Emergency Medicine Department, Semi-Intensive Respiratory Covid Unit - Campus Covid Center, Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy.
Emergency Medicine Department, IRCCS Fondazione Sant'Orsola, Bologna, Italy.
J Vasc Access. 2024 Mar;25(2):498-503. doi: 10.1177/11297298221115002. Epub 2022 Sep 5.
In the daily management of peripheral venous access, the health emergency linked to the COVID-19 pandemic led to re-examining the criteria for choosing, positioning and maintaining the different types of peripheral venous access.
This study aimed to observe the dwell time of long peripheral cannula (LPC, also known as ) in patients affected by COVID 19 related pneumonia. The secondary objective is to study any complications due to mini-midline insertion.
We conducted a prospective observational study on COVID19 patients who arrived at our Semi-Intensive Respiratory Unit from territorial ED between January and April 2021, to whom were positioned an LPC at the time of admission following the SIPUA protocol (Safe Insertion of Peripheral Ultrasound-guided Access). We used Vygon™ Leader-Cath© 18G in polyethylene and 8 cm long catheter.
We enrolled 53 consecutive patients, reaching 769 catheter days. The procedure was performed without immediate complications in 37 patients out of 53 (69.8%). In 14 patients (26.4%), we observed a local hematoma (no one led to a failure or early removal of the device) and in two patients (3.7%) was not possible to draw blood. The average catheter dwell time was 14.5 days, from 3 to 41 days. In 42 patients (79.2%), the device was removed at the end of use. In 11 patients out of 53 (20.8%), the device was removed early due to complications: seven accidental removals, one obstruction, two vein thrombosis, and one superficial thrombophlebitis.
The ultrasound-guided implantation of an 18G LPC in COVID19 patients, regardless of the state of their venous heritage, would seem to be an excellent strategy for these patients, reducing the number of venipunctures and CVC implantation, as well as allowing multiple and high pressure (contrast) infusions.
在日常外周静脉通路管理中，与 COVID-19 大流行相关的卫生紧急情况促使人们重新审视选择、定位和维持不同类型外周静脉通路的标准。
本研究旨在观察 COVID-19 相关肺炎患者使用长外周导管（LPC，也称为）的留置时间。次要目的是研究微型中线插入引起的任何并发症。
我们对 2021 年 1 月至 4 月期间从地区急诊科到达我们半强化呼吸科的 COVID-19 患者进行了一项前瞻性观察性研究，这些患者按照 SIPUA 方案（外周超声引导下安全插入）在入院时被定位 LPC。我们使用 Vygon™ Leader-Cath© 18G 聚乙烯和 8 厘米长的导管。
我们连续纳入了 53 例患者，共 769 天导管留置。在 53 例患者中的 37 例（69.8%）中，该程序在无即时并发症的情况下进行。在 14 例患者（26.4%）中，我们观察到局部血肿（无一例导致器械失败或提前移除），在 2 例患者（3.7%）中无法采血。平均导管留置时间为 14.5 天，最短 3 天，最长 41 天。在 42 例患者（79.2%）中，器械在使用结束时被移除。在 53 例患者中的 11 例（20.8%）中，由于并发症而提前移除器械：7 例意外移除、1 例阻塞、2 例静脉血栓形成和 1 例浅表血栓性静脉炎。
在 COVID-19 患者中，无论其静脉遗产状况如何，超声引导下植入 18G LPC 似乎都是这些患者的一种极好策略，可减少静脉穿刺和中央静脉导管植入的次数，并允许多次和高压（对比）输注。
