Journal of intensive care medicine
-
J Intensive Care Med · May 2010
ReviewPrevention of central venous catheter bloodstream infections.
The majority of nosocomial bloodstream infections in critically ill patients originate from an infected central venous catheter (CVC). Catheter-related bloodstream infections (CRBSIs) cause significant morbidity and mortality and increase the cost of care. ⋯ Evidence-based strategies for the prevention of CRBSI include behavioral and educational interventions, effective skin antisepsis coupled with maximum barrier precautions, the use of antiseptic dressings, and the use of antiseptic or antibiotic impregnated catheters. Achieving and maintaining very low rates of CRBSI requires a multidisciplinary approach involving the entire health care team, the use of novel technologies in patients with the highest risk of CRBSI, and frequent reeducation of staff.
-
J Intensive Care Med · May 2010
Structure, process, and outcome of all intensive care units within the province of British Columbia, Canada.
To describe the total and regional capacity for critical care in British Columbia (BC), Canada, and to describe regional variation in number of intensive care units (ICUs), size of ICUs, length of ICU stay, ICU occupancy, key processes of critical care, and hospital mortality for ICU patients in B.C. ⋯ Variation and lack of availability of key processes for care of critically ill patients in this population identifies opportunities for knowledge translation and systematic improvement including regionalization of care.
-
J Intensive Care Med · May 2010
Use of a helium-oxygen mixture to facilitate ventilation during bronchoscopy through a laryngeal mask airway.
Flexible fiberoptic bronchoscopy may be performed in infants and children for various diagnostic and therapeutic purposes. In infants and children, general anesthesia may be used to facilitate the procedure. When general anesthesia is used, a laryngeal mask may be used to control the airway. However, as the passage of the bronchoscope decreases the cross-sectional airway inside the laryngeal mask airway (LMA) for gas exchange, increases in respiratory resistance may occur. We present our experience with the use of a helium-oxygen mixture to facilitate bronchoscopy through an LMA during general anesthesia in infants and children. ⋯ A helium-oxygen mixture decreases resistance to gas flow during bronchoscopy through an LMA in infants and children receiving general anesthesia with sevoflurane and pressure support ventilation.