tailieunhanh - Báo cáo y học: "Prevention of central venous catheter-related infection in the intensive care unit"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Prevention of central venous catheter-related infection in the intensive care unit. | Frasca et al. Critical Care 2010 14 212 http content 14 2 212 CRITICAL CARE REVIEW L_ Prevention of central venous catheter-related infection in the intensive care unit Denis Frasca Claire Dahyot-Fizelier Olivier Mimoz This article is one of ten reviews selected from the Yearbook of Intensive Care and Emergency Medicine 2010 Springer Verlag and co-published as a series in Critical Care. Other articles in the series can be found online at http ccforum series yearbook. Further information about the Yearbook of Intensive Care and Emergency Medicine is available from http series 2855. Introduction In the USA more than five million patients require central venous access each year. Unfortunately central venous access can be associated with adverse events that are hazardous to patients and expensive to treat. Infection remains the main complication of intravascular catheters in critically ill patients. Catheter-related bloodstream infections have been reported to occur in 3 to 8 of inserted catheters and are the first cause of nosocomial bloodstream infection in intensive care units ICUs with 80 000 cases annually at a cost of 300 million to billon 1 . Additional financial costs may be as high as 30 000 per survivor including one extra week in the ICU and two to three additional weeks in the hospital. Attributable mortality rates range from 0 to 35 depending on the degree of control for severity of illness. The physiopathology of catheter infection is now more clearly understood. Colonization of the endovascular tip of the catheter precedes infection and arises by two main pathways The extraluminal and the intraluminal routes Fig. 1 2 . Migration of skin organisms from the insertion site into the cutaneous catheter tract with colonization of the catheter tip is the most common route of infection for short-term central venous catheters CVCs . For long-term catheters . catheters staying in place more than 15 days the main cause of .

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