入院児における周周周挿入の中枢静脈カテーターの使用に関連する合併症に関連する要因:症例対照研究,ソロカバ,ブラジル,2018-2022年
Mayara Amancio de Souza1, Luciane Cruz Lopes1, Marcus Tolentino Silva2
1Universidade de Sorocaba, Programa de Pós-Graduação em Ciências Farmacêuticas, Sorocaba, SP, Brasil.
まとめ
外部に挿入された中央静脈カテーテルによる合併症は,手術を受けた子供に多く見られます. 集中治療と静脈注射による水分補給は これらの合併症のリスクを高めます
科学分野:
- 小児外科
- 血管へのアクセス装置
- 患者の安全
背景:
- 周回的に挿入された中央静脈カテーテル (PICC) は,長期にわたる静脈アクセスを必要とする小児外科患者のために不可欠です.
- PICCに関連した合併症は,著しい罹病率,長期の入院,および医療費の増加につながる可能性があります.
- PICCの合併症の危険因子を特定することは,患者のアウトカムを改善するために不可欠です.
研究 の 目的:
- 小児手術の患者で周回的に挿入された中央静脈カテーテルの使用に伴う合併症に関連する要因を特定し,評価する.
- この集団におけるPICCの挿入と管理に関する臨床実務を伝え,患者の安全プロトコルを強化する.
主な方法:
- 2018年から2022年の間に公立病院で,外科手術に焦点を当てた症例対照研究が行われました.
- 109人の小児患者 (62例,47人の対照群) の電子医療記録から遡ってデータを収集した.
- 統計分析には,確率比率 (OR) と95%信頼区間 (95%CI) を計算してリスク要因を決定した.
主要な成果:
- PICCの全体的な合併症率は56. 9%で,阻害 (30. 3%),偶然の除去 (10. 1%) と高血症 (9. 2%) が最も多かった.
- 新生児重症治療室 (OR 5. 45) と静脈内給水療 (OR 3. 71) を受けた小児の合併症の確率は著しく高かった.
- 女性 (OR2. 93),全腸内栄養 (OR2. 97),ダウン症候群 (OR19. 19) はPICC阻害のリスク増加と関連していました.
結論:
- PICCに関連する合併症のリスクが高くなります.
- これらのリスク要因を理解することは,ケアを最適化し,有害事象を軽減し,患者,医療機関,およびブラジル統一医療システム (SUS) に利益をもたらすために不可欠です.
- 高リスクグループに対する標的型介入に関するさらなる研究が必要である.
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