BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the u...BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous(IO) access and central venous catheterization(CVC) in critically ill Chinese patients.METHODS: In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned above.RESULTS: A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group(91.7% vs. 50.0%, P<0.001;52.0 seconds vs. 900.0 seconds, P<0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion(1.5 vs. 0.0, P=0.044). Complications were not observed in the two groups.CONCLUSIONS: IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.展开更多
目的针对开展超声引导下桡动脉穿刺置管术的ICU危重症患者,施行优化护理措施,评价其护理效果。方法方便选取2021年1月—2023年1月厦门市苏颂医院重症加强护理病房(Intensive Care Unit,ICU)危重症患者80例为研究对象。以盲选法为分组依...目的针对开展超声引导下桡动脉穿刺置管术的ICU危重症患者,施行优化护理措施,评价其护理效果。方法方便选取2021年1月—2023年1月厦门市苏颂医院重症加强护理病房(Intensive Care Unit,ICU)危重症患者80例为研究对象。以盲选法为分组依据,对照组40例、观察组40例。所有患者均开展超声引导下桡动脉穿刺置管术,对照组接受常规护理措施,观察组接受优化护理措施。统计两组的穿刺成功次数情况、术后并发症发生情况、护理满意度情况、穿刺效果相关指标。结果观察组穿刺一次成功率为87.50%,高于对照组的50.00%,穿刺两次及以上成功率为12.50%,低于对照组的47.50%,差异有统计学意义(χ^(2)=13.091、11.667,P均<0.05)。与对照组相比,观察组穿刺时间更短,穿刺次数更少,护理后的生活质量评分、疾病知识掌握程度评分更高,差异有统计学意义(P均<0.05)。结论针对开展超声引导下桡动脉穿刺置管术的ICU危重症患者,施行优化护理措施,能够提升穿刺一次成功率,降低并发症发生率,提高知识掌握率,提高生活质量。展开更多
目的探讨末端瓣膜耐高压注射型经外周静脉穿刺中心静脉置管(application of power peripherally inserted central catheter solo,Power PICC Solo)与经锁骨下中心静脉置管(central venous catheter,CVC)在造血干细胞移植患者中的应用...目的探讨末端瓣膜耐高压注射型经外周静脉穿刺中心静脉置管(application of power peripherally inserted central catheter solo,Power PICC Solo)与经锁骨下中心静脉置管(central venous catheter,CVC)在造血干细胞移植患者中的应用。方法选取2021年9月—2023年6月厦门大学附属第一医院收治的100例造血干细胞移植患者。根据患者置管方法分为外周静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC)组(n=58)和CVC组(n=42),PICC组采用Power PICC Solo,CVC组采用CVC。比较2组患者的置管成功情况、操作时间、导管置留时间、置管费用、置管后舒适度、患者液体流速、并发症发生率、患者满意度。结果PICC组置管成功率优于CVC组,差异有统计学意义(P<0.05)。PICC组操作时间短于CVC组,导管置留时间长于CVC组,置管费用高于CVC组,差异有统计学意义(P<0.05)。PICC组患者舒适度优于CVC组,差异有统计学意义(P<0.05)。在置管后第1、10、20、30天,PICC组患者液体流速均低于CVC组,且2组患者置管后第30天流速均低于置管后第1天,差异有统计学意义(P<0.05)。PICC组患者血栓性静脉炎发生率高于CVC组,导管感染发生率低于CVC组,差异有统计学意义(P<0.05),2组患者血气胸、导管异位、导管脱落等发生率比较,差异无统计学意义(P>0.05)。PICC组操作技术满意度评分为(17.24±2.17)分,高于CVC组的(14.07±2.68)分,差异有统计学意义(P<0.05)。结论与CVC比较,Power PICC Solo能够提高造血干细胞移植患者一次置管成功率,降低置管操作时间,延长导管置留时间,提高患者置管后舒适度,但置管费用较高,且血栓性静脉炎发生率高。展开更多
基金supported by the Capital Clinical Characteristic Applied Research Project(z151100004015118)the Fostering and Exploring Project of Key Clinical Projects in the Peking University Third Hospital(BYSY2014006)the Health Science Promotion Project of Beijing(TG-2017-83)。
文摘BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous(IO) access and central venous catheterization(CVC) in critically ill Chinese patients.METHODS: In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned above.RESULTS: A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group(91.7% vs. 50.0%, P<0.001;52.0 seconds vs. 900.0 seconds, P<0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion(1.5 vs. 0.0, P=0.044). Complications were not observed in the two groups.CONCLUSIONS: IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.
文摘目的针对开展超声引导下桡动脉穿刺置管术的ICU危重症患者,施行优化护理措施,评价其护理效果。方法方便选取2021年1月—2023年1月厦门市苏颂医院重症加强护理病房(Intensive Care Unit,ICU)危重症患者80例为研究对象。以盲选法为分组依据,对照组40例、观察组40例。所有患者均开展超声引导下桡动脉穿刺置管术,对照组接受常规护理措施,观察组接受优化护理措施。统计两组的穿刺成功次数情况、术后并发症发生情况、护理满意度情况、穿刺效果相关指标。结果观察组穿刺一次成功率为87.50%,高于对照组的50.00%,穿刺两次及以上成功率为12.50%,低于对照组的47.50%,差异有统计学意义(χ^(2)=13.091、11.667,P均<0.05)。与对照组相比,观察组穿刺时间更短,穿刺次数更少,护理后的生活质量评分、疾病知识掌握程度评分更高,差异有统计学意义(P均<0.05)。结论针对开展超声引导下桡动脉穿刺置管术的ICU危重症患者,施行优化护理措施,能够提升穿刺一次成功率,降低并发症发生率,提高知识掌握率,提高生活质量。
文摘目的探讨末端瓣膜耐高压注射型经外周静脉穿刺中心静脉置管(application of power peripherally inserted central catheter solo,Power PICC Solo)与经锁骨下中心静脉置管(central venous catheter,CVC)在造血干细胞移植患者中的应用。方法选取2021年9月—2023年6月厦门大学附属第一医院收治的100例造血干细胞移植患者。根据患者置管方法分为外周静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC)组(n=58)和CVC组(n=42),PICC组采用Power PICC Solo,CVC组采用CVC。比较2组患者的置管成功情况、操作时间、导管置留时间、置管费用、置管后舒适度、患者液体流速、并发症发生率、患者满意度。结果PICC组置管成功率优于CVC组,差异有统计学意义(P<0.05)。PICC组操作时间短于CVC组,导管置留时间长于CVC组,置管费用高于CVC组,差异有统计学意义(P<0.05)。PICC组患者舒适度优于CVC组,差异有统计学意义(P<0.05)。在置管后第1、10、20、30天,PICC组患者液体流速均低于CVC组,且2组患者置管后第30天流速均低于置管后第1天,差异有统计学意义(P<0.05)。PICC组患者血栓性静脉炎发生率高于CVC组,导管感染发生率低于CVC组,差异有统计学意义(P<0.05),2组患者血气胸、导管异位、导管脱落等发生率比较,差异无统计学意义(P>0.05)。PICC组操作技术满意度评分为(17.24±2.17)分,高于CVC组的(14.07±2.68)分,差异有统计学意义(P<0.05)。结论与CVC比较,Power PICC Solo能够提高造血干细胞移植患者一次置管成功率,降低置管操作时间,延长导管置留时间,提高患者置管后舒适度,但置管费用较高,且血栓性静脉炎发生率高。
