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严重肠道功能障碍儿童长期中心静脉置管的乙醇封管预防:6例报告

Ethanol lock prophylaxis in long-stay central venous catheters in children with severe intestinal dysfunction: a report of six cases.

作者信息

Falcão Mário Cícero, de Castro Gabriela Ibrahim Martins, Framil Juliana Valeria de Souza, Bigio Juliana Zoboli Del, Tannuri Ana Cristina Aoun

机构信息

Universidade de São Paulo - USP, Instituto da Criança e do Adolescente, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil.

出版信息

J Vasc Bras. 2022 Jul 6;21:e20210221. doi: 10.1590/1677-5449.202102211. eCollection 2022.

Abstract

The aim of this study was to report on use of ethanol lock in long-term catheters in newborns with severe intestinal dysfunction, dependent on total and prolonged parenteral nutrition, in a Neonatal Intensive Care Center (tertiary level), between 2015 and 2020. Six infants (0.65%) out of the 914 admitted during the period met the inclusion criteria. The median age at catheter placement was 121.5 days. Two Powerpicc (PICC Power Sinergy™, São Paulo), one Groshong (Groshong™ Central Venous Catheter BD, São Paulo), and three silicone catheters were used, all tunneled, and the median dwell duration was 182.5 days. Four patients had at least one episode of infection related to the central venous catheter, and Gram-positive, Gram-negative, and fungal agents were isolated. The median length of hospital stay was 555 days and mortality was 33.3%. The ethanol lock did not cause any side effects and was relatively effective in preventing infections related to the central venous catheter.

摘要

本研究旨在报告2015年至2020年期间,在一家三级新生儿重症监护中心,对严重肠道功能障碍、依赖全肠外营养和长期肠外营养的新生儿使用乙醇封管处理长期留置导管的情况。在此期间收治的914例婴儿中,有6例(0.65%)符合纳入标准。置管时的中位年龄为121.5天。使用了两根Powerpicc(PICC Power Sinergy™,圣保罗)、一根Groshong(Groshong™ 中心静脉导管BD,圣保罗)和三根硅胶导管,均为隧道式,中位留置时间为182.5天。4例患者至少发生1次与中心静脉导管相关的感染,分离出革兰氏阳性菌、革兰氏阴性菌和真菌。中位住院时间为555天,死亡率为33.3%。乙醇封管未引起任何副作用,在预防与中心静脉导管相关的感染方面相对有效。

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