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Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update
- Part of
- Lisa Saiman, Jane D. Siegel, John J. LiPuma, Rebekah F. Brown, Elizabeth A. Bryson, Mary Jo Chambers, Veronica S. Downer, Jill Fliege, Leslie A. Hazle, Manu Jain, Bruce C. Marshall, Catherine O’Malley, Suzanne R. Pattee, Gail Potter-Bynoe, Siobhan Reid, Karen A. Robinson, Kathryn A. Sabadosa, H. Joel Schmidt, Elizabeth Tullis, Jennifer Webber, David J. Weber
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 35 / Issue S1 / August 2014
- Published online by Cambridge University Press:
- 10 May 2016, pp. s1-s67
- Print publication:
- August 2014
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- Article
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- You have access Access
- Open access
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The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:
1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.
2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.
22 - Imaging
- Edited by Nicholas R. Banner, Julia M. Polak, Imperial College of Science, Technology and Medicine, London, Magdi H. Yacoub, University of London
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- Book:
- Lung Transplantation
- Published online:
- 06 January 2010
- Print publication:
- 15 May 2003, pp 274-293
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- Chapter
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Summary
Introduction
The expected radiological appearances and potential surgical complications of lung transplantation vary depending on the type of transplantation that has been performed(see Chapters 13 and 14). Whereas the appearances of medical complications such as rejection, infection and malignancy are common to all types of lung transplant. Some findings are unique to lung transplantation whereas others are related to the effects of cardiothoracic surgery in general. Radiological investigation may provide a specific diagnosis but many pulmonary complications have a nonspecific appearance and their differential diagnosis must be established from the clinical context and from laboratory investigation (see Chapters 20, 21 and 23). Therefore close correlation with time-related clinical and pathological findings is essential.
Postoperative complications
Early complications of lung transplant surgery include haemothorax, pneumothorax, effusion, infection and wound complications.
Haemothorax
This is usually related to surgical bleeding, which is more likely to occur in patients who have undergone previous surgery and those who underwent cardiopulmonary bypass as part of the surgical procedure. Computed tomography (CT) of the chest can localize the extent of a haemothorax and define any underlying parenchymal abnormality.
Pneumothorax
This may occur in all types of lung transplantation and was found in 10% of one series of 138 patients [1]. In heart-lung transplantation it may be bilateral due to the communication between the two pleural spaces; in bilateral sequential lung transplantation performed through an anterior clam shell incision, a similar communication between the pleural spaces occurs anteriorly. Postoperative pneumothoraces may be therefore be unilateral, bilateral and may shift between sides with changes in the patient's posture.
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