Martínez J A, Fernández P, Rodríguez E, Sobrino J, Torres M, Nubiola A, Bugés J
Servicio de Medicina Interna, Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona.
Med Clin (Barc). 1994 Jun 18;103(3):89-93.
The aim of this study was to analyze the complications derived from the use of intravenous cannulae with particular attention being paid to the possible predisposing factors.
A prospective follow up of 569 intravenous cannulae placed in the emergency department or the medical ward of a county hospital was carried out. 492 of these cannulae were peripheral (PC) and 77 central inserted through peripheral veins (CPVC).
Fifty-one percent of the catheters were withdrawn due to complications with the most frequent being phlebitis (35%), followed by extravasation (11.5%). The mean time in situ was 3.61 +/- 3.2 days. The daily risk of complications ranged from 2 to 9% for the CPVC (non significant differences) and between 15% (day 1) and 30% (6 or more days) for the PC. In the latter case there were no differences in the daily specific rate of complications after the first 24 hours. The probability of a catheter remaining in place more than three and six days without complications was 51% and 31%, respectively for the CP and 91% and 87% for the CPVC (p < 0.0001). Of the variables analyzed, age > 65 years, female sex, insertion of the cannula into the back of the hand, the fact of the route being peripheral without the administration of heparin were significantly associated to the development of complications, while the intravenous administration of aminophillin was associated with the appearance of phlebitis. Thirteen percent of the catheters withdrawn due to phlebitis were infected.
The complication most frequent observed in intravenous cannulation was phlebitis, an entity which is generally not of an infectious nature. The risk of unspecific complications every day during catheterization is constant in the case of central peripheral vein cannulae as well as in peripheral cannulae which do show problems during the first 24 hours after placement. Insertion of the cannulae into the veins of the back of the hand, female sex, advanced age and intravenous administration of certain drugs influence in the development of phlebitis.
本研究旨在分析静脉套管使用过程中出现的并发症，并特别关注可能的诱发因素。
对一家县级医院急诊科或内科病房置入的569根静脉套管进行前瞻性随访。其中492根为外周静脉套管（PC），77根为经外周静脉置入的中心静脉套管（CPVC）。
51%的导管因并发症而拔除，最常见的是静脉炎（35%），其次是外渗（11.5%）。导管在位平均时间为3.61±3.2天。CPVC的每日并发症风险为2%至9%（无显著差异），PC的每日并发症风险在第1天为15%，在6天或更长时间为30%。在后一种情况下，放置后24小时后的每日特定并发症发生率无差异。CP和CPVC的导管分别在无并发症的情况下留置超过3天和6天的概率为51%和31%，以及9%和分别为87%（p<0.0001）。在分析的变量中，年龄>65岁、女性、套管插入手背、外周途径且未使用肝素与并发症的发生显著相关，而静脉注射氨茶碱与静脉炎的出现相关。因静脉炎拔除的导管中有13%发生感染。
静脉置管中最常见的并发症是静脉炎，通常不是感染性的。对于中心外周静脉套管以及在放置后最初24小时内出现问题的外周套管，置管期间每天发生非特异性并发症的风险是恒定的。将套管插入手背静脉、女性、高龄和静脉注射某些药物会影响静脉炎的发生。
