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埃塞俄比亚西北部新生儿和婴儿外周静脉留置针相关并发症的发生率、发生时间及预测因素:一项基于机构的前瞻性研究

Incidence, time to occurrence and predictors of peripheral intravenous cannula-related complications among neonates and infants in Northwest Ethiopia: an institutional-based prospective study.

作者信息

Baye Nega Dagnew, Teshome Assefa Agegnehu, Ayenew Atalo Agimas, Amare Tadeg Jemere, Mulu Anmut Tilahun, Abebe Endeshaw Chekol, Tiruneh Gebrehiwot Ayalew, Ayele Teklie Mengie, Muche Zelalem Tilahun, Teklemariam Awgichew Behaile, Melese Biruk Demissie, Agidew Melaku Mekonnen, Seid Mohammed Abdu

机构信息

Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Department of Clinical Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

BMC Nurs. 2023 Jan 11;22(1):11. doi: 10.1186/s12912-022-01164-x.

Abstract

BACKGROUND

Peripheral intravenous cannulas (PIVC) are venous access devices commonly used for the administration of intravenous fluids, drugs, blood products, and parenteral nutrition. Despite its frequent use, it has complications that can seriously threaten patient safety, prolong hospital stays, and increases medical care costs. PIVC complications are associated with increased morbidity and reinsertion attempts are painful and anxiety-provoking for children and their parents. Therefore, this study was aimed to assess the incidence, time to occurrence and identify predictors for PIVC complications among infants admitted to Debre Tabor Comprehensive Specialized Hospital (DTCSH), Northwest Ethiopia.

METHODS AND SETTING

An institutional-based prospective cohort study was conducted on 358 infants admitted to a neonatal intensive care unit and pediatric ward, DTCSH from January 1 to April 30, 2022. A systematic sampling technique was employed.

RESULTS

The incidence rate of PIVC complication was 11.6 per 1000 person-hours observation. PIVC complication was observed in 56.4% (202) of PIVCs, of which infiltration (42.1%) was the most common complication followed by phlebitis (29.7%). The median time to complication was 46 h. Anatomical insertion site (AHR = 2.85, 95%CI: 1.63-6.27), admission unit (AHR = 1.88, 95%CI: 1.07-4.02), sickness (AHR = 0.24, 95% CI: 1.31-4.66), medication type (AHR = 2.04, 95%CI: 1.13-3.66), blood transfusion (AHR = 0.79, 95%CI: 0.02-0.99), clinical experience (AHR = 0.52, CI:0.26-0.84), and flushing (AHR = 0.71, 95%CI: 0.34-0.98) were potential predictors of PIVC complication.

CONCLUSION

Knowing the predictor factors helps clinicians to provide effective care and to detect complications early.

摘要

背景

外周静脉留置针(PIVC)是常用于输注静脉输液、药物、血液制品和肠外营养的静脉通路装置。尽管其使用频繁,但它存在一些并发症,可能严重威胁患者安全、延长住院时间并增加医疗费用。PIVC并发症与发病率增加相关,重新穿刺对儿童及其父母来说既痛苦又令人焦虑。因此,本研究旨在评估埃塞俄比亚西北部德布雷塔博尔综合专科医院(DTCSH)收治的婴儿中PIVC并发症的发生率、发生时间,并确定其预测因素。

方法与背景

2022年1月1日至4月30日,对DTCSH新生儿重症监护病房和儿科病房收治的358例婴儿进行了一项基于机构的前瞻性队列研究。采用了系统抽样技术。

结果

PIVC并发症的发生率为每1000人时观察11.6例。56.4%(202例)的PIVC观察到并发症,其中渗漏(42.1%)是最常见的并发症,其次是静脉炎(29.7%)。并发症发生的中位时间为46小时。解剖插入部位(风险比=2.85,95%置信区间:1.63 - 6.27)、收治科室(风险比=1.88,95%置信区间:1.07 - 4.02)、疾病情况(风险比=0.24,95%置信区间:1.31 - 4.66)、药物类型(风险比=2.04,95%置信区间:1.13 - 3.66)、输血(风险比=0.79,95%置信区间:0.02 - 0.99)、临床经验(风险比=0.52,置信区间:0.26 - 0.84)和冲管(风险比=0.71,95%置信区间:0.34 - 0.98)是PIVC并发症的潜在预测因素。

结论

了解预测因素有助于临床医生提供有效的护理并早期发现并发症。

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Elective replacement of intravenous cannula in neonates-a randomised trial.新生儿选择性静脉置管更换:一项随机试验。
Eur J Pediatr. 2018 Nov;177(11):1719-1726. doi: 10.1007/s00431-018-3234-7. Epub 2018 Sep 6.

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