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普通病房环境下接受肠外营养患者的中心静脉置管并发症:回顾性分析。

Central Venous Access Device Complications in Patients Receiving Parenteral Nutrition in General Ward Settings: A Retrospective Analysis.

机构信息

Nutritional Support Special Nursing Services, St George Hospital, Sydney, Australia.

School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, Australia.

出版信息

JPEN J Parenter Enteral Nutr. 2020 Aug;44(6):1104-1111. doi: 10.1002/jpen.1743. Epub 2019 Nov 29.

Abstract

BACKGROUND

Central venous access devices (CVADs) are used widely in acute clinical settings for the infusion of parenteral nutrition (PN) in patients who are unable to meet their nutrition requirements via the oral or enteral routes. The aim of this study was to characterize the frequency and nature of CVAD complications in patients receiving PN in general ward settings.

METHODS

A retrospective analysis of CVAD-related outcomes for adult patients who received PN from January 2014 to December 2016 was conducted.

RESULTS

A total of 629 CVADs were placed in 475 patients for parenteral administration in general ward settings during the 3-year study period. A total 104 (16.53%) episodes of CVAD-associated complications were reported during this period, including suspected line infection, leak at site, catheter blockage, and generalized patient sepsis. Overall, 13 CVAD catheter-related bloodstream infections (CRBSIs) were diagnosed in the patient cohort over 8695 PN feeding days, giving an incidence of 1.49 CVAD infections per 1000 PN feeding days.

CONCLUSION

The results showed that patients receiving PN through CVADs within general ward settings experience CRBSI at rates no different from those reported within critical care settings. These findings demonstrate that with appropriate nursing care, CVADs appear safe when used for the administration of PN in general ward settings.

摘要

背景

在急性临床环境中,中心静脉通路装置(CVAD)被广泛用于无法通过口服或肠内途径满足营养需求的患者的肠外营养(PN)输注。本研究的目的是描述在普通病房环境中接受 PN 治疗的患者中 CVAD 并发症的发生频率和性质。

方法

对 2014 年 1 月至 2016 年 12 月期间在普通病房接受 PN 的成年患者的 CVAD 相关结局进行回顾性分析。

结果

在 3 年的研究期间,共有 475 名患者在普通病房中使用 629 个 CVAD 进行肠外给药。在此期间共报告了 104 例(16.53%)与 CVAD 相关的并发症,包括疑似导管感染、置管部位渗漏、导管堵塞和全身性患者败血症。在整个患者队列中,共诊断出 13 例 CVAD 相关血流感染(CRBSI),在 8695 天 PN 喂养期间的发生率为每 1000 天 PN 喂养 1.49 例 CVAD 感染。

结论

结果表明,在普通病房环境中接受 CVAD 输注 PN 的患者发生 CRBSI 的比率与在重症监护环境中报告的比率没有差异。这些发现表明,在适当的护理下,CVAD 在普通病房环境中用于 PN 给药时似乎是安全的。

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