Johnston Andrew J, Streater Carmel T, Noorani Remy, Crofts Joanne L, Del Mundo Aldwin B, Parker Richard A
Vascular Access Team, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
J Vasc Access. 2012 Oct-Dec;13(4):421-5. doi: 10.5301/jva.5000071.
Peripherally Inserted Central Catheters (PICCs) are increasingly being used to provide short to medium-term central venous access. The current study was designed to test the hypothesis that PICC valve technology does not influence PICC occlusion rates.
Intensive care unit (ICU) patients who required a PICC were randomized to one of three types of dual lumen PICC (open ended non-valved, Groshong valve, PASV valve). PICC occlusions were recorded and managed with a protocol that used urokinase.
A total of 102 patients were recruited to the study. The overall risk of occlusion per catheter was 35% (95% CI 26% to 44%). The overall rate of occlusion was 76 occlusions per 1000 catheter days (95% CI 61 to 95). Presence or type of valve did not significantly influence this rate (open-ended non-valved PICC 38% of catheters, 79 occlusions per 1000 catheter days; Groshong 38% of catheters, 60 occlusions per 1000 catheter days; PASV 27% of catheters, 99 occlusions per 1000 catheter days). The dose of urokinase required to treat PICC occlusions did not significantly differ between PICC types.
Valved PICCs do not appear to influence PICC occlusion rates.
外周静脉穿刺中心静脉导管(PICC)越来越多地用于提供短期至中期的中心静脉通路。本研究旨在验证PICC瓣膜技术不会影响PICC堵塞率这一假设。
需要PICC的重症监护病房(ICU)患者被随机分为三种双腔PICC类型之一(开放式无瓣膜、Groshong瓣膜、PASV瓣膜)。记录PICC堵塞情况,并采用使用尿激酶的方案进行处理。
共有102名患者纳入本研究。每根导管的总体堵塞风险为35%(95%置信区间26%至44%)。总体堵塞率为每1000导管日76次堵塞(95%置信区间61至95)。瓣膜的存在或类型并未显著影响该比率(开放式无瓣膜PICC导管堵塞率为38%,每1000导管日堵塞79次;Groshong瓣膜导管堵塞率为38%,每1000导管日堵塞60次;PASV瓣膜导管堵塞率为27%,每1000导管日堵塞99次)。不同类型PICC治疗堵塞所需的尿激酶剂量无显著差异。
带瓣膜的PICC似乎不会影响PICC堵塞率。