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成人重症监护环境中中心静脉置管锁定实践:一项确定每个导管腔室锁定时间的单中心观察性研究。

Central venous access device locking practices in the adult critical care setting: a single-centre, observational study establishing duration of locking per catheter lumen.

机构信息

Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada.

Department of Critical Care, Royal Columbian Hospital, New Westminster, BC, V3L 3W7, Canada.

出版信息

Br J Nurs. 2022 Oct 27;31(19):S16-S25. doi: 10.12968/bjon.2022.31.19.S16.

Abstract

PURPOSE

Central line complications remain a problem in critical care patient populations. Various interventions to prevent or treat complications, such as central line-associated bloodstream infection and occlusion, have been the focus of recent research. Although alternative catheter locking solutions have been shown to be effective in other patient populations, their applicability to the critical care setting remains unclear. Due to the high acuity of critical care patients, it is uncertain whether their central lines remain locked for a duration long enough for alternative locking solutions to provide any effect.

METHODS

This single-centre, prospective, observational study aimed to gather information about the length of time central line lumens remain in a locked state in the average critical care patient. Baseline rates of various central line complications were also tracked.

RESULTS

Results of this study indicate that the majority of central lines will have at least one lumen locked for an average of 36.6% of their time in situ.

CONCLUSIONS

It is anticipated that this length of time provides enough exposure for alternative locking solutions to potentially make a difference in central line complications in this patient population. Results of this study can be used for planning future multi-centre, randomized controlled trials investigating the efficacy of novel central line locking solutions to prevent central line complications in critically ill patients.

摘要

目的

中心静脉置管相关并发症仍然是重症监护患者人群中的一个问题。各种预防或治疗并发症的干预措施,如中心静脉相关性血流感染和阻塞,一直是最近研究的重点。尽管替代导管锁定解决方案在其他患者群体中已被证明是有效的,但它们在重症监护环境中的适用性仍不清楚。由于重症监护患者的病情严重,尚不确定他们的中心静脉置管是否保持锁定状态足够长的时间,以使替代锁定解决方案产生任何效果。

方法

这项单中心、前瞻性、观察性研究旨在收集有关普通重症监护患者中心静脉置管腔保持锁定状态的时间长度的信息。还跟踪了各种中心静脉置管并发症的基线发生率。

结果

这项研究的结果表明,大多数中心静脉置管至少有一个腔在原位时保持锁定状态,平均时间为 36.6%。

结论

预计这段时间足以使替代锁定解决方案对该患者群体的中心静脉置管并发症产生影响。本研究的结果可用于计划未来的多中心、随机对照试验,以研究新型中心静脉置管锁定解决方案预防危重症患者中心静脉置管并发症的疗效。

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