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The Clinical Application of Peripherally Inserted Central Catheter in Neonate

Author: LinLiLi
Tutor: CuiQiLiang
School: Guangzhou Medical College
Course: Pediatrics
Keywords: Peripherally inserted Central venous catheter Newborn Catheter ectopic Catheter pathogens Catheter blockage
CLC: R472
Type: Master's thesis
Year: 2010
Downloads: 101
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Abstract


Objective To summarize, explore the the newborns application peripherally inserted central venous catheter puncture choice of vascular and catheter-related infection, blockage risk factors for PICC in the correct use of the neonatal and prevent complications provides scientific basis. Method 1. Collect the Third Affiliated Hospital of Guangzhou Medical College, Shenzhen People's Hospital, Southern Medical University, Maternal and Child Health Hospital of Zhuhai City, Central Hospital of Huizhou, Guangdong Provincial People's Hospital, Maternal and Child Health Hospital of Foshan, Dongguan City, Tung Wah Hospital , 9 Dongguan City KANGHUA Hospital Hospital from August 2000 to July 2009, a total of 973 cases of neonatal the line 1029 cases of PICC surgery. Application SPSS13.0 software, the use of multiple independent samples nonparametric tests (K Independent Samples Test) method, analysis punctured vein catheter ectopic relationship, and part of the case group and then χ2 test; of PICC catheter pathogen colonization, the plugging risk factors first single factor analysis, significant variables screened, then Multivariate Logistic stepwise regression analysis. 1.973 cases of neonatal line 1029 cases time PICC surgery, gestational age 241 weeks to 416 weeks, with an average (31.90 ± 3.16) weeks; birth weight 540g to 5360g, average (1630 ± 580) g; M: F = 1.35: 1 catheter hospitalized 0 ~ 219d, average (32.32 ± 24.98) d; 0 ~ 110d, average (22.81 ± 15.82) d; catheter time from the birth, 106c and 106d, the mean (5.09 ± 8.11) d (592:437); which 1h 24h catheter 324 cases (31.29%), including 1 patient (gestational age 261 weeks, birth weight 870g) after birth that the successful completion of the catheter. Cannulation success rate of 100%. 921/973 cases (94.66%) were cured or improved, 44/973 patients (4.52%) died, 8/973 cases (0.82%) to give up. 2. Catheter ectopic rate of 38.58% (397/1029) by venipuncture catheter ectopic rate: the basilic vein 31.61% (177/560), the middle of venous 51.74% (134/259), 53.16% of the cephalic vein (42/79), axillary vein 31.19% (16/53), 13.63% of the great saphenous vein (3/22), the superficial temporal intravenous 55.00% (11/22). The 6 catheter ectopic rate multiple independent samples nonparametric tests among groups catheter ectopic rate difference was statistically significant (P lt; 0.05). Between the two groups before the χ2 test were compared catheter ectopic rate, the results suggest that by basilic vein and the middle vein, cephalic vein, by the middle of the vein and axillary vein, saphenous vein, cephalic vein and axillary vein, saphenous vein, through the comparison between the great saphenous vein and by the superficial temporal vein catheter ectopic rate difference was statistically significant (P lt; 0.05), and the remaining veins comparison between any two catheter heterotopic rate difference was not statistically significance (P gt; 0.05). Signs of infection and the course of treatment. Excluding admission that significant other infections, 337/1029 cases included in the study, blood culture and catheter tip culture extubation, 41 (12.17%) of the catheter tip cultured 42 pathogens, wherein a catheter (2.38%) were double pathogens. The catheter tip culture and blood cultures while cultivating six cases of the same bacteria, catheter-related bloodstream infection incidence of 1.78% and 0.77/1000 catheter days. Logistic regression analysis of single factor prompted birth weight, tip position, limb swelling, exudate, bleeding and local infection and catheter pathogen colonization occurred (all P lt; 0, 05). Multivariate Logistic stepwise regression analysis indicated that analysis of the results of comparison between the prompt birth weight [class Ⅰ (OR = 0.366,95% CI: 0.136 ~ 0.985, P = 0.047); class COMPARISON OF (OR value of 0.246,95% CI: 0.085 ~ 0.715, P = 0.010)] is catheter pathogen colonization of the protective factors, limb swelling (OR = 3.330,95% CI: 1.525 ~ 7.273, P = 0.003) are independent risk factors for colonization of catheter pathogens. Catheter blockage incidence of 20.02% (206/1029). Single factor logistic regression analysis indicated that indwelling days, hospital days, and bleeding and catheter blockage occurred (all P lt; 0. 05). Multivariate Logistic regression analysis indicated that the number of days stay in control (OR = 1.013,95% CI: 1.001 ~~ 1.025, P = 0.030) and bleeding (OR = 2.828,95% CI: 1.706 ~ 4.688, P = 0.000), both are independent risk factors for catheter blockage. Conclusions In order to reduce the incidence of the PICC catheter procedure catheter ectopic the punctured vein should choose your vein. 2. Strict aseptic birth weight, the smaller the smaller catheter pathogen colonization risk. Catheter limb swelling is an independent risk factor for catheter pathogen colonization. 3. Indwelling days, bleeding is an independent risk factor for catheter blockage.

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