Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary pediatric hospital
Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary pediatric hospital
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DOI：
10.1111/j.1460-9592.2011.03685.x
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发表时间：
2012-03-01
影响因子：
1.7
通讯作者：
Kalkman, Cor J.
中科院分区：
文献类型：
--
作者：
Cuper, Natascha J.;de Graaff, Jurgen C.;Kalkman, Cor J.
背景：通常认为，某些患者特征（例如，体重指数和年龄）预测儿童静脉插管困难，但没有太多的文献评估这些危险因素。在这项研究中，我们调查了成功率的预测因素，在第一次尝试和所需的时间为intravenous cannulation.Methods/Materials：在一项前瞻性队列研究中，我们观察了儿科患者在手术室（n = 1083）和门诊部（n = 178）的三级转诊儿科医院的静脉插管的特点。记录了成功静脉插管的时间、首次尝试的成功以及插管困难的潜在预测因素（年龄、性别、肤色、BMI或体重与年龄z评分、儿童清醒或麻醉、操作员职业和外科专业）。回归模型的构建，以找到显着的predictors.Results：在第一次尝试的成功率分别为73%和81%。在手术室年龄，术者和外科专业可预测成功的首次尝试和成功插管的时间。没有发现显著的预测因素为门诊护理单位。BMI或体重与年龄无关，难以静脉插管。结论：这项研究表明，在五分之一至三分之一的患者，静脉插管需要一次以上的尝试。仅凭容易获得的患者特征很难准确预测静脉插管的难度。
Background: It is generally believed that certain patient characteristics (e.g., Body Mass Index and age) predict difficulty of intravenous cannulation in children, but there is not much literature evaluating these risk factors. In this study, we investigated predictive factors for success rate at first attempt and time needed for intravenous cannulation.Methods/Materials: In a prospective cohort study, we observed characteristics of intravenous cannulations in pediatric patients at the operating room (n = 1083) and the outpatient care unit (n = 178) of a tertiary referral pediatric hospital. Time to successful intravenous cannulation, success at first attempt, and potential predictors for difficult cannulation (age, gender, skin color, BMI or weight-to-age z-score, the child being awake or anesthetized, operator profession and surgical specialty) were recorded. Regression models were constructed to find significant predictors.Results: Success at first attempt was 73% and 81%, respectively. In the operating room age, operator and surgical specialty were predictive for a successful first attempt and time to successful cannulation. No significant predictive factors were found for the outpatient care unit. BMI or weight-to-age was not related to difficult intravenous cannulation.Conclusions: This study shows that in one-fifth to one-third of the patients, intravenous cannulation required more than one attempt. It is difficult to predict with accuracy the difficulty of intravenous cannulation solely with easily obtainable patient characteristics.