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Central Venous Catheter-related Infection in Major Burn Patients: Comparison of Subclavian Vein and Femoral Vein
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Young Ho Jang, Yong Hoon Son, Sang Kyu Kim, Joon Mo Park, Mi Young Lee, Jin Mo Kim
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Korean J Crit Care Med. 2011;26(4):245-249.
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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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Citations
Citations to this article as recorded by
- 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
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Pharmacotherapy of the Failing Heart and Shock
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Jin Mo Kim, Yong Cheol Lee
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Korean J Crit Care Med. 2008;23(1):1-5.
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DOI: https://doi.org/10.4266/kjccm.2008.23.1.1
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2,246
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- No abstract available.
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- In vitro investigation of antioxidant and anti-apoptotic activities of Korean wild edible vegetable extracts and their correlation with apoptotic gene expression in HepG2 cells
Hwang Kyung-A, Hwang Yu-Jin, Park Dong-Sik, Kim Jaehyun, Om Ae-Son Food Chemistry.2011; 125(2): 483. CrossRef
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Subclavian Vein Catheterization by Using 24-Gauge Peripheral Angiocatheter in Pediatric Cadiovascular Surgical Patients
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Jin Mo Kim, Young Ho Jang, Jae Hong Park
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Korean J Crit Care Med. 2005;20(2):159-164.
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Abstract
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- 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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History and Background of Arterial Blood Gas Analysis
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Jin Mo Kim
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Korean J Crit Care Med. 2002;17(2):66-69.
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Abstract
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- No abstract available.
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Comparison of Hemodynamic Changes by the Thoracic Electrical Bioimpedance Device during Endotracheal Intubation or Insertion of Laryngeal Mask Airway in General Anesthesia
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Han Mok You, Jin Mo Kim, Jae Kyu Cheun
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Korean J Crit Care Med. 1998;13(1):67-72.
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Abstract
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- Introduction: we measured the hemodynamic changes by the thoracic electrical bioimpedance (TEB) device during induction of anesthesia, endotracheal intubation or insertion of layngeal mask airway (LMA). This TEB device is safe, reliable and estimate continuously and invasively hemodynamic variables.
METHODS We measured the cardiovascular response of endotracheal intubation or that of LMA insertion in thirty ASA class I patients. General anesthesia was induced with injection of fentany 1 microgram/kg, thiopetal sodium 5 mg/kg and vecuronium 1 mg/kg intravenously. Controlled ventilation was for 3 minutes with inhalation of 50% nitrous oxide and 1.5 vol% of enflurane before tracheal intubation or LMA insertion in all patients. The patient was randomly assinged to either tracheal intubation group (ET group) or laryngeal mask airway group (LMA group). Heart rate (HR), mean arterial pressure (MAP), systemic vascular resistance (SVR), stroke index (SI) and cardic index (CI) were measured to pre-induction, pre-intubation, 1 minute after intubation, 2 minute, 3 minute, 5 minute, 7 minute.
RESULTS MAP and SVR were decreased effectively LMA group than ET group during 1 minute after intubation, 2 minute, 3 minute, 5 minute, 7 minute (p<0.05). HR was decreased effectively LMA group than ET group between pre-induction and 1 minute after intubation, between 1 minute after intubation and 2 minute after intubation (p<0.05). But, SI and CI were no difference between ET group and LMA group during induction of anesthesia and intubation (p<0.05).
CONCLUSION The insertion of LMA is beneficial for certain patients than endotracheal tube to avoid harmful cardiovascular response in the management of airway during anesthesia.
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Management of the Hemodynamically Unstable Patient
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Jin Mo Kim
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Korean J Crit Care Med. 1998;13(1):1-6.
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- No abstract available.
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