RESUMO
Purpose@#In the intensive care unit, a peripherally inserted central catheter (PICC) may be an alternative option to standard central venous catheters, particularly in patients with coagulopathies or at high risk of infection. The purpose of this research was to assess the feasibility of bedside ultrasound (US)-guided PICC placement by critical care fellows on intensive care units. @*Methods@#All bedside US-PICCs inserted by critical care fellows from July 2013 to September 2015 were retrospectively reviewed focusing on the rate of successful insertion, complications of insertion, or during maintenance. @*Results@#A total of 177 US-guided PICCs were inserted in 163 patients and included in the analysis. The median age was 62 years (IQR 50-70 years) and 104 cases (58.8%) were male. There were 172 cases (90.4%) of PICCs inserted in the upper arm. Anticoagulant therapy was used in 26 patients (14.7%) and 8 patients (5.2%) had severe coagulopathies. The median procedural time was 30 minutes (IQR 19-45 minutes). Insertion success rate was 93.2%, and there were no major complications during insertions except for malposition (12.1%). Catheters remained in place for a total of 3,878 days (median 16 days: IQR 8-31 days). There was only 1 case (0.6%) of catheter-related bloodstream infection, and 2 cases (1.2%) of symptomatic venous thromboembolism. @*Conclusion@#Bedside US-guided placement of PICCs by critical care fellows is safe and feasible. The success rate of the procedure was “acceptable,” and was not associated with significant risks of infectious and non-infectious complications, even in patients with coagulopathies.
RESUMO
Purpose@#In the intensive care unit, a peripherally inserted central catheter (PICC) may be an alternative option to standard central venous catheters, particularly in patients with coagulopathies or at high risk of infection. The purpose of this research was to assess the feasibility of bedside ultrasound (US)-guided PICC placement by critical care fellows on intensive care units. @*Methods@#All bedside US-PICCs inserted by critical care fellows from July 2013 to September 2015 were retrospectively reviewed focusing on the rate of successful insertion, complications of insertion, or during maintenance. @*Results@#A total of 177 US-guided PICCs were inserted in 163 patients and included in the analysis. The median age was 62 years (IQR 50-70 years) and 104 cases (58.8%) were male. There were 172 cases (90.4%) of PICCs inserted in the upper arm. Anticoagulant therapy was used in 26 patients (14.7%) and 8 patients (5.2%) had severe coagulopathies. The median procedural time was 30 minutes (IQR 19-45 minutes). Insertion success rate was 93.2%, and there were no major complications during insertions except for malposition (12.1%). Catheters remained in place for a total of 3,878 days (median 16 days: IQR 8-31 days). There was only 1 case (0.6%) of catheter-related bloodstream infection, and 2 cases (1.2%) of symptomatic venous thromboembolism. @*Conclusion@#Bedside US-guided placement of PICCs by critical care fellows is safe and feasible. The success rate of the procedure was “acceptable,” and was not associated with significant risks of infectious and non-infectious complications, even in patients with coagulopathies.
RESUMO
PURPOSE: Asthma prevalence, morbidity, and mortality have been increasing in the whole world in recent years, especially among children. The estimated prevalence of asthma among children in the United States has been increased by almost 40% from 1981 to 1988, making asthma a predominant cause of morbidity in childhood. Recognition of the continued significant social and economic impact of asthma has led the medical community to consider new management strategies emphasizing patient education. Educating asthmatic children about the disease can have demonstrable long-term benefits, including improved independence and compliance as well as better control of asthma symptoms. The specialized asthma summer camps were developed in the late 1960s to provide pleasant camping experiences for the children perceived to be too ill to participate in regular camps. Despite the usefulness and the need of the asthma camp programs, there are a few asthma camp programs developed in Korea. METHODS: As an effort to develop the Korean camp programs for childhood asthma, this study proposes a model of 4-days-camp program for 20 patients who diagnosed as asthma. RESULTS: This successful exercise the model will achieve better control of childhood asthma by leading the patients to participate actively in their asthma treatment. CONCLUSION: Further studies are needed to investigate empirically the positive effects of asthma education programs in camp settings in terms of asthma exacerbations and school day absences due to asthma.