Abdeyazdan Zahra, Sheikhan-Sudani Elaheh, Sadeghnia Alireza, Talakoub Sedigheh
Department of Pediatric and Neonatal Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Student Research Committee, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Nurs Midwifery Res. 2014 Nov;19(6):643-6.
Peripheral insertion of central catheters can be difficult in neonates. We compared the success rates of peripherally inserted central catheters by two methods of using static ultrasound and traditional technique (vein visualization and palpation) in neonates.
In a prospective randomized, controlled trial, 52 neonates with birth weight lower than 1500 g in a level 3 neonatal intensive care unit were enrolled. Neonates were randomized to undergo peripherally inserted central catheter placement using a traditional technique (n = 27) versus static ultrasound-guided technique (n = 25). In the ultrasound group, vein localization was performed and the skin overlying the target vessel was marked. Insertion of catheter was then immediately performed. We recorded and compared success rates in the groups.
Success rate after the first attempt was 68% in ultrasound group and 60% in traditional group. These rates for the second attempt were 50% and 40%, respectively. The overall success rates after two attempts were 84% and 76% in ultrasound and traditional groups, retrospectively (P = 0.24).
There was no significant difference between the two groups regarding PICC success rates, probably because in the present study, most of the subjects were premature neonates whose vasculature was visually detectable.
在新生儿中，经外周静脉穿刺中心静脉置管可能具有挑战性。我们比较了在新生儿中使用静态超声和传统技术（静脉可视化和触诊）两种方法进行经外周静脉穿刺中心静脉置管的成功率。
在一项前瞻性随机对照试验中，纳入了一家三级新生儿重症监护病房中52例出生体重低于1500 g的新生儿。将新生儿随机分为两组，分别采用传统技术（n = 27）和静态超声引导技术（n = 25）进行经外周静脉穿刺中心静脉置管。在超声组中，进行静脉定位并标记目标血管上方的皮肤。然后立即进行导管插入。我们记录并比较了两组的成功率。
超声组首次尝试后的成功率为68%，传统组为60%。第二次尝试的成功率分别为50%和40%。回顾性分析显示，超声组和传统组两次尝试后的总体成功率分别为84%和76%（P = 0.24）。
两组在经外周静脉穿刺中心静脉置管成功率方面无显著差异，可能是因为在本研究中，大多数受试者为早产儿，其血管在视觉上是可检测的。
