Catheter-related bacteremia in a jugular site with tracheostomy and in a femoral site

L Lorente,J Martínez,S Palmero,C García,J Iribarren,J Castedo,J Jiménez,R Galván,M Mora,C Naranjo

doi:10.1186/cc8618

Abstract

In previous guidelines of the Centers for Disease Control and Prevention (CDC) [1] and in the recently published Guidelines of the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) [2] it is recommended to avoid the femoral access to reduce the risk of catheter-related bacteremia (CRB). However, in these guidelines there are no recommendations for the catheter site regarding the presence of tracheostomy, and we have not found data about the incidence of CRB comparing a central jugular site with tracheostomy and a femoral site. The objective of this study was to determine whether a jugular site with tracheostomy may have a higher risk of CRB than a femoral site.

Highlights

We previously showed that erythropoietin (EPO) attenuates the morphological signs of spinal cord ischemia/reperfusion (I/R) injury in swine [1] without, improving neurological function
The clinical use of EPO has been cautioned most recently due to serious safety concerns arising from an increased mortality in acute stroke patients treated with EPO and simultaneously receiving systemic thrombolysis [2]
Sodium 4-phenylbutyrate (PBA) has been reported to act as a chemical chaperone inhibiting Unfolded protein response (UPR)-mediated apoptosis triggered by ischemia in various organs other than the heart

Summary

Introduction

We previously showed that erythropoietin (EPO) attenuates the morphological signs of spinal cord ischemia/reperfusion (I/R) injury in swine [1] without, improving neurological function. Methods We studied 90 patients affected by severe sepsis or septic shock previously enrolled in a prospective trial regarding the impact of glycemic control on inflammation and coagulation. In a retrospective analysis of the data from the SBITS-trial [1] we investigated whether the initial level of serum IgG on admission to the hospital in patients with sepsis and septic shock (before the first administration of the first dose of intravenous immunoglobulins) could be seen as a prognostic parameter for the primary outcome, lethality on day 28, or the secondary endpoints, lethality on day 7 or on the ICU. The aim of this analysis was to assess the impact of real-time continuous glucose monitoring (CGM) on glucose variability in critically ill patients receiving intensive insulin therapy (IIT) Methods This is the post hoc analysis of a prospective, randomized, controlled trial [2]. Respecting anonymity we have statistically evaluated 103 replies (response rate was 13.8%) and compared with data from other European countries

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