Background: Central Line Associated Blood Stream Infections (CLABSI) are significant complications for hospitalized patients. Several different approaches have been used to reduce CLABSI.
Objective: This study aimed to (1) describe a systematic approach used to analyze and reduce CLABSI rates in a surgical ICU (SICU) at a quaternary care medical facility (CLABSI reduction bundle) and (2) examine the association of the bundle on CLABSI rates in the SICU, compared to six unexposed health system ICUs.
Methods: Retrospective analysis of 14,022 adult patients with > 0 central line days within a single health system in the southeastern United States. The CLABSI intervention bundle was created and implemented in July 2021. Single and multiple interrupted time series analyses were performed to assess the impact of the CLABSI bundle on CLABSI rate in SICU (compared to control ICUs) pre- and post-intervention. Secondary analyses examined the association of the bundle with ICU mortality and length of stay.
Results: The CLABSI bundle was associated with a significant immediate effect in reducing the CLABSI rate in the SICU compared with control ICUs. There was no significant change in the slope of CLABSI rate post-intervention, compared to control ICUs. There was no significant association of the CLABSI reduction bundle on ICU length of stay or mortality in the SICU.
Conclusion: The CLABSI bundle was associated with an immediate reduction in CLABSI incidence in the SICU compared to unexposed ICUs. A simple, bundled intervention can be effective in reducing CLABSI incidence in a surgical ICU population.
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http://dx.doi.org/10.1080/03007995.2024.2401097 | DOI Listing |
BMC Anesthesiol
December 2024
Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Aswan University, Aswan, Egypt.
Background: There is no significant evidence verifying the efficacy of liberal versus conservative oxygen therapy on hemodynamics in patients with sepsis. We investigated how liberal and conservative oxygen therapy influenced stroke volume, cardiac output, and vasopressor needs in patients with sepsis undergoing mechanical ventilation.
Methods: This randomized clinical trial included 106 patients with an admission diagnosis of infection, a Sequential Organ Failure Assessment (SOFA) score of two points or higher and required invasive mechanical ventilation for at least 72 h.
Introduction: Advanced airway management and ventilation of trauma patients are often needed during acute stabilization and resuscitation and later, in those admitted. In addition to endotracheal intubation for advanced airway management, tracheostomy is commonly used in critically ill patients when prolonged mechanical ventilation is required. However, the outcomes associated with airway management approaches and the timing of a tracheostomy in critically ill patients are mixed.
View Article and Find Full Text PDFClin Nutr ESPEN
December 2024
Division of Anesthesia, Pain Management and Intensive Care, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv, Israel; Critical Care Department, University College London Hospital NHS Foundation Trust, 235 Euston Rd., London, UK; The Faculty of Medical & Health Sciences, Tel Aviv University, 35 Klatzkin St., Tel Aviv, Israel. Electronic address:
Background And Aims: Tailoring nutrition to measured energy expenditure (EE) and provision of adequate protein amounts, is considered gold standard for critically ill patients. There are currently no recommendations to measure specific substrate utilization or to adapt nutrition accordingly.
Methods: In this retrospective longitudinal study, we analyzed results of 316 simultaneous measurements of indirect calorimetry (IC) and urinary urea nitrogen (UUN) in 191 mechanically ventilated, critically ill patients, admitted to the surgical intensive care unit (SICU) in a tertiary medical center.
Sci Rep
November 2024
Department of Intensive Care Unit, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
Reports on the application of metagenomic next-generation sequencing (mNGS) in adult patients with severe pneumonia after cardiac surgery remain limited. This study aimed to evaluate the clinical outcomes of mNGS analysis of bronchoalveolar lavage fluid (BALF) in such patients.A retrospective cohort study was conducted on adult patients with severe pneumonia after cardiac surgery.
View Article and Find Full Text PDFCureus
October 2024
Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, USA.
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