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Venous blood gas parameters, electrolytes, glucose and lactate concentration in sick neonatal foals: Direct venipuncture versus push-pull technique.

患病新生儿小马驹的静脉血气参数、电解质、葡萄糖和乳酸浓度: 直接静脉穿刺与推拉技术。

  • 影响因子:0
  • DOI:10.1111/evj.13332
  • 作者列表:"Del Prete C","Lanci A","Cocchia N","Freccero F","Di Maio C","Castagnetti C","Mariella J","Micieli F
  • 发表时间:2021-05-01
Abstract

BACKGROUND:Blood collection by indwelling intravenous catheter (IVC) avoids repeated venipuncture, which could cause thrombophlebitis risk, anxiety and pain in patients. OBJECTIVES:To compare blood gas parameters, electrolytes, glucose, lactate and haematocrit concentration obtained from venous blood samples collected via a jugular IVC by push-pull (PP) technique to those obtained by venipuncture in hospitalised foals, at the time of catheter placement (T0) and 24 hours after the beginning of intravenous therapy (T24). STUDY DESIGN:Prospective observational study. METHODS:Paired blood samples were drawn from hospitalised foals at T0 and T24. In each foal, one venous blood sample was collected via IVC by the following PP technique: 2.4 mL of blood was aspirated and immediately reinfused through the catheter three times consecutively, then 1 mL of blood was collected using a 1 mL heparinised syringe. Thereafter, another sample was collected by direct venipuncture of the contralateral jugular vein, with an identical 1 mL heparinised syringe, with a 1-inch, 20-G needle. All samples were analysed with an automated blood gas analyser within 10 minutes of collection. The agreement between the two techniques was assessed by Bland-Altman analysis and intraclass correlation coefficient (ICC). RESULTS:The level of agreement of blood gas values obtained by the two different techniques was high with very small bias and clinically acceptable ICC (>0.907 at T0; >0.794 at T24) for all variables, except for haematocrit (bias -3.52 at T0; -2.44 at T24) and PvO2 at T0 and T24 (ICC 0.669 and 0.733, respectively). MAIN LIMITATIONS:Potential sub-clinical catheter-related complications were not investigated by ultrasound or bacterial culture of the catheter; short duration of the study. CONCLUSIONS:PP technique appears to be acceptable for collection of blood samples for venous blood gas parameters, as well as electrolytes, glucose and lactate in sick neonatal foals.

摘要

背景: 通过留置静脉导管 (IVC) 采血避免了重复静脉穿刺,这可能导致患者血栓性静脉炎的风险、焦虑和疼痛。 目的: 在导管放置时 (T0),将通过颈静脉下腔静脉穿刺 (push-pull) 技术采集的静脉血样本的血气参数、电解质、葡萄糖、乳酸和血细胞比容浓度与住院小马驹静脉穿刺获得的血气参数、电解质、葡萄糖、乳酸和血细胞比容浓度进行比较。和静脉治疗开始后24小时 (T24)。 研究设计: 前瞻性观察研究。 方法: 在T0和t24时从住院的马驹中抽取配对血液样本。在每个小马驹中,通过以下PP技术通过IVC收集一个静脉血样品: 抽吸2.4毫升血液并立即通过导管连续三次重新输注,然后使用1 ml肝素化注射器收集1毫升血液。此后,通过对侧颈静脉的直接静脉穿刺收集另一样品,使用相同的毫升肝素化注射器,使用1英寸20g针头。在收集10分钟内用自动血气分析仪分析所有样品。通过Bland-Altman分析和组内相关系数 (ICC) 评估两种技术之间的一致性。 结果: 两种不同技术获得的血气值的一致性水平较高,偏倚非常小,临床上可接受的ICC (T0时> 0.907; T24时> 0.794),所有变量除外血细胞比容 (T0时偏倚-3.52; T24时-2.44) 和PvO2在T0和T24(分别为ICC 0.669和0.733)。 主要局限性: 潜在的亚临床导管相关并发症未通过超声或导管细菌培养进行研究; 研究持续时间短。 结论: PP技术似乎可用于收集静脉血气参数的血液样本,以及患病新生儿小马驹的电解质,葡萄糖和乳酸。

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