Department of Anaesthesia, Royal Darwin Hospital, Tiwi, NT 0810, Australia.
BMC Anesthesiol. 2013 Dec 24;13(1):49. doi: 10.1186/1471-2253-13-49.
There are wide variations in the physical designs and attributes between different brands of intravenous cannulae that makes product selection and purchasing difficult. In a systematic assessment to guide purchasing, we assessed two cannulae - Cannula P and I. We proposed that the results of in-vitro performance testing of the cannulae would be associated with preference after clinical comparison.
We designed an observer-blinded randomised head-to-head trial between the 18, 20 and 22 gauge versions of Cannula P and I. Our primary end-point was pressure (mmHg) generated during various flow rates and our secondary end-point was the force (Newton) required to slide the catheter away from the needle. This was followed by a prospective electronic survey following a two-week clinical trial period.
The mean difference in resistance between Cannula P and I was: 307 mmHg.L-1.hr-1 (95% CI: 289-325, p < 0.001) for 22G; 135 mmHg.L-1.hr-1 (95% CI: 125-144, p < 0.001) for 20G; and 27 mmHg.L-1.hr-1 (95% CI: 26-28, p < 0.001) for 18G. The mean difference in the force needed to displace the catheter away from its needle was: 1.41 N (95% CI: 1.09-1.73, p < 0.001) for 22G; 0.19 N (95% CI: -0.04-0.41, p = 0.12) for 20G; and 1.96 N (95% CI: 1.40-2.52, p < 0.001) for 18G. After a trial period, all 16 anaesthetist who had used both cannulae preferred Cannula I to P.
The evaluation process described here could help hospitals improve efficient product selection and purchasing decisions for intravenous cannulae.
不同品牌的静脉留置针在物理设计和属性方面存在很大差异,这使得产品选择和采购变得困难。在一项系统评估中,我们对两种留置针——P 型和 I 型留置针进行了评估,以指导采购。我们假设留置针的体外性能测试结果将与临床比较后的偏好相关。
我们设计了一项盲法随机头对头试验,比较了 18G、20G 和 22G 规格的 P 型和 I 型留置针。主要终点是在不同流速下产生的压力(mmHg),次要终点是将导管从针头上滑开所需的力(牛顿)。随后,在为期两周的临床试验结束后进行了前瞻性电子调查。
P 型和 I 型留置针之间的阻力差异平均值为:22G 时为 307mmHg·L-1·hr-1(95%CI:289-325,p<0.001);20G 时为 135mmHg·L-1·hr-1(95%CI:125-144,p<0.001);18G 时为 27mmHg·L-1·hr-1(95%CI:26-28,p<0.001)。将导管从针头上移开所需的力的差异平均值为:22G 时为 1.41N(95%CI:1.09-1.73,p<0.001);20G 时为 0.19N(95%CI:-0.04-0.41,p=0.12);18G 时为 1.96N(95%CI:1.40-2.52,p<0.001)。在试验期间,所有 16 名使用过两种留置针的麻醉师都更喜欢 I 型留置针。
这里描述的评估过程可以帮助医院提高静脉留置针产品选择和采购决策的效率。