SC Medicina di Laboratorio, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Giacomo Venezian, 1 20133 Milan, Italy.
BD Life Sciences - Integrated Diagnostic Solution, Italy.
Eur J Oncol Nurs. 2024 Oct;72:102680. doi: 10.1016/j.ejon.2024.102680. Epub 2024 Jul 31.
Difficult venous access (DVA), characterized by non-visible and non-palpable veins, is common in oncology patients. The objectives of this study were to compare the performances of two blood collection sets in an oncology phlebotomy setting: BD Vacutainer® UltraTouch™ Push Button (UT-PBBCS) and BD Vacutainer® Safety-Lok™ Blood Collection Set (SLBCS). The two sets were evaluated to assess whether use of a smaller gauge (G) needle (down-gauging) may reduce patient pain and improve peripheral venous access experience during phlebotomy in oncology patients.
Questionnaires were used to record patient data (age, gender), phlebotomy procedural observations (venipuncture site, number of collected tubes, blood flow, needle repositioning, underfilled tubes), patient pain perception and phlebotomist difficulty perception scores (0-10 points scale). Specimen quality was evaluated by hemolysis index (HI) on Roche Cobas® 6000.
Subject groups showed no statistical difference. SLBCS (21/23G) or UT-PBBCS (23/25G) were used in 264 (45.8%) and 313 (54.2%) subjects respectively. Lower gauge was preferred for DVA (hand venipuncture), and DVA was associated with tube underfilling but no with type of blood collection set. For UT-PBBCS, pain perception, patients' anxiety level and phlebotomists' difficulty grade were lower when compared to SLBCS (p < 0.001). Blood samples collected with UT-PBBCS showed less hemolysis compared to samples collected with SLBCS (p < 0.001).
Provision of a smaller gauge UT-PBBCS option during phlebotomy in oncology patients with DVA reduces procedural pain and anxiety and improved phlebotomist' experience during sample collection. Despite the down-gauging, hemolysis was lower for UT-PBBCS, keeping sample quality while improving DVA patient comfort.
静脉穿刺困难(DVA)的特点是静脉不可见且不可触及,在肿瘤患者中较为常见。本研究的目的是比较两种在肿瘤采血环境中使用的采血套件:BD Vacutainer® UltraTouch™ Push Button(UT-PBBCS)和 BD Vacutainer® Safety-Lok™ Blood Collection Set(SLBCS)的性能。评估这两种套件,以确定使用较小规格(G)针头(降规)是否可以减轻患者疼痛并改善肿瘤患者采血时的外周静脉通路体验。
使用问卷记录患者数据(年龄、性别)、采血程序观察(静脉穿刺部位、采集的管数、血流情况、针头重新定位、管未完全充满)、患者疼痛感知和采血师困难感知评分(0-10 分)。罗氏 Cobas® 6000 评估样本质量的溶血指数(HI)。
受试组无统计学差异。SLBCS(21/23G)或 UT-PBBCS(23/25G)分别用于 264 例(45.8%)和 313 例(54.2%)患者。在 DVA(手部静脉穿刺)中,倾向于使用较小规格的套件,DVA 与管未完全充满有关,但与采血套件类型无关。与 SLBCS 相比,UT-PBBCS 用于患者时,疼痛感知、患者焦虑程度和采血师难度等级较低(p<0.001)。与 SLBCS 相比,UT-PBBCS 采集的血液样本溶血较少(p<0.001)。
在 DVA 肿瘤患者采血时提供较小规格的 UT-PBBCS 选项可减轻操作过程中的疼痛和焦虑,改善采血师在采集样本过程中的体验。尽管进行了降规,但 UT-PBBCS 的溶血率较低,在提高 DVA 患者舒适度的同时保持样本质量。