Exploring the causes of peripheral intravenous catheter failure based on shape of catheters removed from various insertion sites
Exploring the causes of peripheral intravenous catheter failure based on shape of catheters removed from various insertion sites
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DOI：
10.5582/ddt.2018.01024
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发表时间：
2018-06-01
影响因子：
3.1
通讯作者：
Sanada, Hiromi
中科院分区：
文献类型：
--
作者：
Murayama, Ryoko;Takahashi, Toshiaki;Sanada, Hiromi
外周静脉导管失败的风险根据插入部位的不同而不同。本研究检查了拔除后导管的形状，以根据部位评估导管失效的原因。本研究是对以往研究数据的二次分析。我们的观察性研究是在东京大学医院进行的，为期 6 个月。参与者是通过短外周导管接受输液治疗的住院成人。在拔除导管之前，我们获取了导管插入部位血管和周围组织的超声图像以及所拔除导管的临床图像。我们分析了 142 名参与者的 184 根导管。不同插入部位的导管失败率（29.9%）没有显着差异。 9.2% 的病例出现导管中部弯曲；导管基部的中位弯曲角度为9.1度（范围：0.0度-68.3度）。插入上臂的导管的弯曲角度明显大于插入前臂的导管（p = 0.013）。导管曲率与上臂和前臂放置中的导管故障（14.8% 的故障导管有曲率；p = 0.035）和闭塞（35.3% 的闭塞导管有曲率；p = 0.008）相关。失败的导管从肘部到插入部位的中位距离比幸存的导管短。为防止导管故障，特别是导管弯曲导致的闭塞，应将导管插入远离肘前窝的适当插入部位。
The risk of peripheral intravenous catheter failure varies according to the insertion site. This study examined catheter shape just after removal to evaluate the causes of catheter failure according to site. This study was a secondary analysis of previous study data. Our observational study was conducted during a 6-month period at The University of Tokyo Hospital. Participants were hospitalized adults who received infusion therapy via a short peripheral catheter. We acquired ultrasound images of blood vessels and surrounding tissues at the catheter insertion site before catheter removal and clinical images of the removed catheters. We analyzed 184 catheters from 142 participants. There were no significant differences in the catheter failure rate (29.9%) among insertion sites. Curvature in the middle of the catheter was present in 9.2% of cases; the median bend angle at the catheter base was 9.1 degrees (range: 0.0 degrees-68.3 degrees). The bend angle of catheters inserted in the upper arm was significantly greater than of catheters in the forearm (p = 0.013). Catheter curvature was related to catheter failure (14.8% of failed catheters had curvature; p = 0.035) and occlusion (35.3% of occluded catheters had curvature; p = 0.008) in upper arm and forearm placements. The median distance from the elbow to the insertion site was shorter for failed catheters than for surviving catheters. To prevent catheter failure, especially occlusion resulting from catheter curvature, a catheter should be inserted at an appropriate insertion site far from the antecubital fossa.