Tolomeo Concettina, Mackey Wendy
Section of Pediatric Respiratory Medicine, Yale School of Medicine, New Haven, CT, USA.
Pediatr Nurs. 2003 Sep-Oct;29(5):355-9.
Cystic fibrosis (CF) is a common fatal genetic disorder characterized by chronic pulmonary infections, some of which require intravenous (i.v.) antibiotics. Peripherally inserted central catheters (PICCs) have proven to be an effective means of i.v. delivery in a variety of populations. An evaluation of the effectiveness of the use of PICCs for patients at a CF center in New England was conducted over a 25-consecutive month period. During this time, 61 PICCs were placed in 32 patients with CF requiring i.v. antibiotics. The catheters were in place for a median of 15 days (range 1-155 days). The total number of catheter days in this series was 1,139. Although no serious complications were encountered, minor complications or technical problems occurred in 18 (29.5%) of the 61 catheters. Complications included external breaks in the catheters, shoulder pain, phlebitis, catheter occlusion, accidental dislodgement, local irritation at the insertion site, and yeast infection at the insertion site. No long-term sequelae resulted, and the rate of i.v. antibiotic completion with this mode of i.v. access was high. As a result of the evaluation, PICC access remains the standard of care at this institution for patients with CF requiring i.v. antibiotics for pulmonary exacerbations.
囊性纤维化(CF)是一种常见的致命性遗传疾病,其特征为慢性肺部感染,其中一些感染需要静脉注射(i.v.)抗生素治疗。经外周静脉穿刺中心静脉置管(PICCs)已被证明是在各类人群中进行静脉给药的一种有效方式。在连续25个月的时间里,对新英格兰一家CF中心使用PICCs对患者进行治疗的有效性进行了评估。在此期间,为32例需要静脉注射抗生素的CF患者置入了61根PICCs。这些导管留置的中位时间为15天(范围1 - 155天)。该系列中导管留置的总天数为1139天。虽然未遇到严重并发症,但61根导管中有18根(29.5%)出现了轻微并发症或技术问题。并发症包括导管外部折断、肩部疼痛、静脉炎、导管堵塞、意外移位、穿刺部位局部刺激以及穿刺部位酵母菌感染。未导致长期后遗症,并且通过这种静脉通路进行静脉抗生素治疗的完成率很高。评估结果显示,对于因肺部病情加重而需要静脉注射抗生素的CF患者,PICC通路仍是该机构的标准治疗方式。