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新生儿脐静脉导管与外周静脉穿刺中心静脉导管并发症发生率的比较。

Comparison of complication rates between umbilical and peripherally inserted central venous catheters in newborns.

作者信息

Arnts Inge Johanna Jacoba, Bullens Lauren Maria, Groenewoud Joannes Martinus Maria, Liem Kian Djien

出版信息

J Obstet Gynecol Neonatal Nurs. 2014 Mar-Apr;43(2):205-15. doi: 10.1111/1552-6909.12278. Epub 2014 Feb 6.

Abstract

OBJECTIVE

To compare the complication rates between umbilical central venous catheters and peripherally inserted central venous catheters in newborns and to investigate whether other variables might increase complication rates.

DESIGN

A retrospective observational study.

SETTING

A Level III neonatal intensive care unit (NICU).

PARTICIPANTS AND SETTING

Newborns (gestational age 24-42 weeks).

METHODS

All central venous catheter-related complications were retrospectively analyzed in newborns. The differences in survival rates between the two types of central venous catheters were evaluated using a Kaplan-Meier survival analysis with removal because of complications as the event of interest.

RESULTS

In total, 140 umbilical venous catheters and 63 peripherally inserted central catheters were included. There were no significant differences in removals due to complications between the two catheters. The central line-associated bloodstream infections had the highest complication incidence, followed by obstruction, dislocation, leakage, and extravasation. There were no influences of gestational age, birth weight, and the use of subsequent catheters on the complication incidence.

CONCLUSION

A high complication incidence resulted in removal of the catheters, but it was not significantly different between the two catheters. The prevention of complications should be an important goal in the daily care of infants in the NICU.

摘要

目的

比较新生儿脐静脉中心静脉导管和外周静脉穿刺中心静脉导管的并发症发生率,并研究其他变量是否可能增加并发症发生率。

设计

一项回顾性观察研究。

地点

三级新生儿重症监护病房(NICU)。

参与者和背景

新生儿(胎龄24 - 42周)。

方法

对新生儿所有中心静脉导管相关并发症进行回顾性分析。使用Kaplan-Meier生存分析评估两种类型中心静脉导管的生存率差异,将因并发症而拔除导管作为感兴趣的事件。

结果

共纳入140根脐静脉导管和63根外周静脉穿刺中心静脉导管。两种导管因并发症而拔除的情况无显著差异。中心静脉导管相关血流感染的并发症发生率最高,其次是堵塞、移位、渗漏和外渗。胎龄、出生体重及后续导管的使用对并发症发生率均无影响。

结论

高并发症发生率导致导管拔除,但两种导管之间无显著差异。预防并发症应是NICU日常护理中婴儿护理的重要目标。

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