scholarly journals Risk Factors of Catheter-Related Infection in Patients Undergoing Hemodialysis Using Double Lumen Catheter at Dr. M. Djamil Hospital Padang

2021 ◽  
Vol 6 (1) ◽  
pp. 1292-1299
Author(s):  
Muhammad Iqbal ◽  
Raflis Rustam ◽  
Vendry Rivaldy
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Clinical Manifestations ◽  
Bloodstream Infections ◽  
Sampling Technique ◽  
Exit Site ◽  
Double Lumen ◽  
Exit Site Infection ◽  
Double Lumen Catheter ◽  
Lumen Catheter

Background. Chronic kidney disease (CKD) is a terminal disease requiring hemodialysis. Hemodialysis requires vascular access using a double lumen catheter (DLC). However, the use of DLC may increase complications mainly infection, either infection of exit site or bloodstream. This study is aimed to seek risk factors contributing to the incidence of central catheter-related infections in CKD patients with DLC undergoing HD at Dr. M. Djamil Hospital, Padang. Methods. This study is a prospective study on patients undergoing HD at Dr. M. Djamil Hospital, Padang. This study using consecutive sampling technique. Data were analyzed using SPSS version 25.0. Results. This study involved 40 CKD patients undergoing HD. Majority of the samples had bloodstream infections (67.5%). Clinical manifestations of purulent secretion, duration of catheter used, and hypoalbuminemia had significant differences in the incidence of DLC infection based on bloodstream infection and exit site infection (p<0.05). The most common bacterial found was Pseudomonas aeruginosa (22.5%) which was sensitive to ceftazidime, cefepime, meropenem, amikacin, gentamicin, ciprofloxacin. Conclusion. Factors contributing to the incidence of DLC-related infections at Dr. M. Djamil Hospital are duration of catheter use and hypoalbuminemia. Pseudomonas aeruginosa is the most common cause of DLC-related infections.

scholarly journals DOUBLE LUMEN CATHETERS

2011 ◽  
Vol 18 (03) ◽  
pp. 470-474
Author(s):  
MATEEN AKRAM ◽  
GHULAM ABBAS
Keyword(s):  
Sampling Technique ◽  
Venous Catheter ◽  
Cross Sectional Study ◽  
Double Lumen ◽  
Cross Sectional ◽  
Medical College ◽  
Hemodialysis Unit ◽  
Double Lumen Catheter ◽  
Lumen Catheter ◽  
Sample Technique

Objective: To measure recirculation by Urea based Method in double lumen catheters in patients undergoing hemodialysis. Design: Cross sectional study. Place and duration of study: Hemodialysis unit of Nephrology department of Shaikh Zayed Hospital, Lahore, and Quaid- i-Azam Medical College Bahawalpur for period of eight months from October 2007 to May 2008. Patients and methods: Total 125 adult patients selected with Non probability purposive sampling technique in which hemodialysis were done through double lumen catheter, were studied for recirculation. Access recirculation by urea based method with three sample technique was calculated from following formula; Percentage Recirculation= Systemic (S) – Arterial (A)/ systemic – Venous (V) x 100. Results: Out of 125 patients 53 (42%) were males, whereas 72 (58%) were females. Their mean age was 43.4 ± 15.7 years. Percentage recirculation by urea based method was 10.3± 6.64 with range from 3.6 to 24.8. Conclusions: Our results have shown the upper limit of acceptable recirculation (10.3± 6.6) through double lumen catheter. Central venous catheter remains an important temporary access and in some cases the only achievable access for the patients. This recirculation should be considered when measuring adequacy level in these patients.

scholarly journals Risk factors for Healthcare-Associated Infections caused by KPC-producing Enterobacteriaceae: a case-control study

2020 ◽  
Vol 19 (2) ◽  
pp. 257-286
Author(s):  
André Alvim ◽  
Bráulio Roberto Gonçalves Marinho Couto ◽  
Andrea Gazzinelli
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Healthcare Associated Infections ◽  
Double Lumen ◽  
Double Lumen Catheter ◽  
Factores De Riesgo ◽  
Pressure Injury ◽  
Lumen Catheter ◽  
Healthcare Associated ◽  
Control Study

Objetivo: Evaluar los factores de riesgo para infecciones relacionadas con la asistencia sanitaria causadas por Enterobacteriaceae productoras de carbapenemas.Método: Este es un estudio retrospectivo de casos y controles que consistió en una muestra de 82 pacientes infectados y 164 controles, totalizando 246 pacientes. La recopilación de datos se realizó entre enero y mayo de 2017 mediante la búsqueda en el Sistema Automatizado de Control de Infecciones Hospitalarias y en los registros electrónicos de pacientes.Resultados: Pacientes previamente colonizados con microorganismos gramnegativos (OR: 10.7, 95% CI: 2-60, p=0.007), con cáncer (OR: 20.8, 95% CI: 4-120, p<0.001), utilizando una catéter de doble luz (OR: 30.5, 95% CI: 2-382, p=0.008), con lesión por presión (OR: 136.2, 95% CI: 11- 1623, p<0.001) y permanecer en la Unidad de Cuidados Intensivos (OR: 1.4, 95% CI: 1.2-1.6, p <0.001) fueron más propensos a desarrollar infecciones causadas por Enterobacteriaceae productoras de carbapenemas que el grupo control. El área bajo la curva ROC mostró un buen rendimiento general (0,99; IC 95%: 0,992-0,998) del modelo de regresión logística final.Conclusión: La colonización previa, el cáncer, el uso de catéteres de doble luz, la lesión por presión y la estadía en la UCI fueron factores de riesgo muy importantes para la adquisición de infecciones en el entorno hospitalario. Objective: To evaluate the risk factors for healthcare-associated infections caused by Klebsiella pneumoniae carbapenemase producing Enterobacteriaceae. Method: This is a retrospective case-control study that consisted of a sample of 82 infected patients and 164 controls, totaling 246 patients. Data collection was performed between January and May 2017 through search in the Automated Hospital Infection Control System and in the electronic patient records.Results: Patients previously colonized with gram-negative microorganisms (OR: 10.7, 95% CI: 2-60, p=0.007), with cancer (OR: 20.8, 95% CI: 4-120, p<0.001), using a double lumen catheter (OR: 30.5, 95% CI: 2-382, p=0.008), with pressure injury (OR: 136.2, 95% CI: 11- 1623, p<0.001) and Intensive Care Unit stay (OR: 1.4, 95% CI: 1.2-1.6, p <0.001) had a greater chance of developing Healthcare-associated Infections caused by KPC-producing Enterobacteriaceae than the control group. The area under the ROC curve showed a good overall performance (0.99, 95% CI: 0.992-0.998) of the final logistic regression model. Conclusion: Previous colonization, cancer, double lumen catheter use, pressure injury and ICU stay were very important risk factors for the acquisition of infections in the hospital environment.  

scholarly journals Factors That Influence Thrombus Formation in Early Catheter Dysfunction and Success of Alteplase Therapy in Children with Hemodialysis

2020 ◽  
Vol 1 (2) ◽  
pp. 16-20
Author(s):  
Alexander Jayadi Utama ◽  
Partini Pudjiastuti Trihono ◽  
Raden Suhartono
Keyword(s):  
Risk Factors ◽  
Thrombus Formation ◽  
Statistical Tests ◽  
Therapeutic Modality ◽  
Operating Characteristics ◽  
Double Lumen ◽  
Catheter Dysfunction ◽  
Double Lumen Catheter ◽  
Lumen Catheter ◽  
Receiver Operating

Introduction: The vascular access modality that is often used to perform regular hemodialysis (HD) measures in children with kidney failure is a tunneled double lumen catheter (TDLC), which has increased its use from 60% in 2011 to 78% in 2014 in Indonesia. The incidence of blockage caused by thrombosis is around 50%. These conditions can occur within the first 24 hours after TDLC, and usually develop within two weeks, causing early catheter dysfunction. Alteplase (rt-PA) is a thrombolytic choice for TDLC dysfunction and heparin, streptokinase, and urokinase. This study aims to determine the factors of thrombus formation in early catheter dysfunction and the effectiveness of alteplase as a therapeutic modality. Method: This study was a case-control study with children aged 0-18 years and suffering from stage 4-5 chronic kidney disease (CKD) who underwent regular HD at Cipto Mangunkusumo National Hospital. Statistical analysis using Mann-Whitney, Chi-square, Fisher’s exact, linear regression, and receiver operating characteristic (ROC) statistical tests. The test was carried out using SPSS version 20 for Windows software. Results: During the period of January 2016 to November 2017, 111 subjects met the criteria. A total of 65 subjects (58.6%) were male, and 46 subjects (41.1%) were female. Analysis showed that each albumin level <3.5 g/dL, hemoglobin (Hb) <10 g/dL, and creatinine> 5 mg/dL were risk factors for early catheter dysfunction that improved with rt- PA (p<0, 05). In multivariate analysis, only albumin levels <3.5 g/dL were associated with early catheter dysfunction. Receiver operating characteristics (ROC) curves show that early catheter dysfunction is at risk of albumin levels with a cutoff of ≤3.71 g/dL (sensitivity of 90.9% and specificity of 52.5%) and Hb levels with a cutoff of ≤8.58 g/dL (sensitivity 54.5% and specificity 77.5%). Rt-PA therapy successfully improves the condition of early catheter dysfunction in 20/22 (90.9%) cases. There were no significant side effects on the use of rt- PA in this study. Conclusion: In children undergoing regular HD with TDLC, hypoalbuminemia <3.5 g/dL, Hb <10 g/dL, and creatinine >5 mg/dL were risk factors for early catheter dysfunction. Alteplase may be useful as a safe therapeutic option. Keywords: tunneled double lumen catheter in children, early catheter dysfunction, rt-PA

scholarly journals BACTERIAL SPECTRUM AND ANTIMICROBIAL PATTERN OF BLOOD STREAM INFECTIONS ASSOCIATED WITH NON-TUNNELED DOUBLE LUMEN CATHETER IN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 71 (4) ◽  
pp. 1161-66
Author(s):  
Mehmood Hussain ◽  
Malik Nadeem Azam Khan ◽  
Khalid Rehman ◽  
Irfan Ali Mirza ◽  
Maryam Rehman ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Blood Cultures ◽  
Double Lumen ◽  
Blood Stream Infections ◽  
Gram Negative ◽  
Double Lumen Catheter ◽  
Lumen Catheter

Objective: To assess Bacterial spectrum and antimicrobial pattern of Blood Stream Infections associated with non-tunneled double lumen catheter in hemodialysis patients. Study Design: Prospective observational study. Place and Duration of Study: Department of Nephrology, Pakistan Emirates Military Hospital Rawalpindi Pakistan; Armed Forces Institute of Pathology Rawalpindi, Pakistan, from May 2019 to Apr 2020. Methodology: A total of 753 patients underwent placement of non-tunneled double lumen catheter (457 femoral, 296 Internal Jugular). Patients with clinically suspected bloodstream infections had their catheters removed with tips being sent for culture along with 2 sets of peripheral blood cultures. Patients were labelled as having bloodstream infection if growth of organism was detected in catheter tip and at least one peripheral blood culture. Susceptibility testing was done for available antimicrobials. Results: One hundred and thirty six (18.06%) incidences or 5.48 bloodstream infections per 1000 catheter days, with confirmed growth on blood cultures were identified. Gram positive infections were seen in 76 (55.88%) individuals with most common organism being coagulase-negative Staphylococcus (28.68%), followed by Staphylococcus aureus (21.32%). These organisms had low resistance rates to Vancomycin (0%), Tigecycline (0%), Doxycycline (6.6%) and Linezolid (9.5%). Gram negative infections were seen in 60 (44.11%) patients with Klebsiella pneumoniae (13.24%) being the most commonly identified pathogen followed by Acinetobacter baumannii (12.50%) and had relatively higher degree of antimicrobial resistance. Conclusion: Gram positive organisms were the most common cause of bloodstream infection in this study and were found susceptible to vancomycin and doxycycline whereas gram-negative organisms had high rates of antimicrobial......

scholarly journals Repeat exit site infection in peritoneal dialysis patient with polycythemia vera – a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Edyta Gołembiewska ◽  
Kazimierz Ciechanowski
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Peritoneal Dialysis ◽  
Case Report ◽  
Polycythemia Vera ◽  
Significant Risk ◽  
Renal Amyloidosis ◽  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection ◽  
First Case

Abstract Background Infectious complications of peritoneal dialysis (PD) remain a common cause of catheter loss and discontinuation of PD. Exit site infection (ESI) constitutes a significant risk factor for PD-related peritonitis and determination of predisposing states is relevant. We here present a case of repeat ESI due to Pseudomonas aeruginosa in a PD patient with skin changes in the course of polycythemia vera (PV). Case presentation A 73-year-old PD patient with chronic kidney disease secondary to renal amyloidosis and ankylosing spondylitis, presented to the nephrology unit with signs of ESI. In 2006 he was diagnosed with PV and since then has was successfully treated with hydroxyurea; however, he reported recurrent episodes of developing skin nodules in the course of the disease. Exit site swab yielded Pseudomonas aeruginosa and the infection developed in the ulcerated PV nodule that appeared in exit site 2 weeks earlier. Patient was treated with intraperitoneal amikacin and oral ciprofloxacin, however, due to neurological complications, the treatment had to be interrupted and finally catheter was removed. Similar episode of ESI with Pseudomonas aeruginosa developed in the patient two years earlier and also required catheter removal. Conclusion This is the first case report demonstrating the development of ESI on the polycythemia vera skin lesion in this area. Skin manifestations of PV might be a predisposing factor to ESI in PD patients.

Preliminary Experiment with a Newly Developed Double Balloon, Double Lumen Catheter for Extracorporeal Life Support Vascular Access

ASAIO Journal ◽  
2003 ◽  
Vol 49 (5) ◽  
pp. 583-588 ◽  
Author(s):  
Taisuke Okamoto ◽  
Keisuke Ichinose ◽  
Hironari Tanimoto ◽  
Atsushi Yoshitake ◽  
Yuji Sakanashi ◽  
...  
Keyword(s):  
Vascular Access ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Double Lumen ◽  
Double Balloon ◽  
Double Lumen Catheter ◽  
Lumen Catheter

Interaction between serotonin and efferent vagus nerves in dog lungs

1978 ◽  
Vol 44 (2) ◽  
pp. 144-149 ◽  
Author(s):  
H. L. Hahn ◽  
A. G. Wilson ◽  
P. D. Graf ◽  
S. P. Fischer ◽  
J. A. Nadel
Keyword(s):  
Smooth Muscle ◽  
Vagal Stimulation ◽  
Transpulmonary Pressure ◽  
Pressure Amplitude ◽  
Vagus Nerves ◽  
Pulmonary Resistance ◽  
Double Lumen ◽  
Contralateral Lung ◽  
Double Lumen Catheter ◽  
Lumen Catheter

We anesthetized, paralyzed, and ventilated 32 dogs. In 16 dogs we measured total pulmonary resistance (RL) during inhalation of acetylcholine (ACh), serotonin (5-HT), and histamine (Hist) aerosols. Cooling both cervical vagi reduced the bronchoconstriction caused by 5-HT 64% (P = 0.001), reduced Hist-induced bronchoconstriction 17% (P = 0.003), and did not significantly reduce bronchoconstriction due to ACh. In seven dogs, we ventilated both lungs separately through a double-lumen catheter. Application of 5-HT to one lung increased the transpulmonary pressure amplitude in the homolateral but not in the contralateral lung. Cooling the homolateral vagus reduced this response 32% (P = 0.02). In nine dogs, we stimulated the peripheral ends of both cut cervical vagi before and during aerosol application of ACh, 5-HT, and Hist. ACh and Hist increased baseline RL 97 and 134%, respectively, without increasing the effect of vagal stimulation. 5-HT increased baseline RL only 27% but greatly augmented the effect of vagal stimulation (mean increase, 271%, P = 0.001). We conclude that 5-HT acts to potentiate vagal effects on airway smooth muscle via the efferent vagal pathway.

scholarly journals The development of a risk score for unplanned removal of peripherally inserted central catheter in newborns

2015 ◽  
Vol 23 (3) ◽  
pp. 475-482 ◽  
Author(s):  
Priscila Costa ◽  
Amélia Fumiko Kimura ◽  
Debra Huffman Brandon ◽  
Eny Dorea Paiva ◽  
Patricia Ponce de Camargo
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Neonatal Intensive Care ◽  
Operating Characteristic ◽  
Bivariate Analysis ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Single Lumen ◽  
Double Lumen Catheter ◽  
Lumen Catheter

OBJECTIVE: to develop a risk score for unplanned removal of peripherally inserted central catheter in newborns.METHOD: prospective cohort study conducted in a neonatal intensive care unit with newborn babies who underwent 524 catheter insertions. The clinical characteristics of the newborn, catheter insertion and intravenous therapy were tested as risk factors for the unplanned removal of catheters using bivariate analysis. The risk score was developed using logistic regression. Accuracy was internally validated based on the area under the Receiver Operating Characteristic curve.RESULTS: the risk score was made up of the following risk factors: transient metabolic disorders; previous insertion of catheter; use of a polyurethane double-lumen catheter; infusion of multiple intravenous solutions through a single-lumen catheter; and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points). Accuracy was 0.76.CONCLUSION: the adoption of evidence-based preventative strategies based on the classification and risk factors faced by the newborn is recommended to minimize the occurrence of unplanned removals.

scholarly journals Korelasi antara Letak Ujung Kateter Lumen Ganda Femoralis Jangka Pendek Non-tunneling dengan Laju Aliran darah pada Saat Hemodialisis di RSUP Prof Dr. R. D. Kandou

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Fery Purba ◽  
Richard Sumangkut ◽  
Djoni E. Tjandra
Keyword(s):  
Renal Failure ◽  
Positive Relationship ◽  
Scatter Plot ◽  
Short Term ◽  
Double Lumen ◽  
End Stage Renal Failure ◽  
Double Lumen Catheter ◽  
Lumen Catheter ◽  
Tip Position ◽  
End Stage

Abstract: Patients with end-stage renal failure are unable to survive without dialysis or renal transplantation. To achieve effective dialysis using a double lumen catheter, placement of the catheter tip plays an important role because it may affect blood flow/Quick of Blood (QB). The selection of femoral vein access is more favorable in critical patients. This study was aimed to obtain the correlation between the tip position of the non-tunneling short-term femoral double lumen catheter (DLC) and QB at the time of hemodialysis. This was an analytical correlative and prospective study with a cross-sectional design in patients with end-stage renal failure undergoing hemodialysis using a non-tunneling short-term femoral DLC. This study was conducted at the Hemodialysis Installation of Prof. Dr. R. D. Kandou Hospital Manado. Data were analyzed by using the Pearson's r test. The results showed that there were 31 patients enrolled in this study. The Pearson’s r test obtained an r of 0.147 (statistically weak) and Sig (2-tailed) of 0.430 which showed no correlation but the scatter plot showed a tendency of a weak positive relationship. Conclusion: There was no significant correlation between Qb and the tip position of DLC, albeit, there was a tendency of a weak positive relationship. Increasing the number of samples will more accurately predict the presence or absence of the correlation between Qb and the tip position of the DLC.Keywords: DLC, QB, hemodialysisAbstrak: Pasien dengan penyakit ginjal stadium akhir tidak dapat mempertahankan hidup tanpa dukungan terapi pengganti ginjal yaitu dialisis atau transplantasi ginjal. Untuk mencapai dialisis yang efektif dengan menggunakan kateter lumen ganda, penempatan kateter berperan penting karena dapat memengaruhi aliran darah/Quick of Blood (QB). Pemilihan akses vena femoralis lebih menguntungkan pada pasien kritis. Penelitian ini bertujuan untuk mengetahui korelasi letak ujung kateter lumen ganda femoralis jangka pendek (DLC) dengan QB pada saat hemodialisis. Jenis penelitian ialah analitik korelatif dan prospektif dengan desain potong lintang. Subyek penelitian ialah pasien dengan gagal ginjal tahap akhir yang menjalani hemodialisis menggunakan kateter lumen ganda femoralis jangka pendek non-tunneling. Penelitian dilakukan di Instalasi Hemodialisis RSUP Prof. Dr. R. D. Kandou, Manado. Data dianalisis menggunakan koefisien korelasi Pearson. Hasil penelitian mendapatkan 31 pasien sebagai subyek. Hasil analisis koefisien Pearson terhadap korelasi antara letak ujung DLC dan QB memperlihatkan hubungan statistik lemah (r = 0,147) dengan Sig (2-tailed) 0,430 yang menunjukkan tidak terdapat hubungan bermakna tetapi pada scatter plot terlihat adanya kecenderungan hubungan positif lemah. Simpulan: Tidak terdapat korelasi bermakna antara Qb dan letak ujung DLC tetapi terdapat kecenderungan hubungan positif lemah. Menambah jumlah sampel akan lebih akurat untuk memrediksi ada tidaknya hubungan antara Qb dan letak ujung DLC. Kata kunci: DLC, laju aliran dara (QB), hemodialisis

Sign in / Sign up

Export Citation Format

Share Document