Comparing peripheral venous access between obese and normal weight children
Comparing peripheral venous access between obese and normal weight children
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DOI：
10.1111/j.1460-9592.2009.03198.x
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发表时间：
2010-02-01
影响因子：
1.7
通讯作者：
Tremper, Kevin K.
中科院分区：
文献类型：
--
作者：
Nafiu, Olubukola O.;Burke, Constance;Tremper, Kevin K.
引言：静脉（i. v.）访问有时是困难、耗时和非常令人沮丧的过程。肥胖被广泛认为与外周静脉通路（PIV）放置困难有关。本研究探讨了体重指数（BMI）和静脉通路的儿童接受非心脏外科手术surgery procedures.Methods：我们前瞻性地收集了2-18岁的儿童在我们的机构接受择期非心脏手术的数据之间的关系。所有患者的PIV放置均由经过培训的研究助理（RA）进行，并记录以下内容：年龄、性别、种族、体重、身高和BMI。我们还收集了关于静脉插入部位、尝试次数、操作者人数和使用的静脉插管数量的数据。主要结局变量是首次尝试静脉内放置的成功或失败。样本量计算表明，需要40肥胖和40对照patients.Results：共103（56瘦和47肥胖）患者组成的研究人群。55.2%的患者在首次尝试时实现PIV插管，而39.6%的患者在成功插管前进行了2-3次尝试。肥胖儿童第一次插管失败的可能性高于瘦对照组（P < 0.001）。同样，肥胖儿童更可能需要两个或更多的尝试插管比瘦的儿童（P < 0.001）。结论：这些数据表明，静脉内放置是更困难的肥胖儿童比他们的瘦同龄人，最有可能的网站成功放置在肥胖儿童失败后，手背是手掌表面。了解静脉注射成功的潜在部位有助于提高静脉注射放置的成功率。
Introduction: Intravenous (i.v.) access is sometimes a difficult, time-consuming, and highly frustrating procedure. Obesity is widely believed to be associated with difficult peripheral intravenous access (PIV) placement. This study examined the relationship between body mass index (BMI) and ease of venous access in children undergoing noncardiac surgical procedures.Methods: We prospectively collected data on children aged 2-18 years undergoing elective noncardiac surgery at our institution. A trained research assistant (RA) was present for PIV placement in all patients and noted the following: age, gender, ethnicity, weight, height, and BMI. We also collected data on i.v. insertion site, number of attempts, number of operators, and the number of i.v. cannula used. The main outcome variable was success or failure of i.v. placement on first attempt. Sample size calculation indicated a need for 40 obese and 40 control patients.Results: A total of 103 (56 lean and 47 obese) patients comprised the study population. PIV cannulation was achieved on the first attempt in 55.2% while 39.6% of patients had 2-3 attempts before successful cannulation. Obese children were more likely to have failed attempt at first cannulation than lean controls (P < 0.001). Similarly, obese children were more likely to require two or more attempts at cannulation than lean children (P < 0.001).Conclusion: These data indicate that i.v. placement is more difficult in obese children than their lean peers and that the most likely site for successful placement in obese children after a failed attempt on the dorsum of the hand is the volar surface of the hand. Knowledge of potential sites for successful i.v. access could help to improve the success rate for i.v. placement.