Effectiveness of different central venous catheters for catheter-related infections: a network meta-analysis

Wang, H.; Huang, Tongwang; Jing, Jiyong; Jin, Jie; Wang, P.; Yang, Mengting; Cui, Wenyan; Zheng, Yifeng; Shen, Huahao

doi:10.1016/j.jhin.2010.04.025

Cited by 72 publications

(55 citation statements)

References 74 publications

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“…Importantly, all of the CATCH CVC types were used in routine practice before the trial, but evidence was lacking on their effectiveness for children. 14 Deferred consent in CATCH enabled the participation of children admitted on an emergency basis. CATCH was one of the first UK studies to use deferred consent in children, and ethics committee decisions (Box 1) were based on opinion because there was a lack of evidence about potential biases caused by exclusion of nonconsenting participants.…”

Section: What This Study Addsmentioning

confidence: 99%

Deferred Consent for Randomized Controlled Trials in Emergency Care Settings

et al. 2015

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BACKGROUND: There is limited experience in using deferred consent for studies involving children, which was legalized in the United Kingdom in 2008. We aimed to inform future studies by evaluating consent rates and reasons for nonconsent in a large randomized controlled trial in pediatric intensive care. METHODS:In the CATCH trial, eligible children from 14 PICUs in England and Wales were randomly assigned to 3 types of central venous catheters. To avoid delay in treatment, children admitted on an emergency basis were first randomly assigned to a trial central venous catheter, and we deferred seeking consent to use already collected data and blood samples until after stabilization.RESULTS: Consent was obtained for 984/1358 (72%) of children admitted on an emergency basis. Failure to obtain consent resulted mainly from a lack of opportunity (early discharge or transfer) for survivors and difficulties in seeking consent for children who died. For admissions where there was an opportunity to approach (n = 1298), inclusion rates differed according to survival status: 93/984 (9%) of consented patients died, compared with 58/314 (18%) of nonconsented patients. For children admitted on an emergency basis whose families were approached, 984/1178 (84%) provided deferred consent (n = 15 sites), compared with 441/641 (69%) of children admitted on an elective basis who were approached for prospective consent (n = 9 sites).CONCLUSIONS: Design of emergency randomized controlled trials should balance the potential burden that seeking consent in difficult situations may cause against risk of bias by disproportionately excluding children who die or are transferred. Ethics committees could consider approving the use of already collected data when best efforts to obtain deferred consent are unsuccessful.WHAT'S KNOWN ON THIS SUBJECT: Deferral of consent avoids delaying emergency interventions while ensuring consent to ongoing participation and use of data. Deferred consent is particularly important for enabling trials in pediatric settings, where many medicines and devices are unlicensed and untested for use. WHAT THIS STUDY ADDS:Approaches for seeking deferred consent should balance the potential burden of obtaining consent against risk of bias due to outcome-related attrition. Ethics committees could consider approving data use when best efforts to obtain deferred consent are met with no response.

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Section: What This Study Addsmentioning

confidence: 99%

Deferred Consent for Randomized Controlled Trials in Emergency Care Settings

et al. 2015

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“…An alternative to the existing methods is application of antimicrobial agents based on nanoparticles of different metals and oxides. Thus, silver, copper and titanium dioxide (titania) nanoparticles are widely used and they show strong biocidal effects on many pathogenic bacteria [23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

The sol–gel synthesis of cotton/TiO2 composites and their antibacterial properties

Galkina

Sycheva

Blagodatskiy

et al. 2014

Surface and Coatings Technology

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Access to the published version may require journal subscription. Published with permission from: Elsevier.Standard set statement from the publisher: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT AbstractPresent work is devoted to investigation of structure and functional properties of hybrid nanomaterials based on the TiO 2 -modified cellulose fibers of cotton. The titania hydrosol was successfully prepared using the titanium tetraisopropoxide as precursor and the nitric acid as peptizing agent via the low-temperature sol-gel synthesis in aqueous medium and applied to cotton fabric. For cross-linking of titania nanoparticles to cotton the 1,2,3,4-butanetetracarboxylic acid (BTCA) was used as a spacer. The morphology and composition of the surface pure and TiO 2 modified cotton fibers were investigated by the Scanning Electron Microscopy (SEM). The cotton/TiO 2 composite was characterized by the dielectric permittivity.For the estimation of total titania concentration, all samples were calcined at 650°C. The antimicrobial activity of the treated TiO 2 cotton fibers was investigated against Escherichia coli as a model Gram -negative bacteria after exposure to UV-irradiation for 10 minutes.

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“…Similar to what has been seen with ventilator care and the incidence of pneumonia, educational and behavioral campaigns can reduce these risks [81,82]. In addition, several variations of catheter design have been introduced, including silver alloy, silver iontophoretic, first-(external only) or second-(external and internal) generation chlorhexadine-silver sulfadiazine (CSS) catheters, and antibiotic-impregnated catheters [83][84][85][86][87][88][89][90][91].…”

Section: Blood Stream Infectionsmentioning

confidence: 99%

“…Several independent trials and meta-analyses have demonstrated reduced central venous catheter colonization and CR-BSI with the use of CSS rather than uncoated catheters [87][88][89][90][91][92]. One of the most cited meta-analyses showed a significant reduction in catheter colonization (odds ratio [OR] 0.44; 95% confidence interval [CI] 0.36, 0.54; p < 0.001) as well as in CR-BSI (OR 0.56; 95% CI 0.37, 0.84; p = 0.005) with CSS catheters [92].…”

Section: Blood Stream Infectionsmentioning

confidence: 99%

Use of Silver in the Prevention and Treatment of Infections: Silver Review

Politano

Campbell

Rosenberger

et al. 2013

Surgical Infections

159

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Background: The use of silver for the treatment of various maladies or to prevent the transmission of infection dates back to at least 4000 b.c.e. Medical applications are documented in the literature throughout the 17th and 18th centuries. The bactericidal activity of silver is well established. Silver nitrate was used topically throughout the 1800s for the treatment of burns, ulcerations, and infected wounds, and although its use declined after World War II and the advent of antibiotics, Fox revitalized its use in the form of silver sulfadiazine in 1968. Method: Review of the pertinent English-language literature. Results: Since Fox's work, the use of topical silver to reduce bacterial burden and promote healing has been investigated in the setting of chronic wounds and ulcers, post-operative incision dressings, blood and urinary catheter designs, endotracheal tubes, orthopedic devices, vascular prostheses, and the sewing ring of prosthetic heart valves. The beneficial effects of silver in reducing or preventing infection have been seen in the topical treatment of burns and chronic wounds and in its use as a coating for many medical devices. However, silver has been unsuccessful in certain applications, such as the Silzone heart valve. In other settings, such as orthopedic hardware coatings, its benefit remains unproved. Conclusion: Silver remains a reasonable addition to the armamentarium against infection and has relatively few side effects. However, one should weigh the benefits of silver-containing products against the known side effects and the other options available for the intended purpose when selecting the most appropriate therapy.

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Effectiveness of different central venous catheters for catheter-related infections: a network meta-analysis

Cited by 72 publications

References 74 publications

Deferred Consent for Randomized Controlled Trials in Emergency Care Settings

Deferred Consent for Randomized Controlled Trials in Emergency Care Settings

The sol–gel synthesis of cotton/TiO2 composites and their antibacterial properties

Use of Silver in the Prevention and Treatment of Infections: Silver Review

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