新生儿重症监护病房中中心和非中心静脉导管相关并发症。

Complications associated with central and non-central venous catheters in a neonatal intensive care unit.

机构信息

Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520-8064, USA.

出版信息

J Perinatol. 2012 Dec;32(12):941-6. doi: 10.1038/jp.2012.7. Epub 2012 Feb 16.

DOI:10.1038/jp.2012.7

PMID:22343397

Abstract

OBJECTIVE

The objective of this study is to compare complication rates between peripherally inserted central catheters (PICCs) and peripherally inserted non-central catheters (PINCCs) in the neonatal intensive care unit (NICU).

STUDY DESIGN

A retrospective, observational study was conducted. The PICCs were catheters whose tip terminated in the vena cavae, and PINCCs were defined as those whose tip fell short of this location. Complication rates were assessed using generalized estimating equations modeling.

RESULT

A total of 91 PINCCs and 889 PICCs were placed in 750 neonates. In all, 44.0% of PINCCs had a major complication compared with 25.2% of PICCs (P=0.0001). The unadjusted (unadj.) complication rate among PINCCs was 51.7 per 1000 line days and 15.9 for PICCs (unadj. rate ratio: 3.25; 95% confidence interval (CI): 2.32, 4.55). After adjusting for multiple confounders, the risk remained significantly higher for PINCCs (adjusted odds ratio: 2.41; 95% CI: 1.33, 4.37).

CONCLUSION

The rate of associated complications with the use of PINCCs in the NICU population is more than twice that of the PICCs.

摘要

目的

本研究旨在比较新生儿重症监护病房（NICU）中经外周静脉置入的中心静脉导管（PICC）和外周静脉置入的非中心静脉导管（PINCC）的并发症发生率。

设计

回顾性观察性研究。PICC 是指尖端位于腔静脉的导管，PINCC 则定义为尖端未达到此位置的导管。使用广义估计方程模型评估并发症发生率。

结果

在 750 例新生儿中，共置入 91 根 PINCC 和 889 根 PICC。总的来说，44.0%的 PINCC 发生了主要并发症，而 25.2%的 PICC 发生了（P=0.0001）。未经调整（unadj.）的 PINCC 并发症发生率为每 1000 个导管日 51.7 例，PICC 为 15.9 例（unadj. 率比：3.25；95%置信区间（CI）：2.32，4.55）。在调整了多个混杂因素后，PINCC 的风险仍然显著更高（调整后的优势比：2.41；95%CI：1.33，4.37）。