J Emerg Nurs. 2021 Jan;47(1):123-130. doi: 10.1016/j.jen.2020.05.015. Epub 2020 Sep 23.
Establishing and maintaining peripheral intravenous access in patients with no visible or palpable veins can be arduous. Intravenous catheters placed with ultrasound do not survive as long as traditionally placed catheters. This study was performed to determine the relationship between the catheter length placed into the lumen of the vein using ultrasound and catheter survival.
This was a nonrandomized prospective observational study of admitted patients with difficult intravenous placement in 2017. Subjects had ultrasound-guided peripheral intravenous placement in the emergency department or intensive care unit. The main outcome was the time of catheter survival. Data were analyzed using descriptive statistics and Cox regression.
A total of 98 patients with an average age of 63 years were enrolled. The total number of cases examined was 97 (N = 97), of which 29 intravenous catheters were removed for catheter-related problems (events). The mean (SD) survival time for catheters placed using ultrasound was 3,445 minutes (2,414) or 2.39 days. Peripheral catheter survival was not significantly related to the in-vein length of the catheter (X = 0.03, P = 0.86) nor was it significantly related to any of the covariates.
The survival time of ultrasound-guided intravenous access doubled in the present study from 1674 minutes in a previous 2013 study. The results may have been due to clinician expertise and experience with the peripheral ultrasound-guided method and the use of updated equipment.
在没有可见或可触及静脉的患者中建立和维持外周静脉通路可能非常困难。使用超声放置的静脉内导管的存活时间不如传统放置的导管长。本研究旨在确定使用超声将导管插入静脉管腔的长度与导管存活之间的关系。
这是 2017 年对静脉穿刺困难的住院患者进行的非随机前瞻性观察性研究。受试者在急诊科或重症监护病房进行超声引导下的外周静脉置管。主要结局是导管存活时间。使用描述性统计和 Cox 回归分析数据。
共纳入 98 名平均年龄为 63 岁的患者。共检查了 97 例(N=97)病例,其中 29 根静脉导管因导管相关问题(事件)而被拔出。使用超声放置的导管的平均(SD)存活时间为 3445 分钟(2414)或 2.39 天。外周导管的存活时间与导管在静脉内的长度(X=0.03,P=0.86)无关,也与任何协变量无关。
与 2013 年的一项先前研究相比,本研究中超声引导静脉通路的存活时间增加了一倍,达到 1674 分钟。结果可能是由于临床医生在周围超声引导方法和使用更新设备方面的专业知识和经验。