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疏水性聚氨酯与聚氨酯外周置入中心静脉导管的比较:一项可行性随机对照试验的结果。

A comparison of hydrophobic polyurethane and polyurethane peripherally inserted central catheter: results from a feasibility randomized controlled trial.

机构信息

Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland, 4029, Australia.

Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, 4111, Australia.

出版信息

Trials. 2020 Sep 14;21(1):787. doi: 10.1186/s13063-020-04699-z.

Abstract

BACKGROUND

To evaluate the feasibility of an efficacy trial comparing a hydrophobic polyurethane peripherally inserted central catheter (PICC) with a standard polyurethane PICC.

METHODS

This pilot randomised controlled trial (RCT) was conducted between May 2017 and February 2018. Adult participants (n = 111) were assigned to hydrophobic polyurethane PICC with proximal valve (intervention) or a polyurethane PICC with external clamp (standard care). Primary outcome was trial feasibility including PICC failure. Secondary outcomes were central line-associated bloodstream infection, local infection, occlusion, thrombosis, fracture and dislodgement, phlebitis, local or systemic allergic reaction, and PICC dwell time.

RESULTS

All feasibility outcomes were achieved, apart from eligibility criteria. In total, 338 patients were screened, 138 were eligible (41%), and of these 111 were randomised (80%). Patients received the allocated PICC in 106 (95%) insertions. No patients withdrew from the study and there was no missing data. PICC failure was 24% (13/55) in the intervention group and 22% (12/55) in the standard care group (p = 0.820). PICC failure per 1000 PICC days was 16.3 in the intervention group and 18.4 in the control group (p = 0.755). The average dwell time was 12 days in the intervention and 8 days in the control group.

CONCLUSIONS

This study demonstrates the feasibility of an efficacy trial of PICC materials in an adult population, once adjustments were made to include not only in-patients, but also patients being discharged to the Hospital in the Home service.

TRIAL REGISTRATION

Australia and New Zealand Clinical Trials Registry ACTRN12616001578493 . Prospectively registered on 16 November 2016. The trial protocol was published a priori (Kleidon et al., Vasc Access 3:15-21, 2017).

摘要

背景

评估比较亲水性聚氨酯外周置入中心静脉导管(PICC)与标准型聚氨酯 PICC 的疗效试验的可行性。

方法

本试验为 2017 年 5 月至 2018 年 2 月期间进行的一项前瞻性随机对照试验(RCT)。将成年参与者(n=111)分为使用带近端瓣膜的亲水性聚氨酯 PICC(干预组)或使用带外部夹的标准型聚氨酯 PICC(标准护理组)。主要结局为 PICC 失败的试验可行性。次要结局包括中心静脉相关血流感染、局部感染、闭塞、血栓形成、导管断裂和移位、静脉炎、局部或全身过敏反应以及 PICC 留置时间。

结果

除了纳入标准外,所有可行性结局均达到。共筛选了 338 名患者,其中 138 名符合条件(41%),其中 111 名被随机分配(80%)。106 次置管中患者均接受了分配的 PICC。无患者退出研究,且无缺失数据。干预组的 PICC 失败率为 24%(13/55),标准护理组为 22%(12/55)(p=0.820)。干预组和对照组每 1000 个 PICC 日的 PICC 失败率分别为 16.3 和 18.4(p=0.755)。干预组的平均留置时间为 12 天,对照组为 8 天。

结论

本研究表明,在成年人群中进行 PICC 材料疗效试验是可行的,一旦调整了纳入标准,不仅包括住院患者,还包括出院到医院家庭服务的患者。

试验注册

澳大利亚和新西兰临床试验注册中心 ACTRN12616001578493。于 2016 年 11 月 16 日前瞻性注册。试验方案预先发表(Kleidon 等人,Vasc Access 3:15-21,2017)。

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