Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Jpn J Nurs Sci. 2022 Oct;19(4):e12484. doi: 10.1111/jjns.12484. Epub 2022 Apr 26.
We aimed to reveal detailed descriptive data on peripheral intravenous catheter (PIVC) failure related to insertion timing during the treatment cycle, in patients with lymphoma, leukemia, and myeloma.
We conducted a prospective descriptive study to investigate the incidence of PIVC failure, defined as PIVC removal prior to completing infusion therapy. This was judged by ward nurses for adult patients requiring PIVC insertion for chemotherapy. A research nurse confirmed the timing and determined the causes of PIVC failure using ultrasonographic imaging. Descriptive data were collected in the hematology and oncology ward of a tertiary hospital in Japan.
We recruited 85 patients (with 303 PIVCs), and analyzed 67 patients (with 280 PIVCs). Of these, 118 PIVCs (42%) were inserted during the chemotherapeutic dosing period of the treatment cycle, and 106 (38%), during the rest period. The incidence of cumulative PIVC failure was 43.2% of all analyzed PIVCs (89.97 per 1,000 PIVC days). Of the PIVCs in patients with lymphoma, those inserted during the dosing period were less likely to show PIVC failure (32% vs. 57%, p < .001). Conversely, those inserted after the treatment cycle were more likely to show PIVC failure (22% vs. 7%, p = .002).
This study demonstrated that the incidence of PIVC failure in patients with hematological malignancies was unacceptably high. Conceivably, the incidence of PIVC failure varies by the onset time of side effects in the treatment cycle. This should be considered when using PIVCs and selecting optimal vascular access devices for patients with hematological malignancies.
本研究旨在揭示淋巴瘤、白血病和骨髓瘤患者在治疗周期中不同时间点进行外周静脉置管(PIVC)时,与置管相关的失败的详细描述性数据。
我们进行了一项前瞻性描述性研究,以调查 PIVC 失败的发生率,定义为在完成输液治疗前提前移除 PIVC。这是由需要 PIVC 插入进行化疗的成人患者的病房护士判断的。研究护士通过超声成像确认 PIVC 失败的时间和原因。描述性数据在日本一家三级医院的血液科和肿瘤科病房收集。
我们共招募了 85 名患者(共 303 个 PIVC),并对其中 67 名患者(共 280 个 PIVC)进行了分析。其中,118 个 PIVC(42%)在治疗周期的化疗剂量期插入,106 个 PIVC(38%)在休息期插入。所有分析的 PIVC 中,累积 PIVC 失败的发生率为 43.2%(每 1000 个 PIVC 天 89.97 个)。在淋巴瘤患者中,在剂量期插入的 PIVC 发生 PIVC 失败的可能性较小(32%比 57%,p < 0.001)。相反,在治疗周期后插入的 PIVC 发生 PIVC 失败的可能性更大(22%比 7%,p = 0.002)。
本研究表明,血液恶性肿瘤患者 PIVC 失败的发生率高得不可接受。可以想象,PIVC 失败的发生率因治疗周期中副作用的发生时间而异。在为血液恶性肿瘤患者使用 PIVC 和选择最佳血管通路装置时,应考虑这一点。