Jpen Parenter Enter
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Jpen Parenter Enter · Nov 1992
Randomized Controlled Trial Clinical TrialPrevention of catheter-related sepsis during parenteral nutrition: effect of a new connection device.
A prospective study was carried out to determine the clinical effect of a newly devised catheter connection method (I system) and piggyback access system. Previous studies have demonstrated that the I system avoided bacterial contamination in vitro during tubing change that Luer-Lock connectors did not. The purpose of this study was to investigate the ability of this device coupled with a new closed-system piggyback technique for multipurpose access to reduce catheter-related sepsis in clinical practice. ⋯ In group I, a newly designed closed-system piggyback was used. The incidence of catheter-related sepsis was significantly lower in group I (1.89%/catheter) than in group L (12.10%/catheter) (p < .01, chi 2 analysis), and the average duration of use of each catheter was significantly longer in group I than in Group L (p < .01 by generalized Wilcoxon test). The results of this clinical study suggest that the newly designed connection method and piggyback access system are able to reduce catheter-related sepsis.
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Jpen Parenter Enter · Nov 1992
Case ReportsPlacement of a duodenal feeding tube via gastrostoma with fiberoptic bronchoscope.
We report a case of esophageal disruption that required a duodenal feeding tube. Because of collapse of the gastric outlet secondary to severe emaciation, several attempts to place a tube into the duodenum via gastrostoma had ended in failure. We finally were able to accomplish it with the aid of a fiberoptic bronchoscope and a Swan-Ganz catheter. The procedure is described and discussed.
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Jpen Parenter Enter · May 1992
Randomized Controlled Trial Clinical TrialThiamine, riboflavin, folate, and vitamin B12 status of low birth weight infants receiving parenteral and enteral nutrition.
Thirty infants were randomly assigned to receive either 3 mL of MVI-Pediatric supplement (PAR3 group, parenterally fed) or 2 mL (PAR2 group, parenterally fed). For the first week, 100% received total parenteral nutrition (TPN), 50% by the second, and less than 33% by the third. Eighteen control infants received enteral feeds of infant formula. ⋯ No differences between groups were observed in thiamine pyrophosphate effect, erythrocyte glutathione reductase activity, urinary B1 or B2, or red blood cell folate levels at any time. Plasma folate differed (p less than .05) among the PAR3 group (24 +/- 7 ng/mL), and both the PAR2 (13 +/- 5 ng/mL) and enterally fed (ENT) groups (16 +/- 3 ng/mL) before the initiation of feeds, at week 1 (PAR3 = 32 +/- 15 ng/mL; PAR2 = 18 +/- 4 ng/mL; ENT = 19 +/- 9, ng/mL) and between the PAR3 (30 +/- 16 ng/mL) and PAR2 (16 +/- 4 ng/mL) infants at week 2. Plasma vitamin B12 levels differed among the ENT groups (551 +/- 287 pg/mL) and both the parenteral groups (PAR2 = 841 +/- 405 pg/mL; PAR3 = 924 +/- 424 pg/mL) at week 1 and between the ENT (530 +/- 238 pg/mL) and PAR3 (999 +/- 425 pg/mL) groups at week 2.(ABSTRACT TRUNCATED AT 250 WORDS)
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Jpen Parenter Enter · May 1992
Duplex Doppler ultrasound identifies veins suitable for insertion of central feeding catheters.
Central venous access for feeding catheters may prove difficult in patients who have had numerous previous central line insertions or complications. Duplex Doppler ultrasound was used to identify the anatomy and patency of major central veins in 11 patients in whom attempts at obtaining central venous access by an experienced operator had failed at least once and in 40 control subjects. ⋯ In 7 patients who required central feeding catheter insertion, a suitable vein was identified and the catheter suitably placed, even in 3 subjects where no central vein was considered normal. Duplex Doppler ultrasonography is a useful technique for identifying veins suitable for the insertion of central venous lines when access has previously proved difficult.
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Jpen Parenter Enter · Mar 1992
Experimental study of hub contamination: effect of a new connection device: the I system.
Experimental studies of hub contamination of intravenous catheters were done comparing the standard connection method (Luer-Lock connector) with a newly invented connection method (I system). Immersion of the connection sites into a bacteria-containing solution showed no bacterial contamination of the medium in any tubing. ⋯ A high incidence of bacterial contamination was seen with the Luer-Lock connector, but no bacterial contamination occurred with the I system. These experiments suggest that the use of Luer-Lock connectors is associated with a high risk of bacterial contamination during tubing change, but the I system can prevent contamination during tubing change, which cannot be avoided with Luer-Lock connector.