Zhou Mian, Dong Shan, Zhang Jinghui, Liu Yuping, Zhang Liuliu, Xu Junxia, Yang Ying, He Yulan, Wu Kaiping, Yuan Yuan, Lin Wenqin, Bian Wenxia, Li Juan, Chen Chunli, Xue Youhua, Tao Tingting, Kang Yubiao, Sun Lulu, Yuan Ling, Xu Cuirong
Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha 410008, China.
Int J Nurs Stud. 2024 Mar;151:104676. doi: 10.1016/j.ijnurstu.2023.104676. Epub 2023 Dec 20.
Central venous catheters are widely used in clinical practice, and the incidence of central venous catheter occlusion is between 25 % and 38 %. The turbulence caused by the pulsatile flushing technique is harmful to the vascular endothelium and may lead to phlebitis. The low-speed continuous infusion catheter technique is a new type of continuous infusion that ensures that the catheter is always in a keep-vein-open state by continuous low-speed flushing; hence, avoiding the problem of catheter occlusion.
To investigate the effectiveness of the low-speed continuous infusion catheter technique and the routine care of double-lumen central venous catheters.
This was a prospective, randomized, controlled, open-label trial.
Patients were recruited from 14 medical institutions in China between February and June 2023.
In total, 251 patients were recruited, with 125 in the intervention group and 126 in the control group.
Patients who used double-lumen central venous catheters for infusion treatment were selected, and those who met the sampling criteria were randomly divided into intervention and control groups using the random envelope method. The intervention group used the low-speed continuous infusion catheter technique to maintain catheter patency, whereas the control group used routine care with a trial period of 7 days. The primary outcome was the occlusion rate. The secondary outcomes included nursing satisfaction and complication rates of the two groups.
After 7 days, the rate of catheter occlusion was 28.0 % (35/125, 95 % confidence interval (CI):0.203, 0.367) in the intervention group and 53.97 % (68/126, 95 % CI: 0.449-0.629) in the control group, with a statistically significant difference (χ = 17.488, p < 0.001); at 3 days of intervention, the rate of catheter blockage was 8.0 % (10/125, 95 % CI: 0.039-0.142) in the intervention group and 23.8 % (30/126, 0.167-0.322) in the control group, with a statistically significant difference (χ = 11.707, p < 0.001). Nurse satisfaction was significantly higher in the intervention group (115/125, 92.0 %, 95 % CI: 0.858-0.961) than in the control group (104/126, 82.54 %, 95 % CI: 0.748-0.887) (χ = 5.049, p = 0.025). There were no statistically significant complication rates in either group (p = 0.622).
The low-speed continuous infusion catheter technique helps maintain catheter patency, improves nurse satisfaction, and provides a high level of safety.
Chinese Clinical Trial Registry (ChiCTR2200064007, www.chictr.org.cn). The first recruitment was conducted in February. https://www.chictr.org.cn/showproj.html?proj=177311.
中心静脉导管在临床实践中广泛应用，中心静脉导管堵塞的发生率在25%至38%之间。脉冲式冲管技术引起的血流紊乱对血管内皮有害，可能导致静脉炎。低速连续输注导管技术是一种新型的连续输注方式，通过持续低速冲洗确保导管始终处于保持静脉通畅状态，从而避免导管堵塞问题。
探讨低速连续输注导管技术及双腔中心静脉导管常规护理的效果。
这是一项前瞻性、随机、对照、开放标签试验。
2023年2月至6月期间从中国14家医疗机构招募患者。
共招募251例患者，干预组125例，对照组126例。
选择使用双腔中心静脉导管进行输液治疗的患者，符合抽样标准者采用随机信封法随机分为干预组和对照组。干预组采用低速连续输注导管技术维持导管通畅，对照组采用常规护理，试验期为7天。主要结局是堵塞率。次要结局包括两组的护理满意度和并发症发生率。
7天后，干预组导管堵塞率为28.0%（35/125，95%置信区间（CI）：0.203，0.367），对照组为53.97%（68/126，95%CI：0.449 - 0.629），差异有统计学意义（χ² = 17.488，p < 0.001）；干预3天时，干预组导管堵塞率为8.0%（10/125，95%CI：0.039 - 0.142），对照组为23.8%（30/126，0.167 - 0.322），差异有统计学意义（χ² = 11.707，p < 0.001）。干预组护士满意度显著高于对照组（115/125，92.0%，95%CI：0.858 - 0.961）（104/126，82.54%，95%CI：0.748 - 0.887）（χ² = 5.049，p = 0.025）。两组并发症发生率差异无统计学意义（p = 0.622）。
低速连续输注导管技术有助于维持导管通畅，提高护士满意度，并具有较高的安全性。
中国临床试验注册中心（ChiCTR2200064007，www.chictr.org.cn）。首次招募于2月进行。https://www.chictr.org.cn/showproj.html?proj=177311
