainage way. Design This is a retrospective cohort analysis carried out in a University-affiliated reproductive center from 2012 to 2019, between 359 women with severe OHSS following ascites draining and 345 non-OHSS women (matched by age and retrieved oocyte number).We examined the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth and preterm delivery between the two groups. Within the OHSS group (central venous catheter group vs paracentesis group), odds ratios (ORs) and 95% confidence intervals (CIs) of measure of clinical pregnancy were also analyzed. Result The biochemical pregnancy loss rate of non-OHSS patients was significantly higher than that of severe OHSS patients (11.1% vs 0.6%), the live birth, multiple pregnancy (twin pregnancy) was much more in severe OHSS group than in control group(88.9% vs 73.5%; 57.6% vs 28.1% respectively), and there was no significant difference between singleton and twin preterm rate and neonatal birth weight between OHSS and control group. Binary logistic regression analysis revealed multiple pregnancy and long-protocol showed relatively high odds ratio, suggest that the long-protocol of COS and multiple pregnancy are the risk factor of severe OHSS. Among severe OHSS following ascites draining, in comparison with abdominal paracentesis and central venous catheter, the ascites volume in central venous catheter group was much more than abdominal paracentesis group, there was significant difference between the two groups. There was no significant difference between the two groups in comparison of live birth, and the birth weight of singleton and twin between these two groups. but the premature birth rate of singleton in group 1 was 9.3% (10/107), whereas in group 2, it was 3.75%. Conclusion In conclusion, this preliminary report suggests that for the IVF-ET patients, less basic follicle number, GnRH antagonist cycle, singleton maybe the protective factors for the late-onset OHSS. Paracentesis and central venous catheter are all the effective modality to manage the ascites for the severe OHSS patients. For the patients who have the possibility of repeated paracentesis, catheter is a safe and effective way.

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Pregnancy Outcome in Late-onset Severe OHSS Patients Following Different Ascetic Fluid Drainage and Comparison With the Non-OHSS IVF Patients

10.21203/rs.3.rs-51728/v1 ◽

2020 ◽

Author(s):

Ren YUN ◽

rong li ◽

Yang Shuo ◽

Yang Rui ◽

Song Dong hong ◽

...

Keyword(s):

Central Venous Catheter ◽

Pregnancy Outcome ◽

Live Birth ◽

Late Onset ◽

Multiple Pregnancy ◽

Venous Catheter ◽

Control Group ◽

Central Venous ◽

Significant Difference ◽

Severe Ohss

Abstract Introduction： Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic serious complication during assisted reproductive technology, the aim of our research is to explore the differences of pregnancy outcome between severe OHSS patients and the non-OHSS IVF patients, and also compare the pregnancy outcome of different ascites drainage way of severe OHSS patients.Design: This is a retrospective cohort analysis carried out in a University-affiliated reproductive center from 2012 to 2019 ,between 359 women with severe OHSS following ascites draining and 345 non-OHSS women (matched by age and retrieved oocyte number).We examined the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth and preterm delivery between the two groups. Within the OHSS group (central venous catheter group vs paracentesis group), odds ratios (ORs) and 95% confidence intervals (CIs) of measure of clinical pregnancy were also analyzed.Result： The biochemical pregnancy loss rate of non-OHSS patients was significantly higher than that of severe OHSS patients (11.1% vs 0.6%) , the live birth, multiple pregnancy (twin pregnancy ) was much more in severe OHSS group than in control group(88.9% vs 73.5%; 57.6% vs 28.1% respectively), and there was no significant difference between singleton and twin preterm rate and neonatal birth weight between OHSS and control group. Binary logistic regression analysis revealed multiple pregnancy and long-protocol showed relatively high odds ratio, suggest that thelong-protocol of COS and multiple pregnancy are the risk factor of severe OHSS.Among severe OHSS following ascites draining, in comparison with abdominal paracentesis and central venous catheter, the ascites volume in central venous catheter group was much more than abdominal paracentesis group, there was significant difference between the two groups. There was no significant difference between the two groups in comparison of live birth, and the birth weight of singleton and twin between these two groups. but the premature birth rate of singleton in group 1 was 9.3% (10/107), whereas in group 2, it was 3.75%.Conclusion： In conclusion, this preliminary report suggests that for the IVF-ET patients, less basic follicle number, GnRH antagonist cycle, singleton maybe the protective factors for the late-onset OHSS. Paracentesis and central venous catheter are all the effective modality to manage the ascites for the severe OHSS patients. For the patients who have the possibility of repeated paracentesis, catheter is a safe and effective way.

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Central venous catheter based closed thoracic drainage in the treatment of tuberculous pleuritis

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.4.63 ◽

2019 ◽

Vol 35 (4) ◽

Author(s):

Ling Song ◽

Yueling Zhang ◽

Qiong Jia

Keyword(s):

Quality Of Life ◽

Treatment Group ◽

Central Venous Catheter ◽

Venous Catheter ◽

Control Group ◽

Central Venous ◽

Thoracic Drainage ◽

Significant Difference ◽

Tuberculous Pleurisy

Objective: To explore the clinical effect of central venous catheter closed thoracic drainage in the treatment of tuberculous pleurisy. Methods: One hundred and four patients with tuberculous pleurisy who were admitted to Binzhou People’s Hospital from August 2016 to August 2017 were divided into a control group and a treatment group according to random number table method, 52 each. The control group was treated with conventional pleural puncture and drainage, while the treatment group was treated with closed central venous catheter based thoracic drainage. The clinical efficacy, improvement time of clinical symptoms, total volume of drainage, pleural thickness, and improvement of quality of life and occurrence of adverse reactions were compared between the two groups. Results: Pleural effusion, fever and chest tightness of the treatment group disappeared earlier (P<0.05); the hospitalization time in the treatment group was less than that in the control group (P<0.05); the total amount of drainage in the treatment group was lower than that in the control group (P<0.05); the pleural thickness of the treatment group was higher than that in the control group (P<0.05); the quality of life score in the treatment group was significantly higher than that in the control group (P<0.05). The total effective rates of the treatment group and the control group were 93.5% and 85%, respectively, with a significant difference (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group, with a significant difference (P<0.05). Conclusion: Central venous catheter based closed thoracic drainage is more effective than conventional thoracic puncture and drainage in the treatment of tuberculous pleurisy. It can accelerate the improvement of clinical symptoms, improve the quality of life of patients, and reduce the incidence of complications. It is worth popularizing and applying. doi: https://doi.org/10.12669/pjms.35.4.63 How to cite this:Song L, Zhang Y, Jia Q. Central venous catheter based closed thoracic drainage in the treatment of tuberculous pleuritis. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.63 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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GLUCOCORTICOSTEROID DURING PATCH APPLICATION TO IMPROVE SCAR OUTCOME AFTER CENTRAL VENOUS CATHETER. A RANDOMIZED TRIAL

10.22541/au.161185647.75777799/v1 ◽

2021 ◽

Author(s):

Ida Bo Nissen ◽

Mette Møller Handrup ◽

Karen Bang ◽

Henrik Hasle

Keyword(s):

Placebo Group ◽

Central Venous Catheter ◽

Fusidic Acid ◽

Intervention Group ◽

Venous Catheter ◽

Control Group ◽

Neoplastic Disease ◽

Central Venous ◽

Silicone Gel ◽

Significant Difference

Introduction: Children treated for cancer with a central venous catheter are often bothered by scarring. We studied whether glucocorticosteroid during patch occlusion has a beneficial effect on scar outcome in children and adolescents treated for neoplastic disease. Methods: A double-blinded placebo-controlled randomized clinical trial was performed. The main outcome was the Vancouver Scar Scale (VSS). Secondary outcomes were scar width and scar quality measured using the Patient and observer scar assessment (POSAS). The patients were divided into an intervention groups and a control group. The intervention group was randomized into two groups; Active and placebo group. The active treatment consisted of cream with glucocorticosteroid and fusidic acid. The placebo treatment consisted of cream with fusidic acid. Both groups were also treated with a silicone gel patch for three months after central venous catheter removal. The control group did not receive any specific skin care. Results: Assessment at 6 months were completed for 44 in the intervention group (21 in the active and 23 in the placebo group) and 47 in the comtrol group. The intervention group had a significantly lower VSS and a smaller scar compared to the control group (p = 0.00, p = 0.02). The POSAS by the patients and the study nurse showed no significant difference between the intervention and control groups (p = 0.84, p= 0.36). Conclusions: Silicone gel sheet alone or in combination with application of glucocorticosteroid during sheet occlusion improved scar outcome after removal of central venous catheter in children treated for neoplastic diseases.

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Effect of Central Venous Catheter Care Bundle Implementation on Outcomes of Critically Ill Patients

Evidence-Based Nursing Research ◽

10.47104/ebnrojs3.v2i1.93 ◽

2020 ◽

Vol 2 (1) ◽

pp. 12

Author(s):

Gehan A. F. Atia

Keyword(s):

Central Venous Catheter ◽

Bloodstream Infection ◽

Critically Ill ◽

Critically Ill Patients ◽

Venous Catheter ◽

Care Bundle ◽

Central Venous ◽

Significant Difference ◽

Post Test ◽

Catheter Care

Context: Central venous access device (CVAD) bundles for insertion and maintenance demonstrate a reduction in the frequency of complications and bloodstream infection when implemented with compliance monitoring, with the reported success of CVAD bundles. Aim: This study aimed to examine the effect of central venous catheter care bundle implementation on outcomes of critically ill patients. Methods: Quasi-experimental research (pre/post-test design) used to achieve the aim of this study. The study conducted at general and surgical intensive care units affiliated to Menoufia University and teaching hospital. Two study samples recruited in this study. All nurses working at the ICUs, as mentioned above, were recruited in this study. They were 6o critical care nurses. A convenient sample of all available critically ill patients at the time of the study was subjected to treatment via a central venous catheter. Four study tools used to collect the data of this study. These are a structured interview questionnaire, CVC nurses’ knowledge assessment questionnaire, nurses’ compliance assessment checklists, and patient complications assessment records. Results: The study result showed a highly statistically significant difference between pre and post-test knowledge scores of studied nurses regarding assisting line insertion, removal, maintenance, care, and infection control practices. Besides, a highly statistically significant difference between pre and post-test scores of nurses’ compliance to central venous catheter care practices of assisting in CVC insertion, blood sample withdrawal, medication and fluid administration, CVP measurements, CVC removal, and the management of central venous line complications. The study also revealed a highly statistically significant difference between the study and control group patients regarding the central venous catheter complications. However, signs of infection were the most frequent complications in both groups. Conclusion. The study concluded that a statistically significant difference between pre and post nurses’ knowledge and compliance with the CVC care bundle. The patients’ outcomes were also improved significantly after the implementation of the CVC care bundle compared to the controls. The study recommended the adoption of the current care bundle that should be disseminated and updated following the international organizations’ recommendation for implementing evidence-based practices for successful central line-associated bloodstream infection (CLABSI) prevention.

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Anatomic Site-Specific Complication Rates for Central Venous Catheter Insertions

Journal of Intensive Care Medicine ◽

10.1177/0885066618795126 ◽

2018 ◽

Vol 35 (9) ◽

pp. 869-874 ◽

Cited By ~ 4

Author(s):

Jacob Bell ◽

Munish Goyal ◽

Sallie Long ◽

Anagha Kumar ◽

Joseph Friedrich ◽

...

Keyword(s):

Central Venous Catheter ◽

Complication Rate ◽

Venous Catheter ◽

Complication Rates ◽

Central Venous ◽

Site Specific ◽

Mechanical Complications ◽

Significant Difference ◽

Insertion Techniques ◽

Delayed Complications

Background: Central venous catheter (CVC) complication rates reflecting the application of modern insertion techniques to a clinically heterogeneous patient populations are needed to better understand procedural risk attributable to the 3 common anatomic insertion sites: internal jugular, subclavian, and femoral veins. We sought to define site-specific mechanical and duration-associated CVC complication rates across all hospital inpatients. Methods: A retrospective chart review was conducted over 9 months at Georgetown University Hospital and Washington Hospital Center. Peripherally inserted central catheters and tunneled or fluoroscopically placed CVC’s were excluded. Mechanical complications (retained guidewire, arterial injury, and pneumothorax) and duration-associated complications (deep vein thrombosis or pulmonary embolism, and central line-associated bloodstream infections) were identified. Results: In all, 1179 CVC insertions in 801 adult patients were analyzed. Approximately 32% of patients had multiple lines placed. Of 1179 CVCs, 73 total complications were recorded, giving a total rate of one or more complications occurring per CVC of 5.9%. There was no statistically significant difference between site-specific complications. A total of 19 mechanical complications were documented, with a 1.5% complication rate of one or more mechanical complications occurring. A total of 54 delayed complications were documented, with a 4.4% complication rate of 1 or more delayed complications occurring. There were no statistically significant differences between anatomic sites for either total mechanical or total delayed complications. Conclusions: These results suggest that site-specific CVC complication rates may be less common than previously reported. These data further inform on the safety of modern CVC insertion techniques across all patient populations and clinical settings.

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Positive effect of care bundles on patients with central venous catheter insertions at a tertiary hospital in Beijing, China

Journal of International Medical Research ◽

10.1177/0300060520942113 ◽

2020 ◽

Vol 48 (7) ◽

pp. 030006052094211

Author(s):

Yuling Sun ◽

Zhongying Bao ◽

Yang Guo ◽

Xiaodong Yuan

Keyword(s):

Central Venous Catheter ◽

Scale Score ◽

Venous Catheter ◽

Psychological State ◽

Control Group ◽

Case Group ◽

Central Venous ◽

Care Bundles ◽

Self Rating ◽

Crbsi Rate

Objective This study was performed to evaluate the effect of care bundles on the prevention of central venous catheter-related bloodstream infection (CRBSI) and improvement of patients’ experience. Methods In total, 212 patients with central venous catheter insertions were enrolled in this study. All patients were matched by sex, age, Acute Physiology and Chronic Health Evaluation II score, body mass index, department, and catheter insertion site and were randomly divided into case and control groups (n = 106 each). The control group was given conventional care, and the case group was given care bundles including nurse education, hand hygiene, maximal sterile barrier precautions, bedside observation, and evaluation. The anxiety scores, hospitalization days, CRBSI rate, and degree of satisfaction with hospitalization were compared between the two groups. Results The patients’ mean self-rating anxiety scale score and self-rating depression scale score after nursing intervention were significantly lower in the case group than in the control group. The mean number of hospitalization days and CRBSI rate were significantly lower and the satisfaction rate was significantly higher in the case group. Conclusion Care bundles are essential for preventing CRBSI. They can improve patients’ psychological state and hospitalization satisfaction and reduce the hospitalization days.

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Bundle Approach to Reduce Bloodstream Infections in Neutropenic Hematologic

Acta Médica Portuguesa ◽

10.20344/amp.6002 ◽

2015 ◽

Vol 28 (4) ◽

pp. 474

Author(s):

Jose Manuel Martinez ◽

Luís Leite ◽

Daniela França ◽

Rita Capela ◽

Luísa Viterbo ◽

...

Keyword(s):

Relative Risk ◽

Central Venous Catheter ◽

Bloodstream Infections ◽

Mechanical Valve ◽

Venous Catheter ◽

Positive Pressure ◽

Control Group ◽

Study Group ◽

Central Venous

Introduction: The objective of the study was to reduce, by a bundle of interventions, the global bloodstream infections and catheterrelated bloodstream infections rates in neutropenic hematology patients with a long-term central venous catheter. Material and Methods: This was a non-randomized prospective study. It was conducted in a 20-bed hematology oncology unit (Portuguese Institute of Oncology, Porto, Portugal) between 1st of August 2010 and 31st of January 2012. In this period we introduced a bundle of interventions (study group) and compared the results with the six months prior to implementation (control group). The interventions consisted in the use of a neutral pressure mechanical valve connector instead of a positive pressure mechanical valve connector, a more frequent change of this connector and a more efficient clean solution. One hundred and sixteen hematology patients with a long-term central venous catheter at time superior of 72 h, with 8 867 central venous catheter days [6 756 central venous catheter days in the study group and 2 111 central venous catheter days in the control group] were included in the study. Results: A significant reduction in bloodstream infections rates and catheter-related bloodstream infections rates was achieved. Bloodstream infections rates: [32.69 (control group) vs. 9.43 (study group)], incidence reduction 71% [relative risk 0.2886, CI 95% (0.1793 – 0.4647), p < 0.001] and catheter-related bloodstream infections rates: [17.53 (control group) vs. 4.73 (study group)], incidence reduction 71% [relative risk 0.2936, CI 95% (0.1793 – 0.5615), p < 0.014]. No significant difference (p > 0.05) was found in the neutrophil count at the time of blood culture samples between groups: 69% (< 500 neutrophils/mm3) [71% (study group) vs. 68% (control group)]. Conclusions: The introduction of this bundle of interventions based on the variables of patient, product and practice, supported by the Healthcare and Technology Synergy framework, quickly resulted in a significant reduction of bloodstream infections and catheterrelated bloodstream infections rates.

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Needleless Closed System Does Not Reduce Central Venous Catheter-Related Bloodstream Infection: A Retrospective Study

International Surgery ◽

10.9738/cc132.1 ◽

2013 ◽

Vol 98 (1) ◽

pp. 88-93 ◽

Cited By ~ 5

Author(s):

Mitsuru Ishizuka ◽

Hitoshi Nagata ◽

Kazutoshi Takagi ◽

Keiichi Kubota

Keyword(s):

Central Venous Catheter ◽

Bloodstream Infection ◽

Closed System ◽

Venous Catheter ◽

Time Interval ◽

Central Venous ◽

Significant Difference ◽

Group 2 ◽

Colorectal Cancer Patients ◽

Catheter Related Bloodstream Infection

Abstract The needleless closed system (NCS) has been disseminated in several clinical fields to prevent central venous catheter–related bloodstream infection (CVC-RBSI), in place of the conventional Luer cap system (LCS). The purpose of this study is to examine whether NCS is really superior to conventional LCS for prevention of CVC-RBSI. Between May 2002 and December 2008, 1767 patients received CVC in our department. The time interval from insertion to development of CVC-RBSI was compared retrospectively between selected patients who were treated using the conventional LCS (group 1, n = 89, before June 2006) and the NCS (group 2, n = 406, June 2006 and after). Kaplan-Meier analysis revealed no significant difference in the time interval from insertion to development of CVC-RBSI between the two groups. NCS does not reduce CVC-RBSI in adult colorectal cancer patients who undergo CVC insertion.

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Early Onset versus Late Onset Peripherally Inserted Central Venous Catheter Infections: An Analysis of Risk Factors and Microbiology

Infection Control and Hospital Epidemiology ◽

10.1086/671726 ◽

2013 ◽

Vol 34 (9) ◽

pp. 980-983 ◽

Cited By ~ 6

Author(s):

Paul Chittick ◽

Sobia Azhar ◽

Kalyani Movva ◽

Paula Keller ◽

Judith A. Boura ◽

...

Keyword(s):

Risk Factors ◽

Central Venous Catheter ◽

Early Onset ◽

Late Onset ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Venous ◽

Peripherally Inserted Central Catheters ◽

Catheter Infections ◽

Central Catheters

The risks and microbiology for peripherally inserted central catheters (PICCs) are less well described than those for traditional central catheters, particularly as they pertain to duration of catheterization. We compared patients with early- and late-onset PICC bloodstream infections at our institution and found significant differences in microbiologic etiologies.

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Evaluation of Demographic and Clinical Characteristics of the Patients Undergoing Surgery With Ultrasound in Internal Jugular Vein Cannulation Requiring Central Venous Catheter

Journal of Arak University of Medical Sciences ◽

10.32598/jams.23.4.6103.1 ◽

2020 ◽

Vol 23 (4) ◽

pp. 512-523

Author(s):

Hossein Hemmati ◽

◽

Jalal Aboutalebi ◽

Mohaya Farzin ◽

Ghazaleh Hemmati ◽

...

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Venous Catheter ◽

Ethics Committee ◽

Medical Sciences ◽

Central Venous ◽

Internal Jugular Vein Cannulation ◽

Vein Cannulation ◽

Significant Difference

Background and Aim This study aimed to investigate the demographic and clinical information of patients undergoing surgery with ultrasound in internal jugular vein cannulation. Methods & Materials After the approval of the plan in the ethics committee of Guilan University of Medical Sciences, this study was performed in the general surgery department of Razi Hospital in 2018 on 100 patients in need of central venous catheter implantation. The neck type (distance between the two designated areas) was entered in a special form made by the researcher and after the completion of the design, it was examined and statistically analyzed. Ethical Considerations This research ethically approved by the Ethics Committee of Guilan University of Medical Sciences (Code: IR.GUMS.REC.1396.20) Results The mean age of the studied patients was 58.72±16.09 years. The anatomical and sonographic margins between the two Land Mark areas were higher in men VS women, but there was no statistically significant difference (P>0.05). However, there was no statistically significant difference between the other variables. (P>0.05). Conclusion The findings of this study show that catheterization of the internal jugular vein under the guidance of ultrasound was less access time and fewer complications.

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