Fitzsimons Kathryn Marie, Speekman Joseph, Senior Temora, Curtis Kerrie, Cochrane-Davis Alex, Barnes Richard
Monash Children's Hospital, Melbourne, VIC, Australia.
The Lines Project, Cancer/Palliative Care, Monash Children's Hospital, Melbourne, VIC, Australia.
J Vasc Access. 2020 Nov;21(6):959-962. doi: 10.1177/1129729820918460. Epub 2020 May 5.
Paediatric central venous access devices are associated with significant complications. Failure rates have been estimated to be as high as 25%, with securement failure a significant contributing factor. In this study, we evaluate the use of a subcutaneous securement device, securAcath, in minimising rates of central venous access device dislodgement and unintended early removal within a paediatric population. Data were collected on 52 consecutive paediatric patients, aged less than 18 years old, who required peripherally inserted central catheters and non-cuffed tunnelled centrally inserted central catheters. We found that the rate of securement failure with securAcath was 2.01 per 1000 catheter days. This compared to 2.58 in our previous practice without securAcath. With the use of securAcath, no securement failures were observed in our patients with non-cuffed tunnelled centrally inserted central catheters. There were three instances of securement failure in patients with peripherally inserted central catheters. We conclude that the use of a securAcath fixation device in central venous access devices is an effective method of securement, especially in use with non-cuffed tunneled centrally inserted central catheters. However, when significant tension is applied to the central venous access devices migration is still possible.
儿科中心静脉通路装置会引发严重并发症。据估计，故障率高达25%，固定失败是一个重要的促成因素。在本研究中，我们评估了一种皮下固定装置securAcath在降低儿科患者中心静脉通路装置移位率和意外早期拔除率方面的作用。我们收集了52例年龄小于18岁、需要外周静脉穿刺中心静脉导管（PICC）和非套囊隧道式中心静脉导管（CICC）的连续儿科患者的数据。我们发现，使用securAcath时的固定失败率为每1000导管日2.01次。相比之下，我们之前未使用securAcath时的固定失败率为每1000导管日2.58次。使用securAcath后，我们的非套囊隧道式中心静脉导管患者未观察到固定失败情况。外周静脉穿刺中心静脉导管患者出现了3例固定失败。我们得出结论，在中心静脉通路装置中使用securAcath固定装置是一种有效的固定方法，特别是在与非套囊隧道式中心静脉导管一起使用时。然而，当中心静脉通路装置受到较大张力时，仍有可能发生移位。
