皮肤粘合剂可减少儿童静脉导管失效的发生
Owen Chauhan1, Amy C Plint2, Nick Barrowman3
1Department of Emergency Medicine, IWK Health Centre, Dalhousie University, Halifax, NS, Canada.
Annals of emergency medicine
|January 11, 2025
概括
将皮肤粘合剂添加到外围静脉注射导管 (IV) 并没有降低儿童的失效率. 这种常见的儿科急诊室手术在使用皮肤用于固定时,在IV寿命中没有显著差异.
科学领域:
- 儿科急救医学 儿科急救医学
- 医疗器械安全保护 医疗器械安全
- 临床试验 临床试验
背景情况:
- 周围静脉导管 (IV) 是必不可少的,但在儿科急性护理中经常失败.
- 导管故障会导致患者的不适和增加医疗保健成本.
- 探索新的保护方法来改善IV寿命.
研究的目的:
- 为了评估添加烯酸盐皮肤粘合剂在儿童外围IV的标准固定方法的有效性.
- 为了确定皮肤是否减少了儿科急诊室设置中的IV导管失效率.
主要方法:
- 一项随机对照试验在第三级护理儿科急诊室进行.
- 需要静脉注射的儿科患者 (<18岁) 被随机分配到标准固定或标准固定加皮肤.
- 主要结局是在预期的治疗过程完成前IV失败,使用治疗意图进行分析.
主要成果:
- 招募了557名参与者,527人被纳入治疗意向分析.
- 在皮肤粘合剂组 (83/265) 和对照组 (82/262) 中,输液失效率为31.3%.
- 在两组之间,IV失败的几率 (aOR 0.98;95% CI,0.67-1.42) 或设备失败的时间 (HR 0.99;95% CI,0.73-1.35) 没有显著差异.
结论:
- 将皮肤粘合剂添加到标准的固定技术中并没有降低儿科急诊室患者外围IV的失败率.
- 目前的证据不支持在这个人群中常规使用皮肤粘合剂进行IV固定.
- 进一步的研究可能会探索替代的固定策略或特定的儿科亚群.
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