在儿科ECMO患者中与随后的血管接入相关的并发症
Katelyn S Chan1, Nolan Martin2, Talha Rafeeqi3
1Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA; Department of Surgery, University of Washington, Seattle, WA 98195, USA.
Journal of pediatric surgery
|August 20, 2023
概括
重复使用中央静脉导管 (CVC) 的外周体膜氧化 (ECMO) 导管位点不会显著增加与导管相关的血液感染 (CLABSI) 的风险. 这一发现支持在ECMO脱后使用相同的部位进行随后的中央静脉接入.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染病流行病学 传染病流行病学
- 血管接入管理管理
背景情况:
- 在ECMO后,决定使用中央静脉导管 (CVC) 或远程接入至关重要.
- 这项研究评估了重复使用ECMO管部位用于CVCs的传染性并发症.
研究的目的:
- 为了调查在随后的中央静脉接入中重复使用外围ECMO注射管位时发生感染并发症的风险.
主要方法:
- 对接受外围ECMO (2009-2021) 的儿科患者 (0-18岁) 的回顾性评估.
- 对同一个部位的CVC,不同部位的CVC,PICC和没有后续访问的感染率进行比较.
- 分析包括每1000个线路日的导管相关血流感染 (CLABSI) 率.
主要成果:
- 1个CLABSI (0.94/1000线日) 发生在ECMO后的同一地点与CVC发生.
- 1个CLABSI (0.43/1000线日) 发生在外围插入的中央导管 (PICCs) 上.
- 机构CLABSI利率为1.46/1000线日;差异在统计学上并不显著.
结论:
- 对CVC的ECMO管道位置的重复使用不会导致与替代的CVC或PICC放置相比,CLABSI率显著上升.
- 这表明,在ECMO脱点同时放置CVC是一种安全的选择.
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