University of Groningen, University Medical Center Groningen, Department of Critical Care, Groningen, The Netherlands.
Hanze University of Applied Sciences, Groningen, The Netherlands.
PLoS One. 2019 Mar 13;14(3):e0213754. doi: 10.1371/journal.pone.0213754. eCollection 2019.
Common methods to detect phlebitis may not be sufficient for patients in the intensive care unit (ICU). The goal of this study was to investigate the feasibility of infrared (IR) thermography to objectively detect phlebitis in adult ICU patients. We included a total of 128 adult ICU-patients in a pilot and subsequent validation study. Median [interquartile range] age was 62 [54-71] years and 88 (69%) patients were male. Severity of phlebitis was scored using the visual infusion phlebitis (VIP)-score, ranging from 0 (no phlebitis) to 5 (thrombophlebitis). The temperature difference (ΔT) between the insertion site and a proximal reference point was measured with IR thermography. In 78 (34%) catheters early phlebitis and onset of moderate phlebitis was observed (VIP-score of 1-3). In both the pilot and the validation study groups ΔT was significantly higher when the VIP-score was ≥1 compared to a VIP-score of 0 (p<0.01 and p<0.001, respectively). Multivariate analysis identified ΔT (p<0.001) and peripheral venous catheter (PVC) dwell time (p = 0.001) as significantly associated with phlebitis. IR thermography may be a promising technique to identify phlebitis in the ICU. An increased ΔT as determined with thermography may be a risk factor for phlebitis.
常见的静脉炎检测方法可能并不适用于重症监护病房（ICU）的患者。本研究旨在探讨红外热成像技术客观检测 ICU 成年患者静脉炎的可行性。我们共纳入了 128 名成年 ICU 患者进行了试点和后续验证研究。患者的中位（四分位距）年龄为 62 [54-71] 岁，88 名（69%）患者为男性。静脉炎严重程度采用视觉输液静脉炎（VIP）评分进行评分，范围为 0（无静脉炎）至 5（血栓性静脉炎）。使用红外热成像仪测量插入部位和近端参考点之间的温差（ΔT）。在 78 个（34%）导管中，观察到早期静脉炎和中度静脉炎的发生（VIP 评分为 1-3）。在试点组和验证组中，当 VIP 评分≥1 时，ΔT 均显著高于 VIP 评分为 0 时（p<0.01 和 p<0.001）。多变量分析确定 ΔT（p<0.001）和外周静脉导管（PVC）留置时间（p=0.001）与静脉炎显著相关。红外热成像技术可能是一种有前途的 ICU 静脉炎识别技术。热成像确定的 ΔT 增加可能是静脉炎的一个危险因素。
