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Clinical Approach to Case of PPH
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
A urinary catheter should be inserted. The catheter not only helps improve the uterine tone by emptying the bladder but also allows one to monitor the urine output and the effectiveness of the resuscitation. The urine output should be targeted at least 30 mL/hour.
Male urethral catheterisation
Published in Ian Mann, Alastair Noyce, The Finalist’s Guide to Passing the OSCE, 2021
Catheters are often placed in patients unnecessarily and this exposes patients to infection and urethral injury. For this reason, it is important to establish clearly the indication for inserting a catheter and whether there are any alternatives. Painful urinary retention and shock are two of the emergency scenarios in which to place a urinary catheter. Less urgent indications may include chronic urinary retention, neurological injury/disease, and post-operatively.
Kidney transplantation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Infants and small children are managed in a pediatric intensive care unit. Although most recipients are extubated in the operating room, a small infant with an adult-sized kidney may require mechanical ventilation for 1–2 days. Urine output is replaced with IV fluid milliliter for milliliter for the first 12 hours. Replacement fluids are then gradually tapered. Maintenance of adequate volume status is critical. Any concern regarding graft function should be promptly evaluated via ultrasound with Doppler. The urinary catheter is left in place for 2–3 days. If necessary, satisfactory bladder emptying may be assured with post-micturitional catheterization.
Pregnancy outcomes after ultrasound-guided high-intensity focused ultrasound (USgHIFU) for conservative treatment of uterine fibroids: experience of a single institution
Published in International Journal of Hyperthermia, 2021
J. Rodríguez, J. Isern, N. Pons, A. Carmona, E. Vallejo, J. Cassadó, J. A. De Marcos, M. Paraira, N. Giménez, A. Pessarrodona
During the procedure, the patient lay prone on a movable HIFU table with the abdominal skin in contact with cold degassed water. HIFU treatment was performed under intravenous conscious sedation (remifentanil and propofol) to reduce discomfort and prevent movement. A urinary catheter was inserted to control the volume of the bladder during treatment. An ultrasound pre-scan was conducted from the sagittal view, obtaining different sections with 5-mm separation. We started treating the deepest area of the central section by applying 1–3 s energy exposures separated by 2–4 s. This starting focal point was placed at a distance of 1 cm of the deep border of the fibroid. The output power was 300–400 W, adjusted according to the patient’s discomfort and the gray-scale changes. When the echogenicity of the target spot changed, the transducer was moved to treat the deep areas of the remaining sections and then the shallow regions. The procedure required 1–3 h depending on the number, size and location of the fibroids. The decision to stop treatment was made according to the intra-operative gray-scale sonographic changes and contrast-enhanced ultrasound (SonoVue) [45–47]. After treatment, women were observed for 3 h before being discharged.
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).