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处理中心静脉通路装置堵塞的干预措施:一项系统评价。

Interventions to manage occluded central venous access devices: An umbrella review.

作者信息

Elliott Jessica, Ng Linda, Meredith Carolyn, Mander Gordon, Thompson Murray, Reynolds Lorraine

机构信息

School of Nursing and Midwifery, University of Southern Queensland, Ipswich, QLD, Australia.

Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia.

出版信息

J Vasc Access. 2025 May;26(3):726-734. doi: 10.1177/11297298241246092. Epub 2024 Apr 24.

Abstract

The main objective of this umbrella review is to synthesise available evidence from systematic reviews on the effectiveness of interventions for the management of occlusions in central venous access devices. CVADS have been extensively utilised among the critically ill since the 1950s however have also been linked to an increase in catheter complications. CVAD occlusion can occur in 14%-36% of patients within 1-2 years of catheter placement and is a longstanding complication. Umbrella methodology was applied to review five healthcare databases. Databases were searched for publications from 2009 and 2022 and electronic keywords searches were conducted. The authors searched for reviews that reported on any intervention to prevent, maintain or manage patency of the central venous access devices within an acute care setting. Of the 278 articles identified from the initial search a total of 11 articles were identified. This umbrella review concluded that education enhances patient outcomes and decreases occlusion rates. Further studies are required to explore occlusion reduction strategies in relation to flushing and locking.

摘要

本综合性综述的主要目的是综合系统评价中关于中心静脉通路装置(CVAD)堵塞管理干预措施有效性的现有证据。自20世纪50年代以来,CVAD在重症患者中得到了广泛应用,但也与导管并发症的增加有关。CVAD堵塞可发生在导管置入后1至2年内14% - 36%的患者中,是一种长期存在的并发症。采用综合性方法对五个医疗保健数据库进行了综述。检索了2009年至2022年的数据库出版物并进行了电子关键词搜索。作者搜索了报告在急性护理环境中预防、维持或管理中心静脉通路装置通畅的任何干预措施的综述。在初步搜索中识别出的278篇文章中,共识别出11篇文章。本综合性综述得出结论,教育可改善患者预后并降低堵塞率。需要进一步研究以探索与冲洗和封管相关的减少堵塞策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a62/12117124/76303c0b4218/10.1177_11297298241246092-fig1.jpg

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