Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy
Antibiotics,
Год журнала:
2025,
Номер
14(1), С. 27 - 27
Опубликована: Янв. 3, 2025
Introduction:
Vascular
access
device
(VAD)-associated
infections,
including
catheter-related
(CRBSI)
and
catheter-associated
bloodstream
infections
(CABSI),
present
significant
challenges
in
patient
care.
While
multidisciplinary
VAD
teams
(VATs)
are
equipped
with
protocols
for
managing
these
adherence
to
guidelines
real-life
practice
is
inconsistent.
This
study
aims
evaluate
the
alignment
between
actual
infection
management
practices
VAT-recommended
protocols.
Methods:
We
conducted
a
retrospective,
single-center
at
Luigi
Sacco
Hospital
(May
2021-October
2023)
involving
non-ICU
adult
patients
diagnosed
CRBSI
or
CABSI.
VAT
experts
independently
reviewed
choices,
which
were
divided
into
eight
specific
procedural
options.
These
options
included
variations
removal,
timing
of
repositioning,
combinations
antimicrobial
lock
therapy
systemic
therapy.
Concordance
recommendations
was
evaluated
using
Cohen's
kappa
coefficient.
Results:
Of
2419
placements,
146
(6%)
developed
(84
CABSI,
62
CRBSI).
Clinicians
removed
VADs
66.4%
cases
compared
62.3%
per
recommendations,
moderate
overall
agreement
(Cohen's
=
0.58).
Analysis
categories
revealed
low
(unweighted
0.44,
weighted
0.30)
guidance,
slightly
improved
concordance
cases.
Conclusions:
Our
findings
underscore
discrepancy
protocols,
suggesting
need
clearer,
more
accessible
increased
collaboration.
Enhanced
consultation
simplified
protocol
dissemination
may
improve
consistency
ultimately
lead
better
outcomes.
Язык: Английский
Medication Safety in Intravenous Therapy: Compatibility of Etoposide with Frequently Drugs Used in Tumour Critical Care During Simulated Y-Site Administration
Drug Design Development and Therapy,
Год журнала:
2025,
Номер
Volume 19, С. 1147 - 1161
Опубликована: Фев. 1, 2025
Etoposide
is
an
antineoplastic
agent
widely
used
to
treat
pediatric
and
adult
cancers.
Critically
ill
patients
are
expected
receive
several
intravenous
pharmaceutical
drugs
while
admitted
hospitals.
When
compatibility
data
available,
may
be
administered
simultaneously
through
the
Y-site.
This
study
aimed
determine
of
etoposide
during
simulated
Y-site
administration
with
45
continuous-infusion
that
commonly
in
tumor
critical
care
units.
was
diluted
a
concentration
0.25
mg/mL
0.9%
sodium
chloride
(NS)
other
intravenously
tested
were
reconstituted
according
manufacturer's
recommendations
final
clinical
desired
concentrations.
vitro
by
mixing
5
mL
medications
under
aseptic
conditions
1:1
ratio.
Compatible
solutions
withdrawn
at
certain
time
intervals
(0,
1,
2,
4
hours)
after
visually,
using
Tyndall
beam,
pH,
turbidity,
insoluble
particles,
UV
absorption
as
measures
compatibility.
compatible
38
(84%)
within
four
hours.
Glutathione
human
granulocyte
colony-stimulating
factor
immediately
showed
incompatibility
etoposide.
Within
1
h,
(cefuroxime
sodium,
ilaprazole
mycophenolate,
xuebijing)
incompatible.
one
(ceftazidime)
also
found
incompatible
observation.
Seven
common
h.
If
co
inevitable
drug
infused
port
catheter,
larger
volume
saline
or
dextrose
5%
water
(D5W)
should
flush
catheter
before
infusion
clean
lumen
catheter.
Язык: Английский
Physicochemical Characteristics of Cardiological Drugs and Practical Recommendations for Intravenous Administration: A Systematic Review
Scientia Pharmaceutica,
Год журнала:
2025,
Номер
93(1), С. 13 - 13
Опубликована: Март 12, 2025
Most
cardiological
drugs
need
intravenous
administration
to
have
a
fast
effect
in
an
emergency.
Intravenous
is
linked
complications,
such
as
tissue
infiltration
and
thrombophlebitis.
Aiming
supply
effective
tool
for
the
development
of
appropriate
policies,
this
systematic
review
provides
practical
recommendations
about
diluent,
pH,
osmolarity,
dosage,
vesicant
properties,
phlebitis
rate
most
commonly
used
evaluated
randomized
controlled
trials
(RCTs)
till
31
August
2024.
The
authors
searched
available
IV
RCTs
PUBMED
EMBASE®,
EBSCO-CINAHL®,
Cochrane
Controlled
Clinical
trials.
Drugs’
chemical
features
were
obtained
online,
drug
data
sheets,
scientific
papers,
establishing
that
with
pH
<5
or
>9,
osmolarity
>
600
mOsm/L,
high
incidence
reported
literature,
well
drugs,
require
utmost
caution
during
administration.
A
total
857
papers
316
studies
included.
84
identified,
which
only
(37%)
can
be
safely
infused
via
peripheral
route.
Thrombolytics
anticoagulants
are
considered
safest
classes
one
flagged
“red
flag”
medication.
However,
higher
percentage
other
categories
meet
criteria,
including
antiarrhythmics
(52%),
antiplatelet
agents
(67%),
diuretics
antihypertensives
(70%),
(77%),
vasoconstrictors
inotropics
(89%).
Understanding
physicochemical
properties
essential
significantly
improving
patient
safety
preventing
errors
local
side
effects.
Язык: Английский
Femoral venous access: State of the art and future perspectives
The Journal of Vascular Access,
Год журнала:
2023,
Номер
unknown
Опубликована: Ноя. 13, 2023
In
the
past
5
years,
non-dialysis
femoral
venous
access
has
changed
in
terms
of
indications,
techniques
insertion,
and
expected
incidence
complications.
To
traditional
non-emergency
indication
for
catheters-obstruction
superior
vena
cava-many
other
indications
have
been
added,
both
intensive
non-intensive
care.
The
insertion
technique
evolved,
thanks
to
ultrasound
guided
venipuncture,
tunneling,
based
intraprocedural
tip
location.
Insertion
femorally
inserted
central
catheters
may
be
today
regarded
as
a
procedure
with
an
extremely
low
post-procedural
risk.
risk
infection
is
reduced
by
possibility
exit
site
at
mid-thigh,
use
cyanoacrylate
glue
sealing
site,
appropriate
strategies
prevention.
catheter-related
thrombosis
low,
due
several
concomitant
strategies:
proper
match
between
vein
diameter
catheter
caliber;
accurate
assessment
location
and/or
intracavitary
ECG;
consistent
venipuncture
micro-introducer
kits;
adequate
stabilization
site.
mechanical
complications
lumen
occlusion
are
minimized
when
using
polyurethane,
power
injectable
catheters.
All
these
novelties
brought
revolution
field
access,
so
that
this
route
considered
safe
effective
approaches
catheterization.
Язык: Английский
Development of an Evidence-Based List of Non-Antineoplastic Vesicants
Journal of Infusion Nursing,
Год журнала:
2024,
Номер
47(5), С. 290 - 323
Опубликована: Авг. 27, 2024
Infiltration
of
a
vesicant,
called
extravasation
,
can
result
in
severe
patient
injuries.
Recognition
vesicants
and
their
relative
risk
injury
is
essential
to
prevention,
early
recognition,
appropriate
treatment.
In
this
article,
the
Vesicant
Task
Force
(VTF)
updates
previously
published
Infusion
Nurses
Society
(INS)
vesicant
list
from
2017.
The
2024
INS
diverges
earlier
lists,
such
as
2017
VTF
list,
by
adopting
stratification
approach
based
upon
documented
outcomes,
contrast
reliance
on
expert
consensus
or
only
surrogate
indicators,
pH
osmolarity.
methodology
used
create
updated
explained,
criteria
for
high-
moderate-risk
cautionary
are
defined.
Язык: Английский
Poland’s first vascular access team 3-year analysis: Insights and learnings
The Journal of Vascular Access,
Год журнала:
2024,
Номер
unknown
Опубликована: Май 6, 2024
Background:
During
the
COVID-19
pandemic,
Poland
saw
a
surge
in
interest
midline
catheters
(MCs)
and
Long
Peripheral
Catheters
(LPCs)
for
intravenous
therapy.
Before
this,
MCs
were
not
extensively
utilised
country,
there
was
no
formally
established
Polish
vascular
access
team.
MCs,
which
have
been
used
years
many
countries,
are
now
becoming
increasingly
common
Poland.
This
study
aimed
to
analyse
use
of
3-year
perspective
their
introduction
daily
clinical
practice
based
on
nurse-led
Vascular
Access
Team
(VAT).
Methods:
The
records
adult
patients
who
received
therapy
with
727
293
LPCs
from
January
2021
December
2023
at
University
Clinical
Centre
Medical
Warsaw
analysed.
Results:
main
indication
cannulation
expected
over
5
days
(81.66%,
n
=
833),
71.37%
(
728)
this
group
had
concomitant
difficult
(DIVA).
Over
6
years,
centrally
inserted
central
(CICCs)
due
DIVA
reduced
108
2017
18
2023.
end
reason
removal
64.6%
659),
including
death
switch
CICCs
as
well.
Complications
leading
premature
accounted
31.2%,
such
as:
occlusion
(14.6%),
patient
self-removal
(7.1%)
thrombosis
(3.43%).
Conclusions:
possible
option
peripheral
venous
reduces
CVCs.
Developing
programmes
should
be
investing
staff
competencies,
increases
success
rates.
nurses
physicians
trained
infusion
care
achieve
better
results
LPCs.
Increasing
competence
is
necessary
implementation
full-service
top-level
functioning
VAT.
Язык: Английский
Epidemiology and Clinical Insights of Catheter-Related Candidemia in Non-ICU Patients with Vascular Access Devices
Microorganisms,
Год журнала:
2024,
Номер
12(8), С. 1597 - 1597
Опубликована: Авг. 6, 2024
Vascular
access
devices
(VADs),
namely
peripheral
VADs
(PVADs)
and
central
venous
(CVADs),
are
crucial
in
both
intensive
care
unit
(ICU)
non-ICU
settings.
However,
VAD
placement
carries
risks,
notably
catheter-related
bloodstream
infections
(CRBSIs).
Язык: Английский
Optimizing Infusate Flow Patterns for Minimizing Vein Wall Trauma: An Exploratory Study with a Modified off-Axis Catheter Tip Opening
Amit Bahl,
S. Matthew Gibson,
A.James Walton
и другие.
Therapeutics and Clinical Risk Management,
Год журнала:
2024,
Номер
Volume 20, С. 559 - 566
Опубликована: Сен. 1, 2024
Modifying
the
PIVC
tip
to
direct
infusates
toward
areas
of
highest
hemodilution
may
reduce
vein
wall
damage.
This
study
compared
flow
patterns
between
a
traditional
with
central
opening
and
one
an
off-axis
aperture.
Язык: Английский
Analysis of the Integrated Management Model of Medical Care and Medication in Intravenous Treatment for Critically Ill Patients
Journal of Multidisciplinary Healthcare,
Год журнала:
2024,
Номер
Volume 17, С. 4793 - 4801
Опубликована: Окт. 1, 2024
To
explore
the
effect
of
Integrated
Management
Model
Doctor-Nurse-Pharmacist
Collaboration
on
Safety
Intravenous
Therapy
in
Critically
Ill
Patients.
Язык: Английский
Correlation Between the Use of Vesicant Medications and The Incidence of Phlebitis in Pediatric Ward
Journal of Pharmacy And Bioallied Sciences,
Год журнала:
2024,
Номер
16(Suppl 4), С. S4103 - S4106
Опубликована: Дек. 1, 2024
Phlebitis
is
an
inflammatory
process
that
characterized
by
inflamed
venous
endothelial
cells.
Vesicant
medications
are
found
to
be
one
of
the
causes
phlebitis,
especially
in
pediatric
patients.
To
investigate
correlation
between
use
vesicant
and
phlebitis
incidence.
The
study
was
descriptive
observational
conducted
over
period
June-July
2022
a
ward.
inclusion
criteria
were
male
or
female
inpatients,
aged
1
month-18
years,
receiving
medication
via
intravenous
infusion
for
>24
hours.
data
obtained
then
analyzed
correlations
using
bivariate
multivariate
analysis.
A
total
174
patients
met
criteria;
27.6%
experienced
37.9%
received
medications.
most
frequently
used
ward
gentamicin
(74.24%).
vesicants
administration
>3
drugs
showed
statistically
significant
results
associated
with
incidence
RR:
4.17
(P
<
0.001;
CI
=
2.1-8.3)
RR
2.6
0.012;
1.2-5.5),
respectively.
test
risk
factor
OR
4.41
2.0-9.7).
inpatient
Язык: Английский