Cuper Natascha J, de Graaff Jurgen C, van Dijk Atty T H, Verdaasdonk Rudolf M, van der Werff Desirée B M, Kalkman Cor J
Department of Medical Technology & Clinical Physics, University Medical Center, Utrecht, the Netherlands.
Paediatr Anaesth. 2012 Mar;22(3):223-9. doi: 10.1111/j.1460-9592.2011.03685.x. Epub 2011 Aug 18.
It is generally believed that certain patient characteristics (e.g., Body Mass Index and age) predict difficulty of intravenous cannulation in children, but there is not much literature evaluating these risk factors. In this study, we investigated predictive factors for success rate at first attempt and time needed for intravenous cannulation.
METHODS/MATERIALS: In a prospective cohort study, we observed characteristics of intravenous cannulations in pediatric patients at the operating room (n = 1083) and the outpatient care unit (n = 178) of a tertiary referral pediatric hospital. Time to successful intravenous cannulation, success at first attempt, and potential predictors for difficult cannulation (age, gender, skin color, BMI or weight-to-age z-score, the child being awake or anesthetized, operator profession and surgical specialty) were recorded. Regression models were constructed to find significant predictors.
Success at first attempt was 73% and 81%, respectively. In the operating room age, operator and surgical specialty were predictive for a successful first attempt and time to successful cannulation. No significant predictive factors were found for the outpatient care unit. BMI or weight-to-age was not related to difficult intravenous cannulation.
This study shows that in one-fifth to one-third of the patients, intravenous cannulation required more than one attempt. It is difficult to predict with accuracy the difficulty of intravenous cannulation solely with easily obtainable patient characteristics.
人们普遍认为某些患者特征（如体重指数和年龄）可预测儿童静脉穿刺的难度，但评估这些风险因素的文献并不多。在本研究中，我们调查了首次尝试成功率及静脉穿刺所需时间的预测因素。
方法/材料：在一项前瞻性队列研究中，我们观察了一家三级转诊儿科医院手术室（n = 1083）和门诊护理单元（n = 178）儿科患者的静脉穿刺特征。记录成功进行静脉穿刺的时间、首次尝试的成功率以及穿刺困难的潜在预测因素（年龄、性别、肤色、体重指数或年龄别体重z评分、患儿清醒或麻醉状态、操作人员职业和手术专科）。构建回归模型以找出显著的预测因素。
首次尝试成功率分别为73%和81%。在手术室，年龄、操作人员和手术专科是首次尝试成功及成功穿刺时间的预测因素。在门诊护理单元未发现显著的预测因素。体重指数或年龄别体重与静脉穿刺困难无关。
本研究表明，五分之一至三分之一的患者静脉穿刺需要不止一次尝试。仅根据易于获得的患者特征很难准确预测静脉穿刺的难度。
