Department of Cardiothoracic and Vascular Surgery, Anaesthesia Section, Aarhus University Hospital, Aarhus N, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.
Acta Anaesthesiol Scand. 2024 Nov;68(10):1463-1470. doi: 10.1111/aas.14517. Epub 2024 Aug 26.
Intravenous therapies are essential for hospitalised patients. The rapid dissemination of portable ultrasound machines has eased ultrasound-guided intravenous access and facilitated increased use of long peripheral venous catheters (LPCs). This study aimed to evaluate the clinical performance and complications of LPCs.
Retrospective, observational single-site study. Data from all consecutively inserted LPCs during a period of 18 months was evaluated. The primary endpoint was the all-cause incidence rate of catheter removal. Secondary endpoints included specific reasons for the catheter removal and the associations between predefined characteristics of the patients, the infusions and the catheters with catheter failure.
During the period, 751 PVCs were inserted in 457 patients. The reasons for catheter removal were recorded in 563 cases. The overall incidence rate of catheter removal was 95.8/1000 catheter days (95% CI 88.4-103.8). The median dwell time was 8 days (IQR 5-14), and the total dwell time was 6136 days. Catheter failure occurred in 283 (50.3%) cases, of which the most common cause was phlebitis (n = 101, 17.9%). In multivariable analyses, the use of the cephalic vein was significantly associated with both all-cause catheter failure (p < .001) and catheter failure due to phlebitis (p < .001). In multivariable analyses, vancomycin infusion was not significantly associated with all-cause catheter failure (HR 1.15 (0.55-2.42), p = .71) or catheter failure due to phlebitis (HR 1.49 (0.49-4.53), p = .49).
The overall incidence rate of catheter removal was 95.8/1000 catheter days, and the most common causes of catheter failure were phlebitis, infiltration and unintended catheter removal. The use of the cephalic vein was significantly associated with catheter failure in multivariable analyses. We did not find an association between vancomycin infusion and catheter failure in multivariable analyses.
静脉治疗对于住院患者至关重要。便携式超声机的快速普及使得超声引导下的静脉穿刺变得更加容易，并促进了长外周静脉导管（LPC）的广泛应用。本研究旨在评估 LPC 的临床性能和并发症。
回顾性、观察性单站点研究。评估了 18 个月期间连续插入的所有 LPC 的数据。主要终点是导管拔除的全因发生率。次要终点包括导管拔除的具体原因，以及患者、输液和导管的预定义特征与导管失败之间的关联。
在此期间，457 名患者共插入 751 根 PVC。563 例记录了导管拔除的原因。导管总拔除率为 95.8/1000 导管日（95%CI 88.4-103.8）。中位留置时间为 8 天（IQR 5-14），总留置时间为 6136 天。导管失败发生在 283 例（50.3%）中，最常见的原因是静脉炎（n=101，17.9%）。多变量分析显示，使用头静脉与全因导管失败（p<0.001）和静脉炎导致的导管失败（p<0.001）显著相关。多变量分析显示，万古霉素输注与全因导管失败（HR 1.15（0.55-2.42），p=0.71）或静脉炎导致的导管失败（HR 1.49（0.49-4.53），p=0.49）无显著相关性。
导管总拔除率为 95.8/1000 导管日，导管失败的最常见原因是静脉炎、渗出和意外导管拔除。多变量分析显示，头静脉的使用与导管失败显著相关。多变量分析未发现万古霉素输注与导管失败之间存在关联。
