McCullen Kim L, Pieper Barbara
St. John Hospital and Medical Center, Detroit, MI 48306, USA.
J Wound Ostomy Continence Nurs. 2006 Mar-Apr;33(2):133-9. doi: 10.1097/00152192-200603000-00006.
To identify variables associated with extravasation and resulting tissue damage in neonates with peripheral intravascular therapy.
A retrospective chart review was completed.
Randomly selected medical records of 25 neonates admitted to a neonatal intensive care unit from January 2003 through April 2004 and who experienced peripheral intravascular infiltration were examined.
The Neonatal Tissue Extravasation Tool was created to reflect common descriptive variables of the neonatal population and infused solutions used in their care. Tissue damage was classified with the scale from the Task Force of Pediatric Nursing Research Committee, 1994.
Charts of 15 female and 10 male infants 24 to 39.6 weeks old were reviewed. Extravasation was not significantly related to age, weight, or sex. The most common intravenous medications were total parenteral nutrition (n = 19) and calcium (n = 18). Peripheral intravenous sites were secured with tape. The sites of the infiltrate were the arm (n = 16), foot/leg (n = 5), and scalp (n = 3) (one not recorded). Stages 0 (absence of redness, pain, swelling; flushes with ease) (n = 11) and 4 (severe swelling; blanching, pain, skin breakdown, etc.) (n = 6) were the most common stages. The site of the infiltrate was measured and care described in only 9 neonates.
The intravascular solutions causing the most extensive damage from extravasation were similar to those reported in other studies. No other potential risk factors were identified, but poor documentation about the extravasation site and management of skin damage hampered data collection via retrospective chart review.
确定与接受外周血管内治疗的新生儿渗出及由此导致的组织损伤相关的变量。
完成一项回顾性病历审查。
检查了2003年1月至2004年4月入住新生儿重症监护病房且发生外周血管内渗透的25例新生儿的随机抽取病历。
创建了新生儿组织渗出工具，以反映新生儿群体的常见描述性变量及其护理中使用的输注溶液。根据1994年儿科护理研究委员会特别工作组的量表对组织损伤进行分类。
审查了15名女婴和10名男婴的病历，年龄在24至39.6周之间。渗出与年龄、体重或性别无显著相关性。最常见的静脉用药是全胃肠外营养（n = 19）和钙（n = 18）。外周静脉部位用胶带固定。渗透部位为手臂（n = 16）、足部/腿部（n = 5）和头皮（n = 3）（1例未记录）。0期（无发红、疼痛、肿胀；易于冲洗）（n = 11）和4期（严重肿胀；皮肤变白、疼痛、皮肤破损等）（n = 6）是最常见的阶段。仅对9例新生儿测量了渗透部位并描述了护理情况。
导致渗出造成最广泛损伤的血管内溶液与其他研究报告的相似。未发现其他潜在风险因素，但关于渗出部位和皮肤损伤处理的记录不佳妨碍了通过回顾性病历审查收集数据。
