经皮中心静脉置管在新生儿重症监护病房（NICU）中插入长度的计算公式。

The equations of the inserted length of percutaneous central venous catheters on neonates in NICU.

机构信息

Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

Pediatr Neonatol. 2019 Jun;60(3):305-310. doi: 10.1016/j.pedneo.2018.07.011. Epub 2018 Aug 3.

DOI:10.1016/j.pedneo.2018.07.011

PMID:30217481

Abstract

BACKGROUND

In neonatal intensive care units, a percutaneous central venous catheter (PCVC) is inserted peripherally and threaded into a central venous location, when intravenous access is anticipated for an extended period of time. The tip location of PCVCs should be checked by an X-ray after the procedure. The present study aimed to determine an equation to estimate the optimal insertion length of PCVCs in neonates prior to the procedure.

METHODS

The data of all neonates who had PCVC insertion between May 1st 2015 and April 30 2016 was reviewed. Their gender, body weight and body length at the insertion date, any complications and the tip culture of their PCVCs were recorded. The tip location of the PCVC, which was confirmed by X-ray, was either in the inferior vena cava near to the diaphragm or in the superior vena cava before the right atrial junction, depending on the insertion site. We analyzed the correlation among inserted length of PCVCs, body weight and body length by linear regression to determine an equation for estimating the optimal insertion length of PCVCs. The accuracy of the equations was evaluated prospectively by Pearson's correlation analysis, and the adjusting rate of PCVCs after the initial insertion was compared between the traditional method and using the equation.

RESULTS

The equation of PCVCs inserted in the foot was "insertion length (cm) = 16 + 4.27 × body weight (kg)", in the femoral vein was "inserted length (cm) = 9.8 + 1.7 × body weight (kg)", in the popliteal vein was "inserted length (cm) = -0.3 + 0.45 × body length (cm)", in the hand was "inserted length (cm) = 4.46 + 0.32 × body length (cm)", and in the axillary vein was inserted length (cm) = 1 + 0.18 × body length (cm). The adjusting rate of PCVCs after initial insertion was decreased from 73.5% to 53% following use of the equation.

CONCLUSIONS

Equations provided a convenient and accurate method to estimate the optimal insertion length of PCVCs before their placement.

摘要

背景

在新生儿重症监护病房中，当预计需要长时间进行静脉输液时，经皮中心静脉导管（PCVC）会从外周插入并穿过中心静脉位置。在手术后，应通过 X 光检查 PCVC 的尖端位置。本研究旨在确定一种在手术前估计新生儿 PCVC 最佳插入长度的方程。

方法

回顾了 2015 年 5 月 1 日至 2016 年 4 月 30 日期间所有接受 PCVC 插入的新生儿的数据。记录了他们在插入日期的性别、体重和身长、任何并发症以及 PCVC 的尖端培养情况。PCVC 的尖端位置通过 X 光确认，根据插入部位，位于下腔静脉靠近膈肌附近或上腔静脉在右心房交界处之前。我们通过线性回归分析 PCVC 插入长度、体重和身长之间的相关性，以确定估计 PCVC 最佳插入长度的方程。通过皮尔逊相关分析前瞻性评估方程的准确性，并比较传统方法和使用方程后 PCVC 的调整率。

结果

足部插入的 PCVC 方程为“插入长度（cm）=16+4.27×体重（kg）”，股静脉插入的 PCVC 方程为“插入长度（cm）=9.8+1.7×体重（kg）”，腘窝静脉插入的 PCVC 方程为“插入长度（cm）=-0.3+0.45×身长（cm）”，手部插入的 PCVC 方程为“插入长度（cm）=4.46+0.32×身长（cm）”，腋窝静脉插入的 PCVC 方程为插入长度（cm）=1+0.18×身长（cm）。使用方程后，PCVC 初始插入后的调整率从 73.5%降至 53%。