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新生儿重症监护病房中经外周静脉穿刺中心静脉置管并发症的评估:伊朗某中心的经验

Assessment of the Complications of Peripherally Inserted Central Catheter in Neonates Admitted to the Intensive Care Unit: A Center's Experience in Iran.

作者信息

Moradi Raheleh, Shariat Mamak, Farrokhzad Nahid, Abroon Ameneh, Kafi Soheila, Hamidpoor Azadeh, Hassani Elaheh, Charousaei Hasti, Nayeri Fatemeh Sadat

机构信息

Maternal, Fetal and Neonatal Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran.

Neonatal Intensive Care Unit, Valiasr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran.

出版信息

Iran J Nurs Midwifery Res. 2022 Nov 18;27(6):505-508. doi: 10.4103/ijnmr.ijnmr_20_21. eCollection 2022 Nov-Dec.

Abstract

BACKGROUND

Peripherally Inserted Central Catheter (PICC), which is inserted through peripheral veins into the superior or inferior vena cava, is used to inject medications or parenteral nutrition in neonates with long-term hospitalization in the intensive care unit. In this study, we assessed the complications of PICC in neonates admitted to the intensive care unit in hospital.

MATERIALS AND METHODS

In the present retrospective cohort, neonates admitted to the Neonatal Intensive Care Unit (NICU) of Valiasr Hospital during 2015-2018 had been divided into two groups with PICC and without it. Data included the occurrence of septicemia, tachycardia, perforation of large veins, pulmonary hypertension, cardiac tamponade, pericardial effusion, catheter site necrosis, hemorrhage, anemia, pleural effusion, ascites, phlebitis of catheter track and neonatal death, which were collected, using the comprehensive neonatal registry of Valiasr Hospital. Data analysis was performed with regression, mantel-haenszel and independent -test.

RESULTS

Data from 174 neonates with PICC were compared to 207 infants with classic IV-Line. In the exposure group, the gestational age and birth weight were lower. Based on the results of the double logistic regression test, septicemia and hemorrhage in the injection site, independent of other variables, were related to the use of PICC and the risk of septicemia or hemorrhage in the injection site was significantly reduced if PCIC was used ( < 0.01).

CONCLUSIONS

Using the PICC as a therapeutic procedure in hospitalized neonates in the NICU is a safe method. By improving its replacement skills among physicians and nurses, its side effects are minor and negligible.

摘要

背景

经外周静脉穿刺中心静脉导管(PICC)经外周静脉插入上腔或下腔静脉,用于在重症监护病房长期住院的新生儿中注射药物或进行肠外营养。在本研究中,我们评估了在医院重症监护病房住院的新生儿PICC的并发症。

材料与方法

在本回顾性队列研究中,2015年至2018年期间入住瓦利亚斯尔医院新生儿重症监护病房(NICU)的新生儿被分为有PICC组和无PICC组。数据包括败血症、心动过速、大静脉穿孔、肺动脉高压、心脏压塞、心包积液、导管部位坏死、出血、贫血、胸腔积液、腹水、导管路径静脉炎和新生儿死亡的发生情况,这些数据是通过瓦利亚斯尔医院的综合新生儿登记系统收集的。数据分析采用回归分析、曼特尔 - 亨塞尔检验和独立样本t检验。

结果

将174例有PICC的新生儿数据与207例使用传统静脉输液的婴儿数据进行比较。暴露组的胎龄和出生体重较低。基于双逻辑回归测试结果,注射部位的败血症和出血与PICC的使用有关,且独立于其他变量,如果使用PCIC,注射部位败血症或出血的风险显著降低(P < 0.01)。

结论

在NICU住院新生儿中使用PICC作为一种治疗手段是一种安全的方法。通过提高医生和护士的置管技术,其副作用较小且可忽略不计。

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