不使用皮肤 adhesive dressings 固定婴儿外周静脉导管：概念验证研究。
Securing peripheral intravenous catheters in babies without applying adhesive dressings to the skin: a proof-of-concept study.
机构信息
School of Nursing, Midwifery and Health Practice, Faculty of Health, Victoria University of Wellington, PO Box 7625, Newtown, Wellington, 6242, New Zealand.
Newborn Intensive Care Unit, Capital Coast District Health Board, Wellington, New Zealand.
出版信息
BMC Pediatr. 2022 May 18;22(1):291. doi: 10.1186/s12887-022-03345-8.
BACKGROUND
Most babies admitted to a Neonatal Intensive Care Unit (NICU) require a peripheral intravenous catheter (PIVC). PIVCs are secured using splints and adhesive dressings applied to the skin. Removing the dressings causes skin injury, pain, and risks infection. We designed the Pēpi Splint, which supports PIVCs without the application of adhesive dressings to the skin. We sought to determine the effectiveness and acceptability of the Pēpi Splint using a proof-of-concept design.
METHODS
Eligible babies were > 1000 g and > 30 weeks' corrected gestation admitted to Wellington Regional NICU and who required a PIVC. All babies received the same care as those not in the study, with the addition of the Pēpi Splint. Primary outcomes were the proportion of babies in which the Pēpi Splint secured the PIVC for the required time and proportion of babies who experience an adverse event. Secondary outcomes were the acceptability of the Pēpi Splint as reported by the parents.
RESULTS
Thirty-eight babies, median (range) birth weight 2625 g (396-4970) and gestation 37wk (22-41). When the Pēpi was applied the postnatal weight was 2969 g (1145 - 4970) and gestation 37wk (29 - 41). The Pēpi Splint held the PIVC secure for 34/38 babies (89%), for a duration of 37 h (6 to 97). There were no adverse events. Of the four babies reported to have unsecure PIVCs, two were due to the securement two were displaced during feeding. Fifty-eight parents responded to a questionnaire (32 mothers, 26 fathers). Of these parents 52 (90%) would participate again and 52 (90%) would recommend participating to others. Overall, clinicians reported the Pēpi Splint was easy to use 33/38 (87%).
CONCLUSION
The Pēpi Splint safely secures PIVCs without adhesive dressings being applied to the skin and is acceptable to both parents and clinicians. Our findings provide support for a larger multicentred randomised controlled trial.
TRIAL REGISTRATION
Registered with the Australian and New Zealand Clinical Trials Registry Reference ACTRN12620001335987 .
背景
大多数入住新生儿重症监护病房（NICU）的婴儿需要外周静脉置管（PIVC）。PIVC 是通过夹板和贴在皮肤上的粘性敷料固定的。去除敷料会导致皮肤损伤、疼痛，并增加感染风险。我们设计了 Pēpi 夹板，它可以在不将粘性敷料应用于皮肤的情况下支撑 PIVC。我们使用概念验证设计来确定 Pēpi 夹板的有效性和可接受性。
方法
符合条件的婴儿体重超过 1000 克且校正胎龄超过 30 周，被收入惠灵顿地区 NICU，并且需要 PIVC。所有婴儿都接受了与未参与研究的婴儿相同的护理，除了使用 Pēpi 夹板。主要结局是 Pēpi 夹板固定 PIVC 的时间比例和经历不良事件的婴儿比例。次要结局是父母报告的对 Pēpi 夹板的可接受性。
结果
38 名婴儿，中位（范围）出生体重 2625 克（396-4970）和胎龄 37 周（22-41）。当应用 Pēpi 时，新生儿体重为 2969 克（1145-4970），胎龄为 37 周（29-41）。Pēpi 夹板将 PIVC 固定牢固，38 名婴儿中有 34 名（89%），持续时间为 37 小时（6-97）。没有不良事件。报告的 4 名 PIVC 固定不牢的婴儿中，有 2 名是由于固定，2 名是在喂食过程中移位。58 名父母回答了一份问卷（32 名母亲，26 名父亲）。其中 52 名（90%）父母愿意再次参与，52 名（90%）父母愿意向他人推荐参与。总体而言，临床医生报告说 Pēpi 夹板易于使用 38 名（87%）。
结论
Pēpi 夹板可以安全地固定 PIVC，而无需将粘性敷料应用于皮肤，并且受到父母和临床医生的认可。我们的研究结果为更大规模的多中心随机对照试验提供了支持。
试验注册
澳大利亚和新西兰临床试验注册中心注册，参考号 ACTRN12620001335987 。
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