AbbreviationsAKI: acute kidney inhibitor Navitoclax injury; AKIN: Acute Kidney Injury Network; CI: confidence interval; EBP: extracorporeal blood purification; RRT: renal replacement therapy.Competing interestsSMB, DNC, NG and CR have all participated in ADQI workgroups. NG and CR have participated in AKIN workgroups.AcknowledgementsSMB is supported by a Clinical Investigator Award from the Alberta Heritage Foundation for Medical Research.
Complete data were obtained for 347 patients: 246 patients in group nB, 101 patients in group B. Male/female ratios, average ages, site of insertion, clinical area of insertion and grade of practitioner were similar in both cohorts. There was a significantly higher number of 5-lumen catheters inserted in group B compared with group nB (81% compared with 44%, P < 0.
05), reflecting change in hospital practice. More B catheters (51%) were left in situ longer, for 6 to 10 days, compared with nB catheters (31%) (Figure (Figure1).1). Thirty-one per cent of nB tips grew colonies of at least one pathogen. There was a significant reduction in the number of B tips growing colonies (12% compared with 31%, P < 0.05) (Figure (Figure2).2). The bundle cohort had no MRSA growth compared with four incidences in the nB group.Figure 1Number of days CVCs were left in situ in both cohorts.Figure 2Differences in colony growth in the two cohorts. *P < 0.05.ConclusionOur results indicate that use of dedicated CVC packs was associated with a significant reduction in the colonisation rate of CVCs, despite lines being left in situ for longer periods and the more frequent use of quinlumen catheters in the intervention group.
There was also a trend toward prevention of MRSA colonisation.
Autocalibrated pressure waveform analysis by the FlowTrac/Vigileo? (FTV) system allows determination of cardiac output (CO) from the arterial pressure curve. Controversy exists about the reliability of this technique in comparison with intermittent pulmonary arterial thermodilution (IPATD), especially during cardiac surgery [1,2]. A recent meta-analysis came to the conclusion that “cardiac output values provided by the FloTrac/Vigileo? operating systems with software version 1.07 or later show acceptable agreement with ITD (intermittent thermodilution), both clinically and statistically” .
This conclusion contrasts sharply with our own results  and observations from Compton and colleagues  showing more than 40% percentage error in CO measurements by FTV in comparison with IPATD or transpulmonary thermodilution Brefeldin_A with the PiCCO?-system.When using the FTV-system in patients undergoing non-cardiac surgery and critically ill patients in the intensive care unit (ICU) we have frequently observed increases in CO following a bolus of a vasopressor titrated to achieve a normal mean arterial blood pressure (MAP).