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Induction Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Theoretical risks associated with Foley catheter use include bleeding, fever, displacement of the presenting part, and premature rupture of membranes (PROM) (Figure 23.2). However, no randomized trial has shown an increase in these complications in comparison to other methods. Foley should not be used in women with low-lying placentas. Overall, the Foley catheter is an inexpensive, safe, well-tolerated, and easy tool for cervical dilation [56]. In a review of over 1200 low-risk women who received the intracervical Foley catheter for cervical ripening, there were no adverse events necessitating delivery in the pre-induction ripening period [57]. In a meta-analysis of 26 trials including 5563 women, there was no increased risk of infectious morbidity with Foley catheter use [56]. Foley is as effective as other methods, including misoprostol, and possibly safer than pharmaceutical methods and should be considered as first line in all inductions (see Chap. 21).
Invasive hemodynamic monitoring in obstetrics
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Luis D. Pacheco, Shannon Clark, Gary D. V. Hankins
In addition to mechanical complications, catheter-related infections pose a significant risk to the patient. Infection of the CVC may occur locally at the insertion site, from hub colonization and subsequent infection through the catheter lumen, or through hematogenous seeding of the catheter (5). The Centers for Disease Control and Prevention recommend the subclavian vein as the site of choice to reduce the risk of catheter-related sepsis (9). The Institute for Healthcare Improvement recommends five steps to reduce central-line infections: hand washing, maximal barrier precautions, chlorhexidine skin antisepsis, selection of an optimal catheter site, and prompt removal of the CVC when no longer needed. Antiseptic-containing hubs (chlorhexidine) and antimicrobial-impregnated catheters (minocycline and rifampin) have been shown to decrease the rate of catheter-related bloodstream infections when compared with non-impregnated catheters and should be considered in all CVC insertions when the institutional infection rate exceeds 2% (4,5).
Epidural and Intrathecal Analgesia
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
As with epidural hematomas, it is possible to maximize the chance of early detection of an abscess if epidural analgesia is used in a way that does not mask the onset of neurological changes and if staff maintains a high index of suspicion. The epidural catheter insertion site should be inspected daily and note made of the patient’s temperature. The catheter should usually be removed if inflammation or tenderness at the insertion site is present. Significant local infection should be treated with the appropriate antibiotics and surgical drainage may be required. If the patient develops a fever that is higher than would be expected in the immediate postoperative period, consideration may be given to removal of the catheter, unless the perceived benefit of continuing outweighs possible risks.
The voiding VAS score is a simple and useful method for predicting POUR after laparoscopy for benign gynaecologic diseases: a pilot study
Published in Journal of Obstetrics and Gynaecology, 2022
Woo Yeon Hwang, Kidong Kim, Hye Yon Cho, Eun Joo Yang, Dong Hoon Suh, Jae Hong No, Jung Ryeol Lee, Jung Won Hwang, Sang-Hwan Do, Yong Beom Kim
Bladder catheterisation is an invasive procedure that is used as a diagnostic tool as well as the standard treatment for POUR (Baldini et al. 2009). Previous studies have shown that routine catheterisation increases hospital costs and does not necessarily hasten recovery (Ozturk and Kavakli 2016). In addition, catheterisation carries a potential risk of catheter-related infections, urethral trauma, and patient discomfort (Liang et al. 2009). A portable transabdominal ultrasound scanner is frequently used as an alternative to catheterisation in the diagnosis of POUR. The benefits include avoiding unnecessary invasive catheterisation and increased patient comfort and satisfaction (Lehman and Owen 2001; Choe et al. 2007; Al-Shaikh et al. 2009). However, routine assessment of POUR by bladder ultrasonography in all surgical patients also places a larger workload on the nursing staff. Therefore, we have considered whether there are alternative methods of voiding evaluation that are both useful and less complicated.
The Feasibility and Safety of No Placement of Urinary Catheter Following Lung Cancer Surgery: A Retrospective Cohort Study With 2,495 Cases
Published in Journal of Investigative Surgery, 2021
Yutian Lai, Xin Wang, Kun Zhou, Jianhuan Su, Guowei Che
Urinary catheters have been widely known to be used to drain the bladder when it fails to empty. A urinary catheter is routinely inserted to accurately assess urinary output and reduce risk of POUR, when thoracic surgery, including lung cancer resection, is performed. Currently, the concept of early removal of the urinary catheter on postoperative day 1 or 2 is widely believed in because prolonged indwelling urinary catheters are hypothesized to increase the rate of CAUTI and other catheter-associated adverse events and release patients discomfort caused by urinary catheter [15]. Adverse events for which the Foley catheter is responsible should be noticed, including bacterial colonization, catheter-induced infections and sequential antibiotic resistance or kidney and bladder damage [1]. It has been reported that the removal of urinary catheters within 48 h after operation contribute to a decrease the rates of CAUTI, based on the data showing that a higher increased risk of UTI observed in patients with catheterization duration >2 days [16,17].
Biofilm inhibition and antifouling evaluation of sol-gel coated silicone implants with prolonged release of eugenol against Pseudomonas aeruginosa
Published in Biofouling, 2021
Prasanth Rathinam, Bhasker Mohan Murari, Pragasam Viswanathan
Urinary catheters are an essential part of modern-day medicine practice, with significant contributions to improving clinical outcomes. Bladder catheterization is commonly performed either for a short period of 1–14 days (short-term catheterization [STC]) or >30 days (long-term catheterization [LTC]) (Siddiq and Darouiche 2012). However, the adhesion of microbes and the subsequent formation of biofilms on the implanted catheter surfaces often lead to catheter-associated urinary tract infections (CAUTIs), which account for 80% of all nosocomial urinary tract infections (UTIs) (Siddiq and Darouiche 2012). In addition, biofilm formation supports related biomineralization, which in turn blocks the catheter lumen to cause obstruction and loss of catheter functionality (Fisher et al. 2015). Indeed, with LTC, bacterial colonization and biofilm formation have become inevitable in all types of patients (Azevedo et al. 2017).