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围手术期护理中快速输液导管的有效利用:一项叙述性综述

Effective utilisation of rapid infusion catheters in perioperative care: a narrative review.

作者信息

Scorer Adam, Chahal Rani, Ellard Louise, Myles Paul S, Bradley William P L

机构信息

Department of Anaesthesiology and Perioperative Medicine, The Alfred, Melbourne, VIC, Australia.

Department of Critical Care, University of Melbourne, VIC, Australia.

出版信息

BJA Open. 2025 Jan 22;13:100365. doi: 10.1016/j.bjao.2024.100365. eCollection 2025 Mar.

Abstract

The Rapid Infusion Catheter (RIC) has transformed intravenous (i.v.) access, allowing for rapid fluid delivery peripherally. It may negate the need for a central vein sheath to be placed. This review explores the clinical utility of RICs while addressing technical considerations and potential risks. The RIC is a large-bore i. v. sheath available in two sizes. Its maximal flow rate is 1200 ml min, making it advantageous in significant blood loss scenarios such as trauma and major surgeries. Insertion involves the Seldinger technique. Monitoring and maintaining the RIC is crucial to detect and address immediate complications such as occlusions, infiltration, phlebitis, and extravasation of infusate. Although the related complications share similarities with those of other peripheral i. v. cannulae, they have a lower risk of occlusion and accidental displacement. Catheter removal should be considered once the patient is stable or alternative access is available to avoid infectious complications. Removal of the RIC needs to be performed by those educated in RIC management. Maximal flow rate is an essential factor in assessing the performance of i. v. cannulae, and studies have shown that RICs outperform other peripheral and central catheters in this regard. In conclusion, RIC offers advantages over large-bore central venous access for large-volume rapid infusions, including ease of insertion and reduced severe complications. The RIC demonstrates lower thrombosis rates and a different complication profile than peripherally inserted central catheters. Understanding the characteristics and applications of RICs can help healthcare professionals make informed decisions about their use in various medical scenarios.

摘要

快速输注导管(RIC)改变了静脉通路,使外周快速补液成为可能。它可能无需放置中心静脉鞘。本综述探讨了RIC的临床实用性,同时阐述了技术考量和潜在风险。RIC是一种大口径静脉鞘,有两种尺寸。其最大流速为1200毫升/分钟,在创伤和大手术等大出血情况下具有优势。插入采用Seldinger技术。监测和维护RIC对于检测和处理诸如堵塞、渗漏、静脉炎和输注液外渗等即时并发症至关重要。尽管相关并发症与其他外周静脉套管的并发症有相似之处,但它们的堵塞和意外移位风险较低。一旦患者病情稳定或有其他替代通路,应考虑拔除导管以避免感染并发症。RIC的拔除需由接受过RIC管理培训的人员进行。最大流速是评估静脉套管性能的一个重要因素,研究表明在这方面RIC优于其他外周和中心导管。总之,对于大容量快速输注,RIC比大口径中心静脉通路更具优势,包括易于插入和严重并发症减少。与外周置入中心导管相比,RIC的血栓形成率更低,并发症情况也不同。了解RIC的特性和应用有助于医护人员在各种医疗场景中明智地决定是否使用它。

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