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在现有镇静服务体系下组建儿科经外周静脉穿刺中心静脉置管团队:5年经验总结

Development of a Pediatric PICC Team Under an Existing Sedation Service: A 5-Year Experience.

作者信息

Rainey Shane C, Deshpande Girish, Boehm Haley, Camp Kim, Fehr Annette, Horack Kimberly, Hanson Keith

机构信息

Department of Pediatrics, University of Illinois College of Medicine, Peoria, IL, USA.

Department of Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA.

出版信息

Clin Med Insights Pediatr. 2019 Oct 30;13:1179556519884040. doi: 10.1177/1179556519884040. eCollection 2019.

Abstract

OBJECTIVE

To examine our institutional experiences with ultrasound-guided peripherally inserted central catheter (US-PICC) placement by a dedicated US-PICC team under the umbrella of an existing pediatric sedation service.

METHODS

Retrospective review of quality data examining 968 US-PICC encounters over a 5-year period from 2012 to 2016. Data for each encounter included line indications, success rate, dwelling time, need for sedation, and incidence of complications including venous thrombosis, infection, and accidental removal.

RESULTS

US-PICC lines were successfully placed in 89% of patients with an average age of 5.4 years. Extended antibiotic treatment was the most common indication for US-PICC placement and the mean dwell time was 23 days. Long-term complications were noted in 6.1% of cases, with venous thrombosis and line infection complicating 1.7% and 0.9% of encounters, respectively.

CONCLUSION

Results suggest that our endeavor of creating a dedicated US-PICC team under an existing pediatric sedation service is successful with regard to the number of lines placed, success rates, and incidence of complications. This approach may be beneficial to other institutions seeing to maximize resource utilization and streamline patient care.

摘要

目的

探讨在现有的儿科镇静服务框架下,由专门的超声引导下经外周静脉穿刺中心静脉置管(US-PICC)团队进行US-PICC置管的机构经验。

方法

回顾性分析2012年至2016年5年间968例US-PICC置管的质量数据。每次置管的数据包括置管指征、成功率、留置时间、镇静需求以及并发症发生率,并发症包括静脉血栓形成、感染和意外拔管。

结果

89%的患者US-PICC置管成功,平均年龄为5.4岁。延长抗生素治疗是US-PICC置管最常见的指征,平均留置时间为23天。6.1%的病例出现长期并发症,静脉血栓形成和置管感染分别使1.7%和0.9%的置管情况复杂化。

结论

结果表明,我们在现有的儿科镇静服务下组建专门的US-PICC团队,在置管数量、成功率和并发症发生率方面取得了成功。这种方法可能对其他致力于最大限度利用资源和简化患者护理的机构有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d31a/6823977/e4f621faf5f9/10.1177_1179556519884040-fig1.jpg

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