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Peripherally inserted central catheter placement in a multidisciplinary intensive care unit: A preliminary study demonstrating safety and procedural time in critically ill subjects.

多学科重症监护病房经外周置入中心静脉导管: 一项初步研究,证明危重病患者的安全性和手术时间。

  • 影响因子:1.12
  • DOI:10.1177/1129729820928618
  • 作者列表:"Smith RJ","Cartin-Ceba R","Colquist JA","Muir AM","Moorhead JM","Callisen HE","Patel BM
  • 发表时间:2021-01-01
Abstract

OBJECTIVE:Peripherally inserted central catheters are a popular means of obtaining central venous access in critically ill patients. However, there is limited data regarding the rapidity of the peripherally inserted central catheter procedure in the presence of acute illness or obesity, both of which may impede central venous catheter placement. We aimed to determine the feasibility, safety, and duration of peripherally inserted central catheter placement in critically ill patients, including obese patients and patients in shock. METHODS:This retrospective cohort study was performed using data on 55 peripherally inserted central catheters placed in a 30-bed multidisciplinary intensive care unit in Mayo Clinic Hospital, Phoenix, Arizona. Information on the time required to complete each step of the peripherally inserted central catheter procedure, associated complications, and patient characteristics was obtained from a prospectively assembled internal quality assurance database created through random convenience sampling. RESULTS:The Median Procedure Time, beginning with the first needle puncture and ending when the procedure is complete, was 14 (interquartile range: 9-20) min. Neither critical illness nor obesity resulted in a statistically significant increase in the time required to complete the peripherally inserted central catheter procedure. Three (5.5%) minor complications were observed. CONCLUSION:Critical illness and obesity do not delay the acquisition of vascular access when placing a peripherally inserted central catheter. Concerns of delayed vascular access in critically ill patients should not deter a physician from selecting a peripherally inserted central catheter to provide vascular access when it would otherwise be appropriate.

摘要

目的: 经外周静脉置入中心静脉导管是危重病人获得中心静脉通路的常用方法。然而,关于在急性病或肥胖的情况下外周静脉置入中心静脉导管手术的快速性的数据有限,这两者都可能妨碍中心静脉导管的放置。我们旨在确定危重患者 (包括肥胖患者和休克患者) 外周静脉置入中心静脉导管的可行性、安全性和持续时间。 方法: 这项回顾性队列研究是使用亚利桑那州凤凰城梅奥诊所医院30张床位的多学科重症监护病房中放置的55根经外周静脉置入中心静脉导管的数据进行的。从通过随机便利抽样创建的前瞻性组装的内部质量保证数据库中获得关于完成外周置入中心静脉导管操作的每一步所需时间、相关并发症和患者特征的信息。 结果: 从第一次穿刺开始到手术结束的中位手术时间为14 (四分位距: 9-20) 分钟。无论是危重疾病还是肥胖都没有导致完成经外周穿刺中心静脉导管手术所需时间的统计学显著增加。观察到3例 (5.5%) 轻微并发症。 结论: 危重症和肥胖在放置外周静脉中心静脉导管时不会延迟血管通路的获得。对危重病患者血管通路延迟的担忧不应阻止医生选择外周置入中心静脉导管以在其他情况下提供血管通路。

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