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新生儿科经外周静脉穿刺中心静脉置管不良位置诊断的临床验证

Clinical validation of the diagnosis adverse location of peripherally inserted central catheter in neonatology.

作者信息

Prado Nanete Caroline da Costa, Silva Richardson Augusto Rosendo da, Menezes Harlon França de, Santos Isabele Silva Dos, Santos Rebecca Stefany da Costa, Juraci Sérgio Danillo Santana de Lima, Raimundo Dhyanine Morais de Lima, Almino Romanniny Hévillyn Silva Costa

机构信息

Universidade Federal do Rio Grande do Norte, Programa de Pós-graduação em Enfermagem, Natal, RN, Brazil.

出版信息

Rev Esc Enferm USP. 2025 Aug 4;59:e20250117. doi: 10.1590/1980-220X-REEUSP-2025-0117en. eCollection 2025.

DOI:10.1590/1980-220X-REEUSP-2025-0117en
PMID:40762992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12330225/
Abstract

OBJECTIVE

To determine the accuracy measures of clinical indicators of Nursing Diagnosis (ND) of the International Classification of Nursing Practice (ICNP)®, Adverse Location of Peripherally Inserted Central Catheter in a Neonatal Intensive Care Unit (NICU).

METHODS

Diagnostic accuracy study carried out with 40 neonates admitted to a NICU in Northeastern Brazil. Data collection was performed through clinical examination and application of an institutional instrument. The clinical indicators analysis of the respective ND was performed using accuracy measures.

RESULTS

Among the study participants, the majority were female and had low birth weight. The prevalence of ND was 57.5%. The clinical indicators 'difficulty in catheter progression' and 'absence of blood return' showed high specificity values. The catheter insertion site, prematurity, and the occurrence of adverse events presented higher sensitivity values.

CONCLUSION

Accurate diagnostic inference allows the early identification of inadequate catheter tip positioning, supporting nurses in developing precise and effective interventions to avoid complications.

摘要

目的

确定国际护理实践分类法(ICNP)®中护理诊断(ND)的临床指标在新生儿重症监护病房(NICU)外周静脉穿刺中心静脉导管位置不当方面的准确性指标。

方法

对巴西东北部一家NICU收治的40例新生儿进行诊断准确性研究。通过临床检查和应用机构工具进行数据收集。使用准确性指标对相应ND的临床指标进行分析。

结果

在研究参与者中,大多数为女性且出生体重低。ND的患病率为57.5%。临床指标“导管推进困难”和“无回血”显示出高特异性值。导管插入部位、早产和不良事件的发生呈现出较高的敏感性值。

结论

准确的诊断推断有助于早期识别导管尖端位置不当,支持护士制定精确有效的干预措施以避免并发症。

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本文引用的文献

1
Recommendations for Peripherally Inserted Central Catheter Insertion Depths in Neonates.推荐新生儿外周置入中心静脉导管插入深度。
Neonatology. 2023;120(2):263-267. doi: 10.1159/000528076. Epub 2023 Jan 3.
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Effect of femoral PICC line insertion in neonates with digestive tract disease.股静脉经外周中心静脉置管在消化道疾病新生儿中的应用效果
Am J Transl Res. 2022 Oct 15;14(10):7487-7493. eCollection 2022.
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Terms of specialized nursing language in the care of the newborn with central venous catheter.新生儿中心静脉导管护理的专业护理语言术语。
Rev Bras Enferm. 2022 Jul 29;75(6):e20210572. doi: 10.1590/0034-7167-2021-0572. eCollection 2022.
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Methods for measuring venous peripherally inserted central catheters in newborns.新生儿外周静脉置入中心静脉导管测量方法。
Rev Bras Enferm. 2021 Oct 18;75(2):e20210045. doi: 10.1590/0034-7167-2021-0045. eCollection 2021.
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Peripherally inserted central cathether migration in neonates: Incidence, timing and risk factors.外周置入中心静脉导管在新生儿中的迁移:发生率、时间和危险因素。
J Neonatal Perinatal Med. 2021;14(3):411-417. doi: 10.3233/NPM-200684.
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Neonatal Anthropometric Measures and Peripherally Inserted Central Catheter Depth.新生儿人体测量指标与经外周静脉置入中心静脉导管深度。
Adv Neonatal Care. 2021 Aug 1;21(4):314-321. doi: 10.1097/ANC.0000000000000817.
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Infusion Therapy Standards of Practice, 8th Edition.《输液治疗实践标准》第8版
J Infus Nurs. 2021;44(1S Suppl 1):S1-S224. doi: 10.1097/NAN.0000000000000396.
8
A 1-Year Study on Association between Peripherally Inserted Central Catheter Tip Position and Complications in Neonates.新生儿外周静脉穿刺中心静脉置管尖端位置与并发症相关性的1年研究
J Indian Assoc Pediatr Surg. 2020 Sep-Oct;25(5):276-279. doi: 10.4103/jiaps.JIAPS_87_19. Epub 2020 Sep 1.
9
Nurses' knowledge of peripherally inserted central catheter maintenance and its influencing factors in Hunan province, China: a cross-sectional survey.湖南省护士对外周置入中心静脉导管维护知识及其影响因素的认知:一项横断面调查
BMJ Open. 2020 May 21;10(5):e033804. doi: 10.1136/bmjopen-2019-033804.
10
Paths taken by Brazilian Nursing for the development of terminological subsets.巴西护理学为术语子集发展所采取的路径。
Rev Lat Am Enfermagem. 2020;28:e3270. doi: 10.1590/1518-8345.3132.3270. Epub 2020 May 11.