Criteria of Stephan et al for Use of a Urinary Catheter in a Surgical Patient

Description

Stephan et al listed criteria for the placement of urinary catheters in patients undergoing orthopedic or abdominal surgery. Reduced frequency and duration of catheter use is associated with significant decreases in urinary tract infections, the use of antibiotics and noninfectious complications. The authors are from the University of Geneva.

Patient groups:

(1) hip replacement or related surgery

(2) total knee replacement

(3) abdominal surgery

Reason for Catheter Placement in the OR	Hip Replacement	Knee Replacement
age	> 75 years	> 80 years
ASA class	III to V	NA
weight	obesity	obesity
urinary incontinence	present	present

Other reason for placement of a urinary catheter:

(1) predicted duration of surgery > 5 hours

(2) clinical judgment during postanesthesia care

Urinary catheters are not placed:

(1) just because the patient had not urinated during recovery

(2) based on urinary bladder volume measurements

Criteria for Removal	Hip Replacement	Knee Replacement
postoperative day	2 (third day of use)	1 (second day of use)

A catheter placed because of long duration surgery was usually removed before the patient left the ICU or PACU.

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Criteria of Stephan et al for Use of a Urinary Catheter in a Surgical Patient

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