Use of a cyanoacrylate skin adhesive to reduce external ventricular drain infection rates

2014 ◽  
Vol 121 (1) ◽  
pp. 189-194 ◽  
Author(s):  
Markus J. Bookland ◽  
Vishad Sukul ◽  
Patrick J. Connolly
Keyword(s):  
Wound Care ◽  
External Ventricular Drain ◽  
Positive Skin ◽  
Liquid Polymer ◽  
Intensive Care Patients ◽  
Neurological Intensive Care ◽  
Cyanoacrylate Adhesive ◽  
Skin Flora ◽  
Lower Infection ◽  
The One

Object Ventriculitis related to external ventricular drain (EVD) placement is a significant source of morbidity in neurological intensive care patients. Current rates of EVD-related infections range from 2% to 45% in the literature. The authors sought to determine if a 2-octyl cyanoacrylate adhesive would result in lower infection rate than standard semiocclusive dressings. Methods The authors tracked ventriculitis rates via CSF cultures among 259 patients whose EVD sites were dressed with sterile semiocclusive dressings and underwent routine sterile dressing exchanges every 48 hours. They analyzed data obtained in an additional 113 patients whose EVD sites were dressed one time with a surgical adhesive, 2-octyl cyanoacrylate. Results Ventriculitis rate in patients with standard bioocclusive dressings and wound care was 15.1%, whereas that in patients with a 2-octyl cyanoacrylate dressing was 3.54% (p = 0.002). Staphylococcus genus accounted for 79.5% of instances of ventriculitis among patients with bioocclusive dressings and routine wound care, whereas it accounted for 25.0% of the instances of ventriculitis among patients with a liquid polymer sealant dressing. A 90% reduction in Staphylococcus infection completely accounts for the observed effect (p = 0.04). Conclusions The one-time application of 2-octyl cyanoacrylate to EVD wounds and exit sites provided superior protection against EVD-related ventriculitis compared to conventional EVD-site wound care. Likely this protection results from a barrier to the entry of gram-positive skin flora along the EVD exit tract. The results should be validated in a randomized trial.

Accidental Intraventricular Administration of Phenytoin Through an External Ventricular Drain: Case Report

2011 ◽  
Vol 20 (4) ◽  
pp. 347-345 ◽  
Author(s):  
Paul McConnell ◽  
Catriona MacNeil
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
External Ventricular Drain ◽  
General Intensive Care Unit ◽  
Intraventricular Administration ◽  
Neurological Assessment ◽  
Neurological Intensive Care Unit ◽  
Neurological Intensive Care ◽  
Neurosurgical Intensive Care ◽  
Neurosurgical Intensive Care Unit

A 52-year-old man with an external ventricular drain was transferred from the local neurosurgical intensive care unit to the general intensive care unit for renal replacement therapy. While the patient was in the general intensive care unit, phenytoin was accidentally administered via the external ventricular drain. Tachycardia and hypertension ensued and then seizure activity. The drain was aspirated and then washed out. Propofol was infused for 24 hours and then was stopped to allow continuing neurological assessment. The route of administration of phenytoin was changed from intravenous to oral, and care continued as before. After resolution of the renal failure, the patient was returned to the neurological intensive care unit. He recovered slowly and had no adverse effects due to the error in administration of phenytoin.

scholarly journals Синтез наноразмерных люминофоров Gd-=SUB=-2-=/SUB=-O-=SUB=-3-=/SUB=-:Nd-=SUP=-3+-=/SUP=- полимерно-солевым методом и исследование их основных характеристик

2021 ◽  
Vol 129 (5) ◽  
pp. 650
Author(s):  
А.С. Матросова ◽  
Н.К. Кузьменко ◽  
C.К. Евстропьев ◽  
В.А. Асеев ◽  
Д.П. Данилович ◽  
...  
Keyword(s):  
Thermal Treatment ◽  
Near Infrared ◽  
Homogeneous Solution ◽  
Emission Spectra ◽  
Electron Transition ◽  
Liquid Polymer ◽  
Electron Transitions ◽  
Luminescence Peak ◽  
The One ◽  
Average Size

The article considers the aspects of nanoscale Gd2O3:Nd3+ phosphors synthesis using the liquid polymer-salt method. Within the framework of the method, the double role of polyvinylpyrrolidone (PVP) as an organic solvent in the process of synthesis was determined. On the one hand, PVP stabilizes the process of Gd2O3 crystals formation, preventing their uncontrolled growth and aggregation. On the other hand, PVP serves as a fuel during decomposition (combustion) increasing the temperature of reaction and thus influencing the structural and emission properties of phosphors. It is shown that drying of the initial homogeneous solution containing gadolinium and neodymium salts and PVP at the room temperature for 24 hours followed by thermal treatment at the temperature of 1000 °C for 2 hours allow formation of highly luminescent Gd2O3:Nd3+ near-infrared phosphors. The crystals grown are characterized mainly by the cubic structure and an average size of 40 nm. Experimental results confirmed that the developed method is appropriate for modification of a structure of silica hollow-core antiresonant fibers with thin-film coatings based on the synthesized material and does not result in structural and phase conversion of Gd2O3 crystals. It is found out that emission spectra of nanoscale Gd2O3:Nd3+ phosphors formed by the polymer-salt method at the temperatures of 550 °C and 1000 °C are identical, as follows: 1) the shape of the luminescence peaks is the same for the two mentioned regimes of thermal treatment regardless of intensity, 2) the main luminescence peak is located near the wavelength of 1064 nm and corresponds to a 4F3/2-4I11/2 electron transition, 3) additional luminescence peaks are located close to 900 nm and 1340 nm and refer to 4F3/2-4I9/2 and 4F3/2-4I13/2 electron transitions respectively.

scholarly journals Intensive Care Patients from the First COVID-19 Wave: One-Year Survival after Tocilizumab Treatment

2021 ◽  
Vol 11 (11) ◽  
pp. 1234
Author(s):  
Gabriele Melegari ◽  
Enrico Giuliani ◽  
Chiara Dallai ◽  
Lucia Veronesi ◽  
Elisabetta Bertellini ◽  
...  
Keyword(s):  
Treated Group ◽  
Cytokine Storm ◽  
Icu Patients ◽  
Intensive Care Patients ◽  
One Year ◽  
The One ◽  
Mortality Hazard Ratio ◽  
New Onset

Introduction: An infection by COVID-19 triggers a dangerous cytokine storm, so tocilizumab has been introduced in Italy as an agent blocking the cytokine storm. This paper aims to describe the one-year survival of ICU patients treated with tocilizumab. Methods: This observational study enrolled all patients confirmed to be infected by COVID-19 who were admitted to the ICU in our center. We offered tocilizumab to all non-septic patients if they did not present any contraindications. Results: We enrolled 68 ICU patients in our center on 72 occasions during the enrollment period; we excluded four patients due to study criteria. The one-year mortality hazard ratio of treated patients was 0.64, with a confidence interval of 0.31 to 1.19, with p = 0.169. Among the survivors, 32 of 35 patients answered the phone interview (14 patients in the treated group and 18 in the untreated group); overall, the effect of COVID-19 on quality of life was 58.14%. These effects were lower in the tocilizumab group, with p = 0.016 *. Conclusions: Our observational data follow the most relevant largest trial. Patients treated with tocilizumab had lower rates of new-onset symptoms later COVID-19 ICU hospitalizations. As reported by recent medical literature, the presence of these symptoms suggests that a follow-up program for these types of patients could be useful.

scholarly journals Native Valve Endocarditis Caused by Corynebacterium striatum with Heterogeneous High-Level Daptomycin Resistance: Collateral Damage from Daptomycin Therapy?

2012 ◽  
Vol 56 (6) ◽  
pp. 3461-3464 ◽  
Author(s):  
Truc T. Tran ◽  
Siraya Jaijakul ◽  
Cole T. Lewis ◽  
Lorena Diaz ◽  
Diana Panesso ◽  
...  
Keyword(s):  
Invasive Disease ◽  
Native Valve ◽  
Positive Skin ◽  
Content Type ◽  
Native Valve Endocarditis ◽  
Corynebacterium Striatum ◽  
Skin Flora ◽  
High Level ◽  
Selection Of

ABSTRACTWe describe a patient who developedCorynebacterium striatumnative valve endocarditis after receiving two 6-week courses of daptomycin for the treatment of methicillin-resistantStaphylococcus aureusbacteremia and osteomyelitis. The organism exhibitedin vitroheteroresistance to daptomycin, with two subpopulations showing daptomycin susceptibility (MIC of ≤0.094 μg/ml) and high-level resistance to daptomycin (MIC of ≥256 μg/ml). The selection of daptomycin-resistant Gram-positive skin flora with the potential of causing invasive disease may be a concern during prolonged courses of daptomycin.

The assessment of pain level among an adult ventilated patients in the intensive care unit

Ból ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 23-31
Author(s):  
Magdalena Weisbrot ◽  
Katarzyna Kwiecień-Jaguś ◽  
Wioletta Mędrzycka-Dąbrowska
Keyword(s):  
Intensive Care ◽  
Subjective Impression ◽  
Mechanically Ventilated ◽  
Intensive Care Patients ◽  
Polish Version ◽  
The One ◽  
Pain At Rest ◽  
Patients Experience ◽  
Ventilated Patients ◽  
Experience Pain

Introduction: Pain is a subjective impression, which means that its intensity can only be determined by the person who experiences it. Intensive care patients, often intubated, mechanically ventilated, are unable to determine the intensity of pain in a verbal manner. The pain experienced in these patients may occur both at rest and during various diagnostic, treatment or care procedures. Diagnosis and accurate assessment of pain are the basis for effective pain management. In modern practice, the nursing usually deals with the assessment and it is she who chooses the tool for the patient’s needs. Aim of the study: Analysis of pain complaints of mechanical ventilation patients, using the Polish version of the CPOT scale. Material and methods: The study was conducted using a prospective method, using a standardized CPOT pain assessment scale. The technique of the study consisted in observing patients at rest and during performing nursing procedures, such as tracheal suction and replacement of dressings. 58 patients were qualified for the study at the one of hospital in the Pomeranian province. Results: 20.7% of examined patients experience pain at rest. During tracheal suction, this percentage increased to 60.3%. During the replacement of the dressing, pain was felt by 31%. Conclusion: Mechanically ventilated patients experience pain both at rest and during routine nursing procedures.

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