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内镜科可以对入住三级教学医院的患者外周静脉导管相关并发症发出警示。

The endoscopy department can alert to complications associated with peripheral venous catheters in patients admitted to a tertiary teaching hospital.

作者信息

Pérez-Granda María Jesús, Guzmán Blanco Francisca, Aguado Díaz Sonia, Jiménez Bautista Rosario, Orense Velilla Julia, Rodríguez Calero Juana, Valls María Luisa, Arellano Antonio Vicente, García Santos Pilar, Munoz Patricia, Guembe María

机构信息

Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Department of Nursing, School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain.

出版信息

Heliyon. 2024 Aug 3;10(17):e35082. doi: 10.1016/j.heliyon.2024.e35082. eCollection 2024 Sep 15.

Abstract

BACKGROUND

The more widespread use of peripheral venous catheters (PVC) has led to more frequent complications, not only in PVC-associated bacteremia, but also in phlebitis. This requires the catheter to be removed and increases healthcare costs. Our aim was to assess the PVC-associated complications in an endoscopy department.

METHODS

We performed a cross-sectional, descriptive study on patients admitted to our center and undergoing a procedure in the endoscopy department. We analyzed the appearance of the following PVC-associated complications: obstruction, phlebitis, redness, extravasation, pain, and infection on the day of the study. All catheter tips were sent to the microbiology laboratory for culture using the roll-plate semiquantitative technique. Clinical and microbiological data were collected.

RESULTS

We included a total of 46 patients with 50 PVCs. The median (IQR) age was 70.0 (55.0-81.5) years, and 58.7% were female. The median (IQR) hospital stay was 9.00 (6.00-14.25) days. Of the 50 PVCs, most were inserted in the emergency room (74.0%), and the median (IQR) indwelling time was 5.00 (3.00-7.00) days. The phlebitis rate was 78.0%, which occurred mainly in PVCs inserted in the emergency room (74.3%). The tip was colonized in 9 PVCs (18.0%).

CONCLUSION

The endoscopy department can alert clinicians to PVC-associated complications. PVCs inserted in the emergency room were subject to a higher risk of phlebitis and/or colonization. Therefore, we recommend systematically replacing PVCs inserted in the emergency room within 48 h if preventive measures during insertion cannot be guaranteed.

摘要

背景

外周静脉导管(PVC)使用的日益广泛导致并发症更加频繁,不仅在与PVC相关的菌血症方面,在静脉炎方面亦是如此。这需要拔除导管并增加了医疗成本。我们的目的是评估内镜科中与PVC相关的并发症。

方法

我们对入住本中心并在内镜科接受手术的患者进行了一项横断面描述性研究。我们分析了以下与PVC相关的并发症在研究当天的表现:阻塞、静脉炎、发红、外渗、疼痛和感染。所有导管尖端均采用滚板半定量技术送至微生物实验室进行培养。收集临床和微生物学数据。

结果

我们共纳入了46例患者的50根PVC。年龄中位数(四分位间距)为70.0(55.0 - 81.5)岁,女性占58.7%。住院时间中位数(四分位间距)为9.00(6.00 - 14.25)天。在50根PVC中,大多数是在急诊室插入的(74.0%),留置时间中位数(四分位间距)为5.00(3.00 - 7.00)天。静脉炎发生率为78.0%,主要发生在急诊室插入的PVC中(74.3%)。9根PVC(18.0%)的尖端出现定植。

结论

内镜科可提醒临床医生注意与PVC相关的并发症。在急诊室插入的PVC发生静脉炎和/或定植的风险更高。因此,如果无法保证插入过程中的预防措施,我们建议在48小时内系统性更换在急诊室插入的PVC。

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