Intraosseous is faster and easier than umbilical venous catheterization in newborn emergency vascular access models
Intraosseous is faster and easier than umbilical venous catheterization in newborn emergency vascular access models
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DOI：
10.1016/s0735-6757(00)90001-9
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发表时间：
2000-03-01
影响因子：
3.6
通讯作者：
Yamamoto, LG
中科院分区：
文献类型：
--
作者：
Abe, KK;Blum, GT;Yamamoto, LG
本研究的目的是比较使用骨内（IO）与脐静脉导管插入术（UVC）建立新生儿紧急血管通路的速度和容易程度。本研究为实验设计。共有42名医学生，没有以前的IO和UVC的经验，被招募为研究对象。所有受试者均完成了UVC手术，并随机（通过抛硬币）在两种模型之一中进行IO手术：（1）火鸡骨或（2）塑料婴儿腿。每名受试者在没有实践的情况下对IO和UVC程序进行初始试验（"无经验尝试"），并在实践后对两种程序进行第二次试验（"有经验尝试"），因此，每名受试者总共完成四次尝试（两次IO和两次UVC）。测量IO和UVC放置时间，并使用10 cm视觉模拟量表（VAS）测量IO和UVC的放置难度评分。对于10例手术，在初始"无经验"尝试（52秒对134秒，P <0.001）和"有经验"尝试（45秒对95秒，P = 0.011）中，成功进入的平均经过时间明显更短。在10例手术中，"无经验"和"有经验"尝试的手术难度评分均较低（3.5对5.5，P = 0.001和2.6对4.7，P <0.001），尽管泌尿科医生可能更喜欢UVC，该模型表明，在不经常进行新生儿复苏的那些人中，10导致更容易和更快速的血管通路。因此，在儿科复苏课程中教授UVC的好处应该重新考虑。急诊新生儿血管通路的推荐方法应重新考虑，等待进一步研究。Copyright（C）2000 by W.B.桑德斯公司）。
The purpose of this study is to compare the speed and ease of establishing newborn emergency vascular access using intraosseous (IO) versus umbilical venous catheterization (UVC). The study is an experimental design. A total of 42 medical students, without prior IO and UVC experience, were recruited as study subjects. All subjects per formed the UVC procedure and were randomized (by a coin flip) to perform the IO procedure in one of two models: (1) turkey bone or (2) plastic infant leg. Each subject performed an initial trial for both the IO and UVC procedures without practice ("Inexperienced attempt") and a second trial in both procedures after practice ("Experienced attempt"), such that in total, each subject completed four attempts (two IO and two UVC). IO and UVC placement times were measured, and placement difficulty scores for IO and UVC were measured using a 10 cm visual analog scale (VAS). The averaged elapsed time to successful access was significantly shorter for the 10 procedure on both the initial "inexperienced" attempt (52 versus 134 seconds, P < .001) as well as the "experienced" attempt (45 versus 95 seconds, P = .011). Procedure difficulty scores were lower in the 10 procedure for both "inexperienced" and "experienced" attempts (3.5 versus 5.5, P = .001 and 2.6 versus 4.7, P < .001) as measured on a 10 cm VAS, Although UVC may be preferred by neonatologists, this model suggests that 10 results in easier and more rapid vascular access in those who do not frequently perform newborn resuscitation. As such, the benefit of teaching UVC in pediatric resuscitation courses should be reconsidered. The recommended method of emergency newborn vascular access should be reconsidered pending further studies on this subject. Copyright (C) 2000 by W.B. Saunders Company).