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新生儿中心静脉置管并发的血栓形成与感染

Thrombosis and infection complicating central venous catheterization in neonates.

作者信息

Grisoni E R, Mehta S K, Connors A F

出版信息

J Pediatr Surg. 1986 Sep;21(9):772-6. doi: 10.1016/s0022-3468(86)80364-5.

Abstract

To determine the risk of complication associated with Broviac central venous catheterization in neonates, we reviewed the records of 107 infants who were catheterized an average of 5 weeks after birth and cared for in our neonatal intensive care unit. Forty-five of the 107 neonates (42%) had one or more catheter-related complications. Infants with complications had significantly lower birth weights and gestational age, longer duration of catheterization, and more repeat catheterizations than infants without complications. The mortality rate in infants with complications was not different than that of infants without complications. The most common complications were thrombosis (23 neonates) and infection (20 neonates). The birth weight and the number of catheterizations were the best predictors of the risk of complications as determined by multiple regression analysis. We conclude that the risk of complication associated with central venous catheterization is high in our population of predominantly premature neonates; that the risk of complication is increased in neonates weighing less than 1,000 g or requiring more than one catheter; and that despite the high complication rate central venous catheterization was not associated with increased mortality in this population.

摘要

为了确定新生儿经外周中心静脉置管术(Broviac 中心静脉导管插入术)相关并发症的风险,我们回顾了 107 例婴儿的记录,这些婴儿平均在出生后 5 周接受了导管插入术,并在我们的新生儿重症监护病房接受护理。107 例新生儿中有 45 例(42%)发生了一种或多种与导管相关的并发症。与无并发症的婴儿相比,有并发症的婴儿出生体重和胎龄显著更低,导管插入持续时间更长,重复插管次数更多。有并发症的婴儿死亡率与无并发症的婴儿无差异。最常见的并发症是血栓形成(23 例新生儿)和感染(20 例新生儿)。多元回归分析确定,出生体重和插管次数是并发症风险的最佳预测因素。我们得出结论,在我们以早产儿为主的人群中,中心静脉导管插入术相关并发症的风险很高;体重低于 1000 g 或需要多次插管的新生儿并发症风险增加;尽管并发症发生率很高,但在该人群中,中心静脉导管插入术与死亡率增加无关。

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