Department of Pediatrics, Meir Medical Center, Kfar Saba, Israel.
Pediatrics. 2010 Jul;126(1):e179-86. doi: 10.1542/peds.2009-2920. Epub 2010 Jun 21.
The goal was to determine the interchangeability of peripheral venous catheter (PVC) and venipuncture blood sampling (BS).
Paired blood samples from hospitalized children were obtained through venipuncture and from existing PVCs, following discard of 2 mL of blood. Comparisons of 9 complete blood count indices (white and red blood cell counts, hemoglobin and hematocrit levels, mean corpuscular volume, mean corpuscular hemoglobin level, red blood cell distribution width, platelet count, and mean platelet volume) and 5 basic chemical analysis indices (sodium, potassium, glucose, chloride, and urea levels) were performed, and hemolysis was documented.
Irrespective of gauge, blood samples were obtained successfully from 40 (85.1%) of 47 PVCs, with no abnormal hemolysis. BS through venipuncture took longer than BS from PVCs (175.8 +/- 229.6 vs 104.5 +/- 53.4 seconds; P = .053) and was associated with significantly more distress/crying (73.1% vs 0%; P < .001). There were no significant differences between venipuncture and PVC samples (paired t test). Twenty-one (6%) of 348 pairs analyzed with the Clinical Laboratory Improvement Amendment standards fell outside the range of acceptable variance (8 of 21 aberrations were attributed to glucose measurements). Bland-Altman analysis indicated that, with the exclusion of glucose measurements, BS from PVCs is reliable, with 29 (6.5%) of 448 pairs exceeding the limits of agreement. Of those, 9 cases were clinically significant, but none would have altered clinical management.
PVC sampling was shown to be a pain-reducing method that can be used for children for selected basic analytes. The findings for glucose were unreliable.
确定外周静脉导管（PVC）与静脉采血（BS）的可互换性。
通过静脉穿刺从住院儿童中获得配对的血液样本，并在丢弃 2 毫升血液后从现有的 PVC 中获得。比较了 9 项全血细胞计数指标（白细胞和红细胞计数、血红蛋白和血细胞比容水平、平均红细胞体积、平均红细胞血红蛋白水平、红细胞分布宽度、血小板计数和平均血小板体积）和 5 项基本化学分析指标（钠、钾、葡萄糖、氯和尿素水平），并记录溶血情况。
无论导管的规格如何，都成功地从 47 个 PVC 中的 40 个（85.1%）获得了血液样本，且无异常溶血。与从 PVC 中获取 BS 相比，通过静脉穿刺获取 BS 的时间更长（175.8+/-229.6 秒比 104.5+/-53.4 秒；P=0.053），并且与明显更多的痛苦/哭泣（73.1%比 0%；P<0.001）相关。静脉穿刺和 PVC 样本之间没有显著差异（配对 t 检验）。在符合临床实验室改进修正案标准的 348 对分析中，有 21 对（6%）超出了可接受的变异范围（21 个异常中有 8 个归因于葡萄糖测量）。Bland-Altman 分析表明，排除葡萄糖测量值后，从 PVC 中获取 BS 是可靠的，448 对中有 29 对（6.5%）超出了一致性范围。其中，9 例具有临床意义，但均不会改变临床管理。
PVC 采样是一种减轻疼痛的方法，可用于为儿童提供选定的基本分析物。葡萄糖的结果不可靠。
