新生児の腸内栄養を供給するための周回的に挿入された中央カテーテルと周回的なカヌーラ
Sean B Ainsworth1, William McGuire2
1Neonatal Services, National Health Service Fife, Victoria Hospital, Kirkcaldy, Scotland.
JAMA
|June 22, 2016
まとめ
新生児に周回的に挿入された中央カテーテル (PICC) を使用した親腸栄養は,栄養素の供給を改善し,追加の線路の必要性を軽減します. PICCは,短い周辺カヌーラと比較して,より高い感染率と関連していません.
科学分野:
- 新生児の集中治療
- 小児の栄養
- 血管へのアクセス装置
背景:
- 腸内栄養 (PN) は,腸内栄養を受けられない新生児にとって極めて重要です.
- 短い外周カヌラは,十分な長期PNを提供することに制限があります.
- 周辺に挿入された中央カテーテル (PICC) は,PNの投与のための潜在的な代替手段を提供します.
研究 の 目的:
- 新生児におけるPICC経由のPNの有効性と安全性を比較する.
- 2つのアクセス方法の栄養分配給,成長,有害事象の違いを評価する.
主な方法:
- PICCと短い周辺カヌーラによるPN伝達を分析した比較研究.
- 栄養素の摂取量,成長パラメータ,感染症を含む有害事象の発生率の評価
- 血管へのアクセス装置の設置のレビュー
主要な成果:
- PICCによる親腸栄養は,短い周辺カヌーラと比較して優れた栄養分供給を示した.
- PICCでPNを投与された新生児は,その後のカテーテルまたはカヌーラを必要としなかった.
- PICCの使用で侵襲的な感染率の有意な増加は観察されなかった.
結論:
- PICCベースのPNは,栄養支援の改善と,新生児の再アクセスの必要性の減少と関連しています.
- 新生児におけるPICCの使用は,感染のリスクが増加しない安全な代替手段です.
- PICCは新生児の親体栄養のための効果的な血管アクセス戦略です.
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