Phelps S J, Helms R A
J Pediatr. 1987 Sep;111(3):384-9. doi: 10.1016/s0022-3476(87)80458-4.
The influence of 11 variables on the infiltration of peripheral venous lines (PVLs) was evaluated during 151 infusions in patients younger than 1 year of age. Infusions were followed from the time of cannula placement to discontinuation. Fifty-eight percent of PVLs were infiltrated by 36.30 +/- 33.53 hours (mean +/- SD; median 40 hours, range 10 to 187 hours). No difference between infiltrated and noninfiltrated PVLs was noted with regard to patient age, gender, weight, cannula type, cannula gauge, cannula site, infusion device, potassium or dextrose concentration, medications, or rate of solution administration (P greater than 0.05). Infiltration was observed more often in black than in white infants (P = 0.03) and in patients with lower controller solution head heights (P = 0.01). The time to infiltration was decreased significantly for steel verus Teflon cannulas (P = 0.02), for administration of intravenous medication versus no administration of medication (P = 0.03), for peripheral parenteral nutrition solutions compared with 5% or 10% dextrose solutions (P = 0.014), and with increasing cannula gauge (P = 0.05). The time to infiltration did not differ significantly for gravity-controlled versus positive-pressure infusion device delivery (P = 0.51) or for potassium concentrations less than or equal to 20 mEq/L versus greater than 20 mEq/L (P = 0.13). Infusion device occlusion alarms were associated with only 19% of infiltrations. No sloughing of skin or necrosis of tissue occurred related to infiltration.
在151例1岁以下患儿的输液过程中，评估了11个变量对周围静脉留置针（PVL）渗漏的影响。从置管时起至输液结束进行全程观察。58%的PVL在36.30±33.53小时（平均±标准差；中位数40小时，范围10至187小时）发生渗漏。在患者年龄、性别、体重、留置针类型、留置针规格、置管部位、输液装置、钾或葡萄糖浓度、药物或溶液输注速度方面，渗漏和未渗漏的PVL之间未发现差异（P>0.05）。观察发现，黑人婴儿比白人婴儿更常发生渗漏（P=0.03），且在控制溶液高度较低的患者中更常发生渗漏（P=0.01）。钢质与聚四氟乙烯留置针相比，渗漏时间显著缩短（P=0.02）；静脉用药与未用药相比，渗漏时间显著缩短（P=0.03）；外周肠外营养溶液与5%或10%葡萄糖溶液相比，渗漏时间显著缩短（P=0.014），且随着留置针规格增大，渗漏时间缩短（P=0.05）。重力控制与正压输液装置给药的渗漏时间无显著差异（P=0.51），钾浓度≤20 mEq/L与>20 mEq/L的渗漏时间也无显著差异（P=0.13）。输液装置堵塞警报仅与19%的渗漏相关。未发生与渗漏相关的皮肤脱屑或组织坏死。
