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有影响吗?外周静脉穿刺中心静脉导管的回顾性研究:哥伦比亚的单中心经验。

Making a difference? A retrospective review of peripherally inserted central catheters: A single-center experience in Colombia.

作者信息

García-Zambrano Laura, Morales-Gómez Daniel, Dennis-Halley Michael J, Román-Ortega Carlos F, Cabrera-Rivera Paulo A, Parra Marcela

机构信息

General Surgery Research Group, Fundación Cardioinfantil-La Cardio, Bogotá, Colombia.

School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.

出版信息

SAGE Open Med. 2023 Oct 5;11:20503121231201349. doi: 10.1177/20503121231201349. eCollection 2023.

Abstract

INTRODUCTION

Peripherally inserted central catheters (PICCs) are an effective tool as a medical device in patients who require them. However, it is a procedure that has been associated with multiple complications and possible negative outcomes for the health of the patients. This paper seeks to describe the main complications derived from the insertion and maintenance of peripherally inserted central venous catheters (PICCs), based on the experience of a vascular accesses group in a cardiovascular center in Colombia.

METHODS

A retrospective cross-sectional analytical study of the adult population undergoing PICC insertion at the Fundación Cardioinfantil-Instituto de Cardiología, during the period between 2019 and 2020 by the vascular access program, was performed.

RESULTS

The frequency of any registered complication was 15.9% for 2019 and 11.2% for 2020. Bleeding at the procedure site occurred in 15.3% during 2019 and 7.0% in 2020, making it the most frequent complication during the procedure. All the variables of complications associated with infection (bacteremia, phlebitis, and catheter-related infection) showed a decrease in 2020 compared to the previous year. The central line-associated bloodstream infection registered for the year 2019 was 1.94 bacteremia's/1000 catheters-day compared to 0.29 bacteremia's/1000 catheters-day.

CONCLUSIONS

There has been a 4.7% reduction in the frequency of any registered complication after the implementation of the vascular access groups. Global and specific complications decreased significantly from 2019 to 2020. Notably, bacteremia, a common post-procedure complication, showed a substantial decrease in frequency compared to national and worldwide literature. It is also been described that complications associated with infection showed a decrease in 2020 compared to 2019. Whether or not all these findings are directly or somewhat related to the results stemming from the vascular access groups still needs further investigation.

摘要

引言

经外周静脉穿刺中心静脉置管(PICC)对于有需求的患者而言是一种有效的医疗设备。然而,该操作会引发多种并发症,并可能对患者健康产生不良后果。本文基于哥伦比亚一家心血管中心血管通路团队的经验,旨在描述经外周静脉穿刺中心静脉置管(PICC)的插入和维护过程中产生的主要并发症。

方法

对2019年至2020年期间在儿童心脏病基金会 - 心脏病学研究所接受血管通路团队进行PICC置管的成年患者进行回顾性横断面分析研究。

结果

2019年任何已记录并发症的发生率为15.9%,2020年为11.2%。2019年操作部位出血发生率为15.3%,2020年为7.0%,使其成为操作过程中最常见的并发症。与感染相关的所有并发症变量(菌血症、静脉炎和导管相关感染)在2020年较上一年均有所下降。2019年记录的中心静脉导管相关血流感染为1.94例菌血症/1000导管日,而2020年为0.29例菌血症/1000导管日。

结论

血管通路团队实施后,任何已记录并发症的发生率降低了4.7%。从2019年到2020年,总体和特定并发症均显著下降。值得注意的是,与全国和全球文献相比,作为常见术后并发症的菌血症发生率大幅下降。研究还表明,与感染相关的并发症在2020年较2019年有所减少。所有这些发现是否直接或部分与血管通路团队的结果相关仍需进一步研究。

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