Kaufman Jonathan, Fitzpatrick Patrick, Tosif Shidan, Hopper Sandy M, Donath Susan M, Bryant Penelope A, Babl Franz E
Royal Children's Hospital, Parkville, Victoria, Australia.
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
BMJ. 2017 Apr 7;357:j1341. doi: 10.1136/bmj.j1341.
To determine if a simple stimulation method increases the rate of infant voiding for clean catch urine within five minutes. Randomised controlled trial. Emergency department of a tertiary paediatric hospital, Australia. 354 infants (aged 1-12 months) requiring urine sample collection as determined by the treating clinician. 10 infants were subsequently excluded. Infants were randomised to either gentle suprapubic cutaneous stimulation (n=174) using gauze soaked in cold fluid (the Quick-Wee method) or standard clean catch urine with no additional stimulation (n=170), for five minutes. The primary outcome was voiding of urine within five minutes. Secondary outcomes were successful collection of a urine sample, contamination rate, and parental and clinician satisfaction with the method. The Quick-Wee method resulted in a significantly higher rate of voiding within five minutes compared with standard clean catch urine (31% 12%, P<0.001), difference in proportions 19% favouring Quick-Wee (95% confidence interval for difference 11% to 28%). Quick-Wee had a higher rate of successful urine sample collection (30% 9%, P<0.001) and greater parental and clinician satisfaction (median 2 3 on a 5 point Likert scale, P<0.001). The difference in contamination between Quick-Wee and standard clean catch urine was not significant (27% 45%, P=0.29). The number needed to treat was 4.7 (95% confidence interval 3.4 to 7.7) to successfully collect one additional urine sample within five minutes using Quick-Wee compared with standard clean catch urine. Quick-Wee is a simple cutaneous stimulation method that significantly increases the five minute voiding and success rate of clean catch urine collection. Australian New Zealand Clinical Trials Registry ACTRN12615000754549.
确定一种简单的刺激方法是否能在五分钟内提高婴儿清洁中段尿排尿率。随机对照试验。澳大利亚一家三级儿科医院急诊科。354名(年龄1至12个月)经主治医生判定需要采集尿样的婴儿。随后排除10名婴儿。将婴儿随机分为两组,一组采用浸有冷液体的纱布进行轻柔的耻骨上皮肤刺激(n = 174,即快速排尿法),另一组采用标准清洁中段尿且不进行额外刺激(n = 170),持续五分钟。主要结局是五分钟内排尿。次要结局包括成功采集尿样、污染率以及家长和医生对该方法的满意度。与标准清洁中段尿相比,快速排尿法在五分钟内排尿率显著更高(31%对12%,P<0.001),比例差异为19%,支持快速排尿法(差异的95%置信区间为11%至28%)。快速排尿法成功采集尿样的比例更高(30%对9%,P<0.001),家长和医生的满意度也更高(在5分李克特量表上中位数分别为2对3,P<0.001)。快速排尿法与标准清洁中段尿在污染方面的差异不显著(27%对45%,P = 0.29)。与标准清洁中段尿相比,使用快速排尿法在五分钟内成功多采集一份尿样所需治疗人数为4.7(95%置信区间3.4至7.7)。快速排尿法是一种简单的皮肤刺激方法,能显著提高五分钟内排尿率及清洁中段尿采集成功率。澳大利亚新西兰临床试验注册中心编号ACTRN12615000754549。