Surgical infections
-
Surgical infections · Feb 2006
Comparative Study Clinical TrialDoes enteral glutamine supplementation decrease infectious morbidity?
Although some studies have demonstrated lower infectious morbidity in patients receiving supplemental glutamine, there remains no consensus on the utility of such treatment. This study was designed to investigate the effects of supplemental enteral glutamine on the rate and outcomes of infection in critically ill surgical patients. ⋯ Supplemental enteral glutamine in the dose studied does not appear to influence the acquisition or characteristics of infection in patients admitted to a mixed STICU.
-
Surgical infections · Feb 2006
Mentors decrease compliance with best sterile practices during central venous catheter placement in the trauma resuscitation unit.
In the academic trauma unit during initial evaluation and resuscitation of trauma victims, central venous catheters are often placed by multiple operators. There are few data on compliance with accepted, standard sterile practices during such procedures. ⋯ Secondary operators, typically trauma surgery attendings, trauma/critical care fellows, or senior surgical residents, function as mentors in academic institutions and act as role models. Secondary operators participated in many of the studied cases, yet failed to demonstrate consistent use of MBP. In elective central venous catheter placement, those where there was the greatest opportunity to follow MBP, we observed a statistically significant difference in compliance rate between the primary and secondary operators. The study suggests the need to address the performance of the secondary operators and to educate them, as although they may be technically experienced in placing central venous catheters, they may comply less consistently with MBP.
-
Fever is common in surgical patients. The list of potential causes is long and includes many noninfective etiologies. ⋯ The workup and therapy for the individual patient may differ, depending on the underlying disease and clinical appearance and the clinician's suspicion for infection. Subsequent testing should be based on the clinical findings. Perhaps more money is wasted in the evaluation of early postoperative fever than on any other aspect of postoperative care.
-
Surgical infections · Jan 2006
ReviewRecommendations and reports about central venous catheter-related infection.
Central venous catheters (CVCs) are used to deliver a variety of therapies, as well as for measurement of hemodynamic parameters. The major associated complication is catheter-related blood stream infection (CRBSI). ⋯ Central venous catheters are used commonly to deliver a variety of therapies, such as large amounts of fluid or blood products during surgery or in intensive care units, chemotherapy, and parenteral nutrition, as well as for measurement of hemodynamic variables. The major complication associated with CVCs is CRBSI.
-
Yeasts and molds now rank among the most common pathogens in intensive care units. Whereas the incidence of Candida infections peaked in the late 1970s, aspergillosis is still increasing. ⋯ The incidence of invasive fungal infection is increasing, but so too are the choices of agents for therapy. For reasons of efficacy and safety, therapy with an echinocandin or azole antifungal agent is supplanting the use of polyenes.