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L Lorente

Publications and source records attributed to L Lorente.

50 records · Page 3Linked to original sources
PubMedDate not supplied

A randomized trial on the effect of tubing changes on hub contamination and catheter sepsis during parenteral nutrition.

In previous studies the contamination of the catheter hub was found to be a common portal of entry for bacteria causing catheter-related sepsis. Since hub manipulations during tubing changes may increase the risk of contamination, a prospective trial was conducted to find out the effects of the frequency of tubing replacements on hub colonization and catheter sepsis rates. The results were compared with those obtained during an outbreak of coagulase negative staphylococci septicemia. Fifty-two patients were randomly allocated into two groups. Group A (n = 20) had the line changes every 2 days while group B (n = 32) had it replaced every 4 days. When the catheter was removed, the catheter tip and the hub were cultured by a quantitative method. Sterile, colonized, or infected hubs were equally distributed in both groups (A: 80, 15, and 5% vs B: 84, 6, and 10%). There were three episodes of catheter sepsis, one in group A and one in group B due to hub infection, and one in group B due to hematogenous seeding of the catheter tip. There were significant (p less than 0.001) differences between the trial and the historic series in respect to rates of hub colonization infection (19 vs 50%) and catheter sepsis (5.7 vs 40%). Delaying tubing changes does not increase catheter sepsis or hub contamination rates and, together with adequate hub protection, has proved to be a valuable factor in controlling an outbreak of catheter sepsis due to the coagulase negative staphylococci.

Bacterial Infections↗
PubMedDate not supplied

A 70% hepatectomy in the rat using a microsurgical technique.

An experimental model of 70% hepatectomy in the rat using a microsurgical technique is described. An operative microscope (Carl Zeiss 10x2) dissection made it possible to identify the hilar anatomical variations and then to avoid unexpected damage to the arterio-portal and biliary branches belonging to the remaining hepatic parenchyma. The use of this microsurgical technique allows for a more homogenous experimental model because it avoids the functional impairment of the remaining liver.

Animals↗
PubMedDate not supplied

Arterial microanastomosis technique by using only one stitch.

The starting point of this work is the description of a microsurgical technique designed to carry out termino-terminal arterial anastomosis in rats. The technique is based on the intussusception of the afferent vessel of the anastomosis in the efferent vessel, both of which are fixed by a horizontal U-shaped stitch. Of the twelve cases which make up this series, haemorrhage appeared in two, and a postanastomotic aneurysm developed in one. The lack of complications both before and after operating, even in the long term, in the balance of the cases (75%), together with the simple and quick procedure of this kind of anastomosis, makes this technique a possible alternative to the classical techniques of vascular microanastomosis in experimental surgery.

Anastomosis, Surgical↗
PubMedDate not supplied

[Bacteriologic control of total parenteral nutrition formulations at the Bellvitge Hospital].

Septic complications often lead to halting nutritional parenteral therapy. In general, the source of infection lies in the mixture, the connection and/or point of catheter insertion. The objective of this study is to show the need for bacteriological control throughout the parenteral nutrition process in order to assess the efficacy of the methods used, discover the source of infection and establish an in-house quality control. Different methods for bacteriological control of parenteral nutrition mixtures are studied and are compared with the method used at our hospital which is based on routine culture sampling after the mixture is prepared and before it is perfused, on repeating bacteriological control cultures and on performing bacteriological assessments of the catheter. In order to achieve this goal, 28.501 nutritional parenteral samples from 1,782 patients were studied. Only 185 (0.65%) samples were originally positive, and only 59 of them (0.21%) remained positive following a verification culture. Of the 6 culture-verified septic cases, 5 corresponded to Enterobacter cloacae and 1 to Klebsiella pneumoniae.

Bacterial Infections↗
PubMedDate not supplied

Washout of the pig liver with Haemaccel after hypothermic preservation.

In hepatic preservation by simple perfusion and hypothermic storage, a portal and hepatic washout before revascularization would avoid receptor hyperkaliema. In this report we study the effectiveness of this washout with Haemaccel at room temperature. Large-White pigs were used and eight livers were perfused "in situ" via the portal wein with Hartmann's solution containing 10,000 IU of heparin at 4 degrees C, and afterwards, via portal and arterial routes with C2 solution at 4 degrees C. After a cold ischemia time of less than 31/2 hours a liver washout via the portal vein and hepatic artery with Haemaccel before portal revascularization was done. The high concentrations of glucose, K+, GOT, GPT and LDH in the effluents obtained during the washout are attributed to Haemaccel hyperosmolarity. A portal and arterial hepatic washout associated with free drainage of the first 50-100 ml of portal venous blood after hepatic portal revascularization through the infrahepatic inferior vena cava (IH-IVC), prevents hyperkaliemia from occurring after a portal and arterial revascularization in the orthotopic liver transplant (OLT) in pigs.

Animals↗
PubMedDate not supplied

[The bacteriological control of TPN mixtures at the Hospital de Bellvitge].

The complications of sepsis often make it necessary to suspend nutritional therapy. The origin of these is the nutritive mixture as well as the catheter connection and/or point where it has been inserted. The aim of this study is to show the need for bacteriological control of the whole process, in order to evaluate the effectiveness of the methods used, dilucidate the origin of the sepsis and establish an internal quality control. Study of different methods for bacteriological control of the nutritive mixtures, comparing them with the methods used in our Hospital, which is based on systematic culture of the mixtures, the collecting of samples after preparation and prior to perfusing the mixture through the patient, the performing of a further culture control and a bacteriological examination of the catheter. For this purpose, 28,501 nutritive mixtures were studied, corresponding to 1,782 patients. Of these, 185 samples were initially positive (0.65%) and only 59 samples showed positive cultures (0.21%). Of the 6 cases of sepsis discovered and confirmed by haemoculture, 5 corresponded to Enterobacter cloacae and 1 to Klebsiella pneumoniae.

Bacteria↗
PubMedDate not supplied

Changes in serum insulin levels during orthotopic liver transplantation in the pig.

Insulin and glucose levels were measured in 13 orthotopic liver transplantations in pigs. After portal revascularization a significant increase in the glucose levels takes place (p less than 0.01). When the infrahepatic vena cava clamp is removed, a significant increase in glucose and insulin concentrations (p less than 0.05) takes place. After the end of the operation the insulin levels decrease significantly with respect to initial values (p less than 0.05).

Animals↗
PubMedDate not supplied

Auxiliary liver transplantation in the pig without portal blood: a study of a new technique for application to the heterotopic hepatic xenotransplant.

An auxiliary liver transplantation surgical technique in the pig, in which the graft only receives blood flow via the hepatic artery since an end-to-side portacaval shunt is performed in the donor animal prior to the transplantation, is described. The functional impairment of the receptor liver was done by a ligature of the choledoch, provoking death by sepsis in six of the transplanted animals at 8.16 +/- 6.61 days post transplantation. The auxiliary liver never suffered atrophy and prevented jaundice. It can be concluded that this simple surgical technique could be applied to the heterotopic xenotransplantation when the complications inherent in the immunological aggression are eliminated.

Animals↗