Division of Pediatric Critical Care, Rady Children's Hospital, San Diego, CA.
Department of Pediatrics, University of California at San Diego, La Jolla, CA.
Pediatr Crit Care Med. 2022 Apr 1;23(4):277-285. doi: 10.1097/PCC.0000000000002903. Epub 2022 Feb 18.
To determine the frequency and characteristics of complications of peripherally administered hypertonic saline (HTS) through assessment of infiltration and extravasation.
Retrospective cross-sectional study.
Freestanding tertiary care pediatric hospital.
Children who received HTS through a peripheral IV catheter (PIVC).
None.
We conducted a single-center retrospective review from January 2012 to 2019. A total of 526 patients with 1,020 unique administrations of HTS through a PIVC met inclusion criteria. The primary endpoint was PIVC failure due to infiltration or extravasation. The indication for the administration of HTS infusion was collected. Catheter data was captured, including the setting of catheter placement, anatomical location on the patient, gauge size, length of time from catheter insertion to HTS infusion, in situ duration of catheter lifespan, and removal rationale. The administration data for HTS was reviewed and included volume of administration, bolus versus continuous infusion, infusion rate, infusion duration, and vesicant medications administered through the PIVC. There were 843 bolus infusions of HTS and 172 continuous infusions. Of the bolus administrations, there were eight infiltrations (0.9%). The continuous infusion group had 13 infiltrations (7.6%). There were no extravasations in either group, and no patients required medical therapy or intervention by the wound care or plastic surgery teams. There was no significant morbidity attributed to HTS administration in either group.
HTS administered through a PIVC infrequently infiltrates in critically ill pediatric patients. The infiltration rate was low when HTS is administered as a bolus but higher when given as a continuous infusion. However, no patient suffered an extravasation injury or long-term morbidity from any infiltration.
通过评估渗透和外渗来确定外周给予高渗盐水（HTS）的并发症的频率和特征。
回顾性横断面研究。
独立的三级儿科护理医院。
通过外周静脉导管（PIVC）接受 HTS 的儿童。
无。
我们进行了一项 2012 年 1 月至 2019 年的单中心回顾性研究。共有 526 名患者的 1020 次 HTS 通过 PIVC 给药符合纳入标准。主要终点是由于渗透或外渗导致的 PIVC 失败。收集了 HTS 给药的指征。记录了导管数据，包括导管放置的位置、患者的解剖位置、管号、从插入导管到 HTS 输注的时间、导管在体内的使用时间以及导管移除的理由。回顾了 HTS 的给药数据，包括给药量、推注与连续输注、输注速度、输注时间以及通过 PIVC 给予的刺激性药物。有 843 次 HTS 推注和 172 次连续输注。在推注中，有 8 例渗透（0.9%）。连续输注组有 13 例渗透（7.6%）。两组均无外渗，无患者需要伤口护理或整形外科团队的药物治疗或干预。两组均未因 HTS 给药而出现明显的发病率。
在危重病儿科患者中，通过 PIVC 给予 HTS 很少渗透。当 HTS 作为推注给药时，渗透发生率较低，但作为连续输注给药时，渗透发生率较高。然而，没有患者因任何渗透而遭受外渗损伤或长期发病率。
