Ramachandran P, Cohen R S, Kim E H, Glasscock G F
Department of Pediatrics, Stanford University School of Medicine, Santa Clara Valley Medical Center, San Jose, Calif 95128.
J Perinatol. 1994 Jul-Aug;14(4):280-4.
Reliable vascular access can be problematic in sick low-birth-weight neonates. Umbilical venous catheters are one form of vascular access that can be used in this population. A retrospective review of experience with umbilical venous catheters in our neonatal intensive care unit from January 1989 through December 1991 was conducted. This included 128 patients: 70 with single-lumen (Gesco Umbilicath II) and 58 with double-lumen (Becton-Dickinson Careflow) catheters. Birth weight, gestational age, catheter life span, complications, and number of punctures for peripheral intravenous lines were analyzed. The mean birth weight, gestational age, and catheter life span did not differ significantly between catheter types. The incidence of catheter-related sepsis did not differ significantly (two single-lumen, three double-lumen) and occurred only in neonates with a catheter life span greater than 10 days. The number of intravenous punctures was significantly decreased in those neonates with double-lumen umbilical venous catheters (p < 0.0001). We conclude that in sick low-birth-weight infants the use of double-lumen umbilical venous catheters entails no greater risk than the use of a single-lumen umbilical venous catheter and may reduce iatrogenic stress associated with the starting of peripheral intravenous lines.
对于患病的低体重新生儿来说，建立可靠的血管通路可能存在问题。脐静脉导管是可用于这一人群的一种血管通路形式。我们对1989年1月至1991年12月期间在我们新生儿重症监护病房使用脐静脉导管的经验进行了回顾性研究。这包括128例患者：70例使用单腔（Gesco Umbilicath II）导管，58例使用双腔（Becton-Dickinson Careflow）导管。分析了出生体重、胎龄、导管使用寿命、并发症以及外周静脉穿刺的次数。两种导管类型之间的平均出生体重、胎龄和导管使用寿命没有显著差异。导管相关败血症的发生率没有显著差异（单腔导管2例，双腔导管3例），且仅发生在导管使用寿命超过10天的新生儿中。双腔脐静脉导管的新生儿静脉穿刺次数显著减少（p < 0.0001）。我们得出结论，对于患病的低体重婴儿，使用双腔脐静脉导管并不比使用单腔脐静脉导管风险更大，并且可能减少与外周静脉穿刺相关的医源性应激。
