Veinlite transillumination in the pediatric emergency department - A therapeutic interventional trial
Veinlite transillumination in the pediatric emergency department - A therapeutic interventional trial
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DOI：
10.1097/pec.0b013e318163db5f
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发表时间：
2008-02-01
影响因子：
1.4
通讯作者：
Waltzman, Mark L.
中科院分区：
文献类型：
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作者：
Katsogridakis, Yiannis L.;Seshadri, Roopa;Waltzman, Mark L.
目的：我们假设透照可以增加儿科急诊患者的外周静脉（IV）插入成功率。主要结果是成功的第一次尝试，和次要结果是成功的2 attempts.Methods：我们评估了静脉插入儿科急诊科医生和护士使用的Veinlite（transLite，糖地，得克萨斯州）。需要非紧急IV插入的患者如果年龄小于3岁或年龄在3至21岁之间且有难以进入的病史，则入组。参与者被随机分配到透照或非透照组。使用混合效应logistic回归模型进行分析，调整供应商effect.Results：我们评估了240例患者。在调整了显著协变量（安全导管[P = 0.008]、可见性[P = 0.01]和可触知性[P = 0.03]）并控制了提供者效应后，透照患者首次尝试静脉置入更有可能成功（P = 0.03;比值比，2.1 [95%置信区间，1.1-3.91）。在调整了显著的协变量（安全导管[P < 0.001]、位置[P = 0.005]和可触知性[P = 0.05]）并控制了提供者的影响后，透照患者在2次尝试内静脉置入更有可能成功（P = 0.01;比值比，3.5 [95%置信区间，1.4-8.9]）。群内相关性为随机效应的供应商是10%，在第一次尝试和16%within 2 attempts.Conclusions：调整后的多个显着的协变量和控制随机效应的供应商，我们的研究结果表明，在使用静脉透照插入在第一次尝试和2次尝试内的好处。与标准实践相比，该技术似乎有助于儿科患者的非紧急IV放置。
Objectives: We hypothesized that transillumination would increase peripheral intravenous (IV) insertion success rates in pediatric emergency department patients. Primary outcome was success in first attempt, and secondary outcome was success within 2 attempts.Methods: We evaluated IV insertion by pediatric emergency department physicians and nurses using the Veinlite (TransLite, Sugar Land, Tex). Patients who required nonemergent IV insertion were enrolled if younger than 3 years or aged 3 to 21 years with a history of difficult access. Participants were randomly assigned to transillumination or nontransillumination. Analyses were performed using a mixed-effects logistic regression model adjusting for provider effect.Results: We evaluated 240 patients. After adjusting for significant covariates (safety catheter [P = 0.008), visibility [P = 0.01], and palpability [P = 0.03]) and controlling for provider effect, IV placement was more likely successful in first attempt in transilluminated patients (P = 0.03; odds ratio, 2.1 [95% confidence interval, 1.1-3.91). After adjusting for significant covariates (safety catheter [P < 0.001], location [P = 0.005], and palpability [P = 0.05]) and controlling for provider effect, IV placement was more likely successful within 2 attempts in transilluminated patients (P = 0.01; odds ratio, 3.5 [95% confidence interval, 1.4-8.9]). Intracluster correlation for random effect of provider was 10% in first attempt and 16% within 2 attempts.Conclusions: After adjusting for multiple significant covariates and controlling for random effect of provider, our results indicated a benefit in the use of Veinlite transillumination for IV insertion in first attempt and within 2 attempts. This technique seemed to facilitate nonemergent IV placement in pediatric patients compared with standard practice.