Clinical signs of infection during continuous postoperative epidural analgesia in children: the value of catheter tip culture

Abstract

Minor local signs of inflammation and infection are common in pediatric patients during continuous epidural infusion. Epidural catheter tips are also frequently culture positive in patients with and without local signs and who may not go on to develop further signs or symptoms of infection. Routine culture of catheter tips is unnecessary as it is not a good predictor of epidural space infection.

Infant lumbar and thoracic epidurals for abdominal surgeries: cases in a paediatric tertiary institution

“…(8) Although postoperative fever in children is common and only a very small proportion of cases are associated with a septic process, (9) epidural catheter-related infections can be devastating and hard to diagnose or treat. (10) The features of neuraxial infections can also be difficult to detect. Hence, sterile insertion techniques should be emphasised and vigilant postoperative monitoring is necessary.…”

Transfer of the morbidly obese from anaesthetic room to theatre

“…Patients with malignancy have a systematic suppression of the host immune function and have a significantly increased risk for infection in comparison with patients without malignancy [1]. The group with absolute neutrophil count greater than 500 per microlitre and no immunosuppressive therapy represents the least immunosuppressed patients with cancer, but some level of risk of infection may still exist [2]. Patients undergoing surgery for malignancies are also at risk as a result of anatomic factors.…”

“…Patients undergoing surgery for malignancies are also at risk as a result of anatomic factors. Patients undergoing head and neck surgery are at higher risk for aspiration pneumonia and infections by skin and oral mucosal flora [2,3]. Patients with biliary tract obstruction are usually treated with stents or diverting procedures that enable colonisation of the biliary tract with intestinal flora which increases the risk of postoperative infection.…”

“…Direct invasion through the colonic mucosa is associated with local abscess formation and sepsis by enteric flora. Streptococcus bacteraemia is associated with colon cancer [2]. Other factors specific to oncology patients which increase the risk of infection include tumour obstruction of hollow viscera, infection of necrotic tumour, extensive debulking, nodal dissection, prolonged use of surgical drains, catheter-related sepsis, ventilator-associated pneumonia and malnutrition [2].…”

“…Several recent papers have investigated desaturation (S a O 2 < 90%) in morbidly obese patients. Berthoud et al [2] found that after 3 min pre-oxygenation, morbidly obese (BMI > 35 kg.m )2…”