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外周静脉置管类型和材料对新生儿人群治疗失败的影响。

Effect of peripheral intravenous catheter type and material on therapy failure in a neonatal population.

机构信息

Neonatal Intensive Care Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar.

Hamad Medical Corporation, Doha, Qatar.

出版信息

J Vasc Access. 2023 Nov;24(6):1284-1292. doi: 10.1177/11297298221080071. Epub 2022 Feb 23.

Abstract

BACKGROUND

In neonatal settings vascular access devices are essential for treatment. However, their use is not without risks. The design and materials of peripheral vascular access devices have been evaluated amongst adult populations, but contemporary studies in neonatal settings are scant.

PURPOSE/OUTCOME MEASURES: This research describes the prevalence of peripheral intravenous catheter failure related to three different catheter types with the intent to identify modifiable risks that might be used to evaluate device efficacy, innovate neonatal practice, and support future policy developments.

METHOD AND SETTING

This was a retrospective observational analysis of routinely collected anonymized intravenous therapy related data. The study was carried out at the tertiary neonatal intensive care unit (112 beds) of the Women's Wellness and Research Center of Hamad Medical Corporation, Doha, Qatar.

PARTICIPANTS

Neonates who were admitted to the unit requiring intravenous treatment wherefore peripheral intravenous cannulation was indicated, were included in this study.

RESULTS

The use of different type of catheters resulted in significantly less therapy failures as phlebitis and increased dwell time, compared with the control groups. This remains significant after adjusting for age at insertion, gestational age, birth weight, and catheter type.

CONCLUSIONS

The study's findings are in accord with international literature concerning adult and pediatric patients concerning the superiority of PUR over PTFE catheters with respect to the risk of phlebitis and longer dwell times. However, the risk of failure of therapy did not differ between catheters. This finding is reassuring and supports practitioner judgment when selecting peripheral catheter devices.

摘要

背景

在新生儿环境中,血管内接入装置对于治疗至关重要。然而,它们的使用并非没有风险。外周血管接入装置的设计和材料已经在成人人群中进行了评估,但在新生儿环境中的当代研究却很少。

目的/结果衡量标准:本研究描述了三种不同类型的外周静脉导管失败的流行率,旨在确定可能用于评估器械疗效、创新新生儿实践和支持未来政策发展的可修改风险。

方法和设置

这是对 routinely collected anonymized intravenous therapy related data 进行的回顾性观察性分析。该研究在卡塔尔多哈哈马德医疗公司妇女健康与研究中心的三级新生儿重症监护病房(112 张床位)进行。

参与者

本研究纳入了需要静脉治疗且需要外周静脉置管的新生儿。

结果

与对照组相比,使用不同类型的导管可显著减少因静脉炎和延长留置时间而导致的治疗失败。在调整插入时的年龄、胎龄、出生体重和导管类型后,这仍然具有统计学意义。

结论

该研究的结果与国际上关于成人和儿科患者的文献一致,即与 PTFE 导管相比,PUR 导管在静脉炎和更长留置时间方面的风险更小。然而,治疗失败的风险在导管之间没有差异。这一发现令人安心,并支持从业者在选择外周导管装置时的判断。

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