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超声引导下经外周静脉穿刺中心静脉置管术:一项随机对照试验方案。

Ultrasound-guided PIVC insertion: a randomised controlled trial protocol.

机构信息

Nurse Practitioner, Children's Health Queensland Hospital and Health Service, and School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.

Senior Research Fellow, Children's Health Queensland Hospital and Health Service, and School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.

出版信息

Br J Nurs. 2023 Jul 27;32(14):S22-S28. doi: 10.12968/bjon.2023.32.14.S22.

Abstract

Ultrasound-guided insertion of peripheral intravenous catheters (PIVCs) is an alternative to traditional anatomical landmark-based insertion. However, data on its performance in paediatric patients of varying levels of difficult intravenous access are limited. The researchers hypothesise that ultrasound-guided PIVC insertion will increase first-attempt success compared with landmark technique. This randomised, parallel-group, single-centre, superiority trial commenced recruiting in July 2021, including hospitalised children (aged 0 (>37 weeks gestation) to 18 years) requiring a PIVC. It will recruit 180 children, stratified by degree of perceived difficulty, and centrally randomised into two groups (ratio 1:1). The primary outcome is first-attempt PIVC insertion success. Secondary outcomes include total number of PIVC insertion attempts, PIVC insertion failure, post-insertion complications, dwell time, patient/parent satisfaction, and healthcare costs. The current study will inform the superiority of ultrasound-guided PIVC insertion in comparison with landmark technique. Adoption by healthcare facilities might improve patient outcomes and decrease healthcare costs.

摘要

超声引导外周静脉置管(PIVC)是一种替代传统解剖标志定位插入的方法。然而,关于其在不同静脉穿刺难度水平的儿科患者中的表现的数据有限。研究人员假设与地标技术相比,超声引导 PIVC 插入将提高首次尝试成功率。这项随机、平行组、单中心、优效性试验于 2021 年 7 月开始招募需要 PIVC 的住院儿童(胎龄大于 37 周的 0 岁至 18 岁)。它将招募 180 名儿童,按感知难度程度分层,并进行中央随机分组(比例为 1:1)。主要结局是首次尝试 PIVC 插入的成功率。次要结局包括 PIVC 插入尝试的总数、PIVC 插入失败、置管后并发症、留置时间、患者/家长满意度和医疗保健成本。本研究将证明与地标技术相比,超声引导 PIVC 插入具有优越性。医疗机构的采用可能会改善患者的结局并降低医疗保健成本。

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