OPTIMAL INTERVAL FOR TRIPLE-LUMEN CATHETER CHANGES - A DECISION-ANALYSIS
200; analysis; catheter-related infection; central venous catheterization; complications; consecutive patients; decision; Health Care Sciences & Services; hyperalimentation; infectious; intensive-care-unit; maintenance; Medical Informatics; risk-factors; sepsis; single-lumen; total parenteral-nutrition; triple-lumen catheter
A survey of 53 university and community hospitals revealed that 73% of the institutions had no standard policy for the replacement of triple-lumen catheters (TLCs). Since the maintenance of a TLC in place for a prolonged period may lead to infectious complications, it appeared warranted that standards of management be developed. A decision-tree model was constructed for evaluating the optimal time for changing a TLC that would minimize infection. Cost estimates and health effects at three-, five-, and ten-day change intervals were considered for catheter insertion and complications resulting from such insertion. The results suggested that prophylactic catheter changes should occur no later than every five days, provided that there are no signs of infection. However, sensitivity analysis of several variables suggested that individual institutions should establish policy timing changes based upon careful interpretation of their own data. A model was developed to assist in determining the optimal time to change a TLC based upon such data.
Ritchey N P; Caccamo L P; Carter K J; Castro F; Erickson B A; Johnson W; Kessler E; Ruiz C A
Medical Decision Making
1995
1995-04
Journal Article
<a href="http://doi.org/10.1177/0272989x9501500206" target="_blank" rel="noreferrer noopener">10.1177/0272989x9501500206</a>
Severe nonimmune hydrops secondary to parvovirus B-19 infection: Spontaneous reversal in utero and survival of a term infant.
Female; Humans; Male; Ultrasonography; Pregnancy; *Pregnancy Complications; Pre-Eclampsia/*complications; Erythema Infectiosum/blood/*complications/prevention & control; Hydrops Fetalis/blood/diagnostic imaging/*etiology; Immunoglobulin Allotypes/analysis; Immunoglobulin G; Prenatal; Infectious
We present a case of intrauterine infection with parvovirus B-19 and accompanying severe nonimmune hydrops at 26 weeks' gestation. The fetus showed progressive recovery on ultrasound. A term infant was delivered with hepatosplenomegaly as the only abnormality.
Humphrey W; Magoon M; O'Shaughnessy R
Obstetrics and gynecology
1991
1991-11
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