Acute and Critical Care

Young Ho Jang

2 Articles

Central Venous Catheter-related Infection in Major Burn Patients: Comparison of Subclavian Vein and Femoral Vein: Young Ho Jang, Yong Hoon Son, Sang Kyu Kim, Joon Mo Park, Mi Young Lee, Jin Mo Kim; Korean J Crit Care Med. 2011;26(4):245-249.; DOI: https://doi.org/10.4266/kjccm.2011.26.4.245

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BACKGROUND
A central venous catheter (CVC) is usually inserted in patients with severe burns and the selection of the CVC is often difficult due to widespread burned skin. We investigated the incidences of colonization and catheter-related blood stream infection (CRBSI) according to the insertion site of the CVC in major burn patients METHODS: In 63 adult massive burn patients in the intensive care unit, 93 CVCs (47 polyurethane standard CVCs and 46 Oligon anti-mocrobial CVCs) were randomly inserted via the subclavian vein (SCV group, n = 66) or femoral vein (FEV group, n = 27). All catheter tips removed were routinely cultured. Bacterial findings from the burn wound and peripheral blood were also monitored in all patients RESULTS: There was no significant difference in the average insertion length of the CVC (14.3 +/- 6.8 days in SCV and 13.6 +/- 3.8 days in FEV) between the two groups. There were no significant differences in CVC colonization (48.5% in SCV and 63.0% in FEV) and CRBSI (7.6% in SCV and 11.1% in FEV) between the two groups. Logistic analysis found that the use of polyurethane standard CVC is significantly associated with increased risk of CVC colonization (odds ratio = 2.68) CONCLUSIONS: The placement of the CVC via the femoral vein does not increase the incidence of CVC colonization in massive burn patients. The use of Oligon anti-microbial CVC may be helpful to reduce CVC colonization in major burn patients.

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An Ounce of Prevention Saves Tons of Lives: Infection in Burns
Nishant Merchant, Karen Smith, Marc G. Jeschke
Surgical Infections.2015; 16(4): 380. CrossRef

Subclavian Vein Catheterization by Using 24-Gauge Peripheral Angiocatheter in Pediatric Cadiovascular Surgical Patients: Jin Mo Kim, Young Ho Jang, Jae Hong Park; Korean J Crit Care Med. 2005;20(2):159-164.

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Abstract PDF: BACKGROUND
Central venous catheterization (CVP) often leads to unacceptable complications, especially in pediatrics. To reduce these complications, we modified the venipucture by using 24-gauge peripheral angiocatheter (24-AG) in pediatric patients. METHODS: A 24-AG attached to a 3 cc syringe instead of a thin-wall steel needle in the commercial CVP kit was inserted and advanced in the direction of the inmominate vein with 45degrees angle. When blood was observed in the syrige, the 24-AG was more advanced into the subclavian vein and the 24-AG stylet was removed. A J-guide wire was inserted through lumen of the angiocather. The following procedure was the same as the Sheldinger technique. RESULTS: 202 pediatric patients received subclavian venipuncture by the method mentioned above. The overall success rate was 96.5%. The rate of success for the first attempt was 85.6% and the average number of venipuncture was 1.3+/-0.1. The overall complications was 6.4%, including hematoma formation (1.5%), pneumothorax (1.5%), bleeding at the puncture site (1.0%), mild hemothorax (0.5%) and pleural puncture without pneumothorax (2.0%). CONCLUSIONS: The subclavian venepuncture by using 24-gauge peripheral angiocatheter was reliable and useful technique in pediatric patients. The overall complications by this method was reduced compared to other reports.

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