Mobility therapy and central or peripheral catheter-related adverse events in an ICU in Brazil

Abstract

OBJECTIVE: To determine whether mobility therapy is associated with central or peripheral catheter-related adverse events in critically ill patients in an ICU in Brazil. METHODS: A retrospective analysis of the daily medical records of patients admitted to the Clinical Emergency ICU of the University of São Paulo School of Medicine Hospital das Clínicas Central Institute between December of 2009 and April of 2011. In addition to the demographic and clinical characteristics of the patients, we collected data related to central venous catheters (CVCs), hemodialysis (HD) catheters and indwelling arterial catheters (IACs): insertion site; number of catheter days; and types of adverse events. We also characterized the mobility therapy provided. RESULTS: Among the 275 patients evaluated, CVCs were used in 49%, HD catheters were used in 26%, and IACs were used in 29%. A total of 1,268 mobility therapy sessions were provided to patients while they had a catheter in place. Catheter-related adverse events occurred in 20 patients (a total of 22 adverse events): 32%, infection; 32%, obstruction; and 32%, accidental dislodgement. We found that mobility therapy was not significantly associated with any catheter-related adverse event, regardless of the type of catheter employed: CVC-OR = 0.8; 95% CI: 0.7-1.0; p = 0.14; HD catheter-OR = 1.04; 95% CI: 0.89-1.21; p = 0.56; or IAC-OR = 1.74; 95% CI: 0.94-3.23; p = 0.07. CONCLUSIONS: In critically ill patients, mobility therapy is not associated with the incidence of adverse events involving CVCs, HD catheters, or IACs.

Complication and failures of central vascular access device in adult critical care settings

“…Studies originated in Europe (31; 49%) (31-61), North America (12; 19%) (8, 62-72), South America (5; 8%) (22,(73)(74)(75)(76), Oceania (6; 10%) (77-82), Asia (4; 6%) (83-86), and Middle East (5; 8%) (87-91). There were 24 RCTs (38%), 28 prospective (44%) and 11 retrospective studies (17%).…”

“…complications per 1,000 catheter days(22,34,36,49,55,56,63,64,67,72,76,82,85). Due to lack of consistency in outcome definitions, some study outcomes were eligible including: catheter dysfunction(34), CRBSI(73), kinking(76), fixation failure(74,76), displacement(76), infection(22,56), exudate(74), catheter related infection(57)(58)(59), catheter infection (56), local reaction(74). (95% CI 3-12; 4 studies; 1,481 CVADs) and highest pooled IR 11.2 (0-22.9) per 1,000 catheter days (3 studies; 8,809 catheter days).…”

Effects that passive cycling exercise have on muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients: a randomized clinical trial

“… 9 However, these deleterious effects of immobility can be reversed or mitigated by physical therapy, 10 , 11 which contributes to decreased length of stay in the ICU and hospital. 12 Studies demonstrate that early mobilization of critically ill patients is considered a safe approach 13 that is aimed at preserving muscle mass and reducing muscle weakness after hospital discharge and that facilitates resumption of activities of daily living. 14 , 15 According to Hodgson et al, 16 early mobilization is defined as the intensification and early application (within the first 2 to 5 days of critical illness) of the physical therapy that is administered to critically ill patients.…”

Suturing central venous catheters

“…E. Cavus 1, *, C. Byhahn 2 , V. Dö rges 1 1 Kiel, Germany and 2 Oldenburg, Germany *E-mail:e.cavus@ap-holstein.de Editor-We read with interest the article by Kleine-Brueggeney and colleagues, 1 who compared six videolaryngocopes during routine airway management in patients with simulated difficult airways.…”