Backgrounds and AimsLong term central venous access for Home Parenteral Nutrition (HPN) is associated with catheter related complications. The most studied and well known of these is Catheter Related Blood Stream Infection (CRBSI).This paper looks at other venous access complications, including blocked and damaged catheters, catheter related thrombosis and CRBSI. This paper will also present treatment outcomes for each of these complications. This paper will also examine if there are any correlating patient or catheter related factors that can help predict future catheter related complications. By demonstrating the treatment outcomes for each line complication, it is hoped this will contribute to the literature that could be used for standard setting in complications related to long term central venous access.
MethodsHPN data was analysed from the Greater Glasgow and Clyde (GGC) Home Parenteral Nutrition Database (HPN) which is a comprehensive, prospectively maintained electronic record of all HPN patients treated in GGC. The time period of data collection was 1998-2017. Descriptive statistics were used to report data frequency, age, and catheter days' distributions. Data were not normally distributed and so non-parametric tests were used.Spearman's Rho correlation was used to measure correlation between two numeric groups. Catheter complications were reported as a rate in count data, meaning that more than one event could be recorded per patient, with 1,000 catheter days as the person-time denominator. Poisson means test and Fisher exact tests were used to compare different rates, as complications were treated as count data increasing over variable total time periods. P < 0.05 with 95% confidence interval (CI) was considered significant in all tests. Comparisons between binary data sets used 2 sample t-test to compare the groups.
ResultsFrom 169 patients, 101 (59.8%) were female and 68 (40.2%) were male. The age when first starting HPN ranged from 16 to 79 years old with a median of 56 years. Total catheter days was 173,151 derived from 408 catheter insertions on 169 patients. 282 complications occurred in 85 patients over the study period. An overall catheter complication rate of 1.62/1000 days was found. 84 patients did not experience a single complication. There were 171 proven catheter infections in 66 patients over the study period. Infection rate from the entire period of report was 1.35 infections/1000 catheter days. This decreased over time. Infection was found to be correlated with length of time on HPN, catheter location, catheter diameter and use of Taurolock-Hep100. Thrombosis (n=16) was associated with total time on HPN(r 2 = 0.187, P <0.05) and the number of infections (r 2 = 0.207 P <0.05). Damage was strongly associated with increasing time on HPN with (r 2 of 0.494 and P <0.005). Blockage was not associated with any patient or catheter factors. Overall catheter salvage rate for CRBSI by antibiotic treatment was 61.87%.Success varied according to organism cultured. Catheter salvage was less succe...
Background: Anemia and acute lower respiratory tract infections are persistent and pervasive public health problems. Objective-To determine the relation of iron deficiency anemia with lower respiratory tract infection. Methods: The study included 82 diagnosed cases of acute lower respiratory tract infection in infants and children of age 6 months to 5 years. Detailed history and physical examination was done according to predesigned proforma. Laboratory investigations like complete blood count, red blood cell morphology and serum ferritin was carried out. Data was statistically analyzed. Results: Out of 82 cases, 34 cases were iron deficiency positive. Among 82 cases, majority of them were below 24 months. Gender wise, male population was higher compared to female. Sixty one percent of the cases belonged to middle class and 39% belonged to lower class. Cough was present in all acute lower respiratory tract infection patients followed by fast breathing, fever, chest in drawing, noisy breathing, poor feeding and the least of all was bluish discoloration of face/lips. The overall mean temperature, pulse rate and respiratory rate were 100.36
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.