Jatczak Leonardo, Puton Renan Camargo, Proença Alencar Junior Lopes, Rubin Leonardo Colussi, Borges Luiza Brum, Saleh Jaber Nashat, Corrêa Mateus Picada
Faculdade Meridional - IMED, Passo Fundo, RS, Brasil.
Instituto Vascular de Passo Fundo - INVASC, Passo Fundo, RS, Brasil.
J Vasc Bras. 2023 Sep 18;22:e20230070. doi: 10.1590/1677-5449.202300702. eCollection 2023.
Central venous catheters are essential for management of hospitalized patients, but their insertion is subject to complications that can make them unusable and/or cause patient morbidity. There are few data on the incidence of these complications and the variables associated with these outcomes in Brazil.
To determine the incidence of mechanical complications and failures of short stay central venous catheters fitted by the vascular surgery service at a teaching hospital and identify variables associated with their occurrence.
This was a prospective cohort of 73 attempts to fit patients with a central venous catheter performed by the vascular surgery service at a teaching hospital from July to October of 2022.
Mechanical complications occurred in 12 cannulation attempts (16.44%) and there were 10 failures (13.70%). The factors associated with mechanical complications were less experienced operators (p < 0.001), less specialized operators (p = 0.014), a failed attempt prior to requesting help from the vascular surgery service (p = 0.008), and presence of at least two criteria for difficulty (p = 0.007).
The local incidence of mechanical complications and central venous cannulation failures was similar to rates described in the international literature, but higher than rates in other Brazilian studies. The results suggest that the degree of experience of the person fitting the catheter, history of a failed prior attempt, and presence of at least two criteria for difficulty identified before the procedure were associated with worse outcomes.
中心静脉导管对于住院患者的管理至关重要，但其插入过程可能会出现并发症，导致导管无法使用和/或引发患者发病。在巴西，关于这些并发症的发生率以及与这些结果相关的变量的数据很少。
确定教学医院血管外科安装的短期中心静脉导管的机械并发症和失败发生率，并识别与其发生相关的变量。
这是一项前瞻性队列研究，对2022年7月至10月期间教学医院血管外科为患者安装中心静脉导管的73次尝试进行了研究。
12次插管尝试（16.44%）出现机械并发症，10次（13.70%）失败。与机械并发症相关的因素包括经验较少的操作人员（p < 0.001）、专业性较低的操作人员（p = 0.014）、在向血管外科寻求帮助之前尝试失败（p = 0.008）以及存在至少两项困难标准（p = 0.007）。
机械并发症和中心静脉插管失败的当地发生率与国际文献中描述的发生率相似，但高于巴西其他研究中的发生率。结果表明，安装导管人员的经验程度、先前尝试失败的历史以及在操作前存在至少两项困难标准与较差的结果相关。
