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超声引导下静脉置管在儿科急诊中的应用。

VeinViewer-assisted Intravenous catheter placement in a pediatric emergency department.

机构信息

Department of Pediatric Emergency Medicine, Hasbro Children's Hospital, Providence, RI, USA.

出版信息

Acad Emerg Med. 2011 Sep;18(9):966-71. doi: 10.1111/j.1553-2712.2011.01155.x. Epub 2011 Aug 19.

Abstract

OBJECTIVES

Peripheral intravenous catheter (PIV) placement is a common, painful, and frequently difficult procedure in children. The VeinViewer is a device that delineates subcutaneous veins using near-infrared light and video technology. To the best of our knowledge, the benefit of this device for PIV placement in children in the emergency department (ED) has not been studied.

METHODS

The authors enrolled a prospective, randomized sample of children aged 0 to 17 years who required a nonemergent PIV in a tertiary care pediatric ED. Participants were randomized to standard PIV cannulation (SC) or PIV cannulation with the VeinViewer (VV). The primary outcome measure was time to PIV placement. Secondary outcome measures included number of PIV attempts and pain scores as reported by the child, parent or guardian, and nurse using a 100-mm visual analog scale (VAS).

RESULTS

A total of 323 patients completed the study: 174 boys and 149 girls. Age, sex, and body mass index (BMI) were not different between groups. There were no differences in time to PIV placement, number of PIV attempts, or pain scores for the overall study group. However, a planned subgroup analysis of children age 0 to 2 years (n = 107) did yield significant results for the geometric mean time to place the PIV (121 seconds [VV] vs. 167 seconds [SC], p = 0.047) and for nurses' perception of pain (median VAS 34 [VV] vs. 46 [SC], p = 0.01).

CONCLUSIONS

While no results were significant for the overall study group, subgroup analysis of children age 0 to 2 years suggests that the VeinViewer may decrease the time to PIV placement.

摘要

目的

外周静脉置管(PIV)是儿童中常见的、痛苦的、且常难以实施的操作。VeinViewer 是一种利用近红外光和视频技术描绘皮下静脉的设备。据我们所知,该设备在急诊科(ED)中对儿童 PIV 置管的益处尚未被研究过。

方法

作者纳入了在一家三级儿童 ED 需要非紧急性 PIV 的 0 至 17 岁的前瞻性、随机样本。参与者被随机分配至标准 PIV 置管(SC)或 VeinViewer 辅助 PIV 置管(VV)。主要结局指标为 PIV 置管时间。次要结局指标包括 PIV 尝试次数和由儿童、父母或监护人以及护士使用 100mm 视觉模拟量表(VAS)报告的疼痛评分。

结果

共有 323 名患者完成了研究:174 名男孩和 149 名女孩。组间年龄、性别和体重指数(BMI)无差异。总体研究组的 PIV 置管时间、PIV 尝试次数或疼痛评分无差异。然而,对年龄 0 至 2 岁的儿童(n = 107)的计划亚组分析确实得出了 PIV 置管时间的几何均数(121 秒[VV]比 167 秒[SC],p = 0.047)和护士对疼痛的感知(中位数 VAS 34[VV]比 46[SC],p = 0.01)有显著差异。

结论

虽然总体研究组的结果无统计学意义,但对年龄 0 至 2 岁的儿童的亚组分析表明,VeinViewer 可能会缩短 PIV 置管时间。

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