Unbeck M, Förberg U, Ygge B-M, Ehrenberg A, Petzold M, Johansson E
Division of Orthopaedics, Danderyd Hospital and Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
Acta Paediatr. 2015 Jun;104(6):566-74. doi: 10.1111/apa.12963. Epub 2015 Mar 11.
The aims of this study were to describe the characteristics of peripheral venous catheters (PVCs), including dwell time and reasons for removal, and explore predictors for PVC-related complications.
We included PVCs in 2032 children - 484 neonatal and 1548 paediatric - from 12 inpatient units. Data were retrieved from the patient record system, and predictors for complications were explored using logistic regression analyses.
Just over one-third (35.4%) of the PVCs were removed due to complications, in particular infiltration and occlusion (51.9 and 48.4/1000 PVC days, respectively). PVC survival time was shorter in neonatal than paediatric patients (4 versus 5 days), and infiltration was more frequent in neonatal patients (92.8 versus 38.7/1000 PVC days). Infiltration was associated with younger age (odds ratio 0.97) for neonatal patients and with younger age (OR 0.96), insertion in the bend of the arm (OR 1.48) or ankle (OR 2.81) for paediatric patients. Occlusion was, both for neonatal and paediatric patients, associated with longer dwell time (OR 1.32 and 1.22 respectively), insertion in the ankle (OR 5.00 and 3.51) or foot (OR 3.47 and 1.99).
PVC-related complications, particularly infiltration and occlusion, were more common in hospitalised children but decreased with the child's age.
本研究旨在描述外周静脉导管（PVC）的特征，包括留置时间和拔除原因，并探索PVC相关并发症的预测因素。
我们纳入了来自12个住院科室的2032名儿童的PVC，其中新生儿484名，儿科患者1548名。数据从患者记录系统中获取，并使用逻辑回归分析探索并发症的预测因素。
略超过三分之一（35.4%）的PVC因并发症而拔除，尤其是渗漏和堵塞（分别为每1000个PVC日51.9次和48.4次）。新生儿患者的PVC存活时间比儿科患者短（4天对5天），新生儿患者的渗漏更频繁（每1000个PVC日92.8次对38.7次）。新生儿患者的渗漏与年龄较小有关（比值比0.97），儿科患者的渗漏与年龄较小（比值比0.96）、在手臂弯曲处（比值比1.48）或脚踝处（比值比2.81）插入有关。对于新生儿和儿科患者，堵塞均与留置时间较长有关（分别为比值比1.32和1.22）、在脚踝处（比值比5.00和3.51）或足部（比值比3.47和1.99）插入有关。
PVC相关并发症，尤其是渗漏和堵塞，在住院儿童中更常见，但随着儿童年龄的增长而减少。
