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氰基丙烯酸酯胶在新生儿经皮-腔静脉导管无缝线固定中的应用。

Use of cyanoacrylate glue for the sutureless securement of epicutaneo-caval catheters in neonates.

机构信息

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Neonatal Intensive Care Unit, Infermi Hospital, Rimini, Italy.

出版信息

J Vasc Access. 2022 Sep;23(5):801-804. doi: 10.1177/11297298211008103. Epub 2021 Apr 8.

Abstract

INTRODUCTION

Epicutaneo-caval catheters (ECC) are pivotal for drug and fluid infusion in neonates. Given the intrinsic importance of the catheter for the patients' health and the need to avoid stressful and painful procedures on premature or critically ill newborns with fragile and poor vein asset, it is clearly necessary an accurate bundle for ECC insertion and management to avoid complications that may lead to non-elective ECC removal. Among others, dislodgment is an acknowledged complication, and conventionally adopted fixing devices seem alone unsatisfying in relation to ECC securement.

OBJECT

To evaluate the usefulness of medical Cyanoacrylate Glue (CG) as a solution to strengthen conventional ECC securement.

METHODS

Since the use of CG has become part of our ECC insertion bundle in 2018, the present study compares all term and preterm neonates admitted in our NICU in 2018 who required an ECC for any cause (92 cases) with an historical cohort formed by all neonates who required an ECC in 2017 (80 patients).

RESULTS

CG added to usual securement devices is effective in reducing ECC accidental dislodgment. Moreover, it is easy and safe to apply and remove, limits bleeding and oozing at the puncture site, and may also be an effective antimicrobial mechanical barrier.

摘要

简介

经皮股静脉置管(ECC)在新生儿的药物和液体输注中起着关键作用。鉴于导管对患者健康的内在重要性,以及需要避免对早产儿或患有严重疾病的新生儿进行有压力和痛苦的操作,这些新生儿的血管脆弱且不良,因此,对于 ECC 的插入和管理,有必要制定一个准确的方案来避免可能导致非选择性 ECC 移除的并发症。其中,导管脱出是公认的并发症,传统采用的固定装置在 ECC 固定方面似乎并不令人满意。

目的

评估医用氰基丙烯酸酯胶(CG)作为加强传统 ECC 固定的解决方案的有效性。

方法

自 2018 年 CG 开始应用于我们的 ECC 插入方案以来,本研究比较了 2018 年在我们新生儿重症监护病房(NICU)因任何原因需要 ECC 的所有足月和早产儿(92 例),以及 2017 年因需要 ECC 而形成的历史队列所有早产儿(80 例)。

结果

CG 与常规固定装置联合使用可有效降低 ECC 意外脱出的风险。此外,CG 易于操作,且安全去除,限制了穿刺部位的出血和渗血,还可能作为一种有效的抗菌机械屏障。

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