超声引导下治疗性血液成分去除术外周静脉通路充分性的标准。
Ultrasound-based criteria for adequate peripheral venous access in therapeutic apheresis procedures.
机构信息
Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA.
Department of Pathology and Laboratory Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
出版信息
J Clin Apher. 2021 Dec;36(6):797-801. doi: 10.1002/jca.21930. Epub 2021 Aug 4.
BACKGROUND
Apheresis procedures require adequate vascular access to achieve adequate inlet flow rates. Central dialysis-type catheters are often used in apheresis, despite their multiple risks. Peripheral venous access is a safe and effective option for many patients.
AIM
We previously demonstrated that ultrasound guidance reduces central venous catheter use in apheresis patients; however, no validated criteria for preprocedural evaluation of peripheral veins exist. Here, we hypothesized that ultrasound-based criteria could predict the adequacy of a peripheral vein for apheresis procedures.
PATIENTS/METHODS: In this pilot cohort study, we reviewed the procedural outcomes for 50 cases of peripheral venous procedures that used our ultrasound-based criteria.
RESULTS
Of the procedures that met our criteria, 96% (46/48) were successfully completed. Overall, our criteria had 100% sensitivity, 50% specificity, 96% positive predictive value, and 100% negative predictive value.
CONCLUSION
Our criteria justify an evidence-based ultrasound-guided standard for evaluation of peripheral venous access for apheresis procedures.
背景
为了达到足够的入口流速， 血浆分离术需要有充足的血管通道。 虽然中心透析型导管存在多种风险，但仍常被用于血浆分离术。 对于许多患者来说， 外周静脉通路是一种安全有效的选择。
目的
我们之前的研究表明， 超声引导可减少血浆分离术患者中心静脉导管的使用； 然而， 目前还没有经过验证的外周静脉术前评估标准。 在此， 我们假设基于超声的标准可以预测外周静脉进行血浆分离术的充分性。
患者/方法： 在这项试点队列研究中， 我们回顾了 50 例使用我们的超声标准的外周静脉手术的手术结果。
结果
在符合我们标准的手术中， 96%（46/48）成功完成。 总体而言， 我们的标准具有 100%的敏感性、50%的特异性、96%的阳性预测值和 100%的阴性预测值。
结论
我们的标准为基于证据的超声引导外周静脉通路评估标准提供了依据， 适用于血浆分离术。
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