停留时间和血流感染的风险与外周静脉导管
Marie-Céline Zanella1, Gaud Catho1, Holly Jackson1
1Infection Control Program and World Health Organization Collaborating Centre, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.
JAMA network open
|April 24, 2025
概括
周围静脉导管 (PIVC) 停留时间在3天后显著增加了血流感染 (BSI) 风险. 审查PIVC的必要性,并考虑更换超过3天以防止PIVC相关的BSI.
科学领域:
- 传染性疾病 传染性疾病
- 患者安全 患者安全
- 医疗器械 医疗器械
背景情况:
- 与外周静脉导管 (PIVC) 相关的血流感染 (BSI) 是罕见的,但可以预防的不良事件.
- 讨论了PIVC停留时间和BSI风险之间的关系.
研究的目的:
- 分析PIVC维持治疗期间BSI的风险.
- 调查PIVC停留时间和BSI风险之间的关联.
主要方法:
- 在住院患者中对371,061名PIVC进行观察性队列研究.
- 使用危险率函数和基于内核的方法分析每日BSI风险.
- 多变量物流模型用于在不同的停留时间切线 (>3, >4, >5, >6天) 上比较BSI风险.
主要成果:
- 在前两天,BSI的瞬间风险很低,随后迅速增加.
- 在PIVC维护3天后,BSI风险显著增加 (AOR,13.55).
- 升高的BSI风险持续超过3天 (AORs在5.38至8.53之间).
结论:
- PIVC停留时间与BSI的发展有关.
- 在3天的停留时间后,应审查PIVC的指示,并考虑更换.
- 这一发现支持优化PIVC管理以降低感染率.
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