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在外围插入的中央导管中使用氨酸并没有改变早产婴儿的选择性切除和并发症率

Dirk Wackernagel¹, Vanessa Gavelli², Per Nydert³

¹Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.

Clinical nutrition ESPEN

|March 20, 2025

概括

在新生儿中,将肝素添加到外围插入的中央导管 (PICC) 中,并没有改善移除率或减少并发症. 这项研究发现停留时间没有显著差异,质疑肝素.

科学领域:

新生儿重症监护室新生儿重症监护室
血管接入装置是指血管接入装置.
儿科药理学儿科药理学

背景情况:

周围插入的中央导管 (PICC) 对于向早产和生病的新生儿注射缩的肠道营养和高风险药物至关重要.
尽管欧洲儿科胃肠病学,肝病学和营养学会 (ESPGHAN) 2018年指导方针,但氨酸经常用于新生儿重症监护室 (NICU) 延长PICC功能.
预防性肝素改善PICC结果的疗效仍在争论中.

研究的目的:

调查新生儿群体中预防性肝素使用和选择性PICC清除率之间的关联.
评估预防性肝素对与PICC相关的并发症率的影响.
为了确定肝素是否会影响新生儿PICC的停留时间.

主要方法:

2017年期间在两个III级NICU安置的所有PICC的回顾性分析.
包括132个PICC (90个在肝素组,42个在对照组) 在排除36个设备后.
选择性去除率,并发症发生率和接受预防性肝素治疗的新生儿与未接受预防性肝素治疗的新生儿之间的停留时间的比较.

主要成果:

在肝素组 (73%) 和对照组 (71%) 之间没有观察到可选PICC去除率的显著差异 (调整后的几率比率为0.95 [0.31,2.89],p > 0.9).
在两组中,并发症的发生率相似,在肝素组为19%,在对照组为19%.
平均停留时间没有显著差异 (肝素组:10天[IQR 6,17];对照组:8天[IQR 7,12]) (调整后的危险比为0.70[0.45,1.09],p=0.11).

结论:

在新生儿中通过PICC进行预防性氨酸的使用并没有提高选择性去除率或减少并发症.
PICCs的停留时间不受预防性肝素的使用显著影响.
这些发现不支持常规使用肝素来改善新生儿的PICC可用性,符合ESPGHAN的建议.

关键词:

导管可以在内置.药物安全药物安全肝素是一种肝素.新生儿的婴儿新生儿的婴儿新生儿父母肠道营养是一种营养.

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