Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark.
Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.
J Clin Apher. 2020 Jun;35(3):200-205. doi: 10.1002/jca.21780. Epub 2020 Apr 27.
Central venous catheters (CVC) can facilitate a reliable blood flow for apheresis procedures, but the placement is time-consuming and costly and the incidence of catheter-related complications is high. Ultrasound can aid nurses to insert peripheral venous catheters (PVC), which is safer for the patients.
We evaluated the use of CVC vs PVC for all apheresis procedures 3 years after the implementation of structured training of apheresis nurses to perform ultrasound-guided PVC. Ultrasound can visualize the needle tip and target vessel dynamically and guide peripheral venous catheterization with an increased success rate. Time consumption for PVC insertion was measured.
In 10 months, we performed 1294 apheresis procedures on 227 patients, where 97.4% were performed with PVC. Hundred percent of extracorporeal photophoresis (off-line ECP) and peripheral blood stem cell collections on adults were performed with PVC. Patients who were treated with CVC (n = 8) were either children, had poor peripheral blood flow due to dehydration or admitted to an intensive care unit and had CVC for other reasons. Time consumption for PVC placement with ultrasound was 11 minutes on average.
Training of apheresis nurses in ultrasound-guided peripheral venous catheterization can enable close to 100% of apheresis procedures to be performed by PVC.
中心静脉导管（CVC）可促进血液顺利通过血浆分离术，但置管过程耗时且昂贵，且导管相关并发症的发生率较高。超声可以帮助护士进行外周静脉置管（PVC），这对患者来说更安全。
在对进行血浆分离术的护士进行了结构培训以实施超声引导下的 PVC 后 3 年，我们评估了所有血浆分离术使用 CVC 与 PVC 的情况。超声可以动态可视化针尖和目标血管，并提高外周静脉置管的成功率。测量了 PVC 插入的时间消耗。
在 10 个月内，我们对 227 名患者进行了 1294 次血浆分离术，其中 97.4% 使用了 PVC。所有的体外光化学疗法（离线 ECP）和成人外周血干细胞采集均使用 PVC 完成。使用 CVC（n=8）的患者均为儿童，因脱水导致外周血流不佳，或因其他原因入住重症监护病房而使用 CVC。使用超声进行 PVC 置管的平均时间为 11 分钟。
对进行血浆分离术的护士进行超声引导下外周静脉置管的培训，可以使近 100%的血浆分离术通过 PVC 完成。
