优化输液流模式以减少静脉壁创伤:使用改良离轴导管尖端开口的探索性研究。

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics
Therapeutics and Clinical Risk Management Pub Date : 2024-09-04 eCollection Date: 2024-01-01 DOI:10.2147/TCRM.S479846
Amit Bahl, S Matthew Gibson, Alexis Walton
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引用次数: 0

摘要

目的:改造 PIVC 的顶端,将输液引向血液稀释最严重的区域,可减少静脉壁损伤。本研究比较了带有中心开口的传统 PIVC 和带有离轴孔径的 PIVC 的血流模式:这是一项探索性观察分析,在一家三级医院急诊科(ED)进行,比较了两种静脉导管的流动模式:PIVC 1(2.95 厘米 20 号导管 [Autoguard, Becton Dickinson])和 PIVC 2(3.68 厘米 20 号导管 [Osprey, SkyDance Vascular])。通过传统触诊/视诊法放置 PIVC 并用超声波捕捉冲洗过程的成人急诊患者均符合条件。对超声波进行审查,以确定静脉、导管和血流特征。主要结果是输液离开导管的角度。次要结果包括导管尖端对静脉壁的方向、与静脉壁的距离、血管痉挛和层流/湍流:2023 年 12 月的数据包括 28 个导管(10 个 PIVC 1,18 个 PIVC 2)。患者平均年龄为 53.7 岁;53.6% 为女性。静脉直径/深度相似:PIVC 1 为 0.35 厘米/0.41 厘米,PIVC 2 为 0.37 厘米/0.47 厘米。60% 的 PIVC 1 和 11.1% 的 PIVC 2 的导管尖端指向静脉壁后方(P=0.018)。PIVC 1 的输液流向偏离静脉壁的角度为 0.20°(SD 0.63),PIVC 2 为 7.61°(SD 5.71)(PC结论:PIVC 1 的输液流向偏离静脉壁的角度为 0.20°(SD 0.63),PIVC 2 为 7.61°(SD 5.71)):在这项探索性研究中,与传统的中央开口装置相比,具有离轴尖端孔径的外周血管接入装置显示出更大的远离静脉壁的输液流角。这种重新定向可能会减少静脉壁的创伤和并发症,但还需要进一步研究,才能将这种技术的临床效果配对起来。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimizing Infusate Flow Patterns for Minimizing Vein Wall Trauma: An Exploratory Study with a Modified off-Axis Catheter Tip Opening.

Objective: Modifying the PIVC tip to direct infusates toward areas of highest hemodilution may reduce vein wall damage. This study compared flow patterns between a traditional PIVC with a central opening and one with an off-axis aperture.

Methods: This was an exploratory observational analysis conducted at a tertiary care emergency department (ED) comparing flow patterns of two intravenous catheters: PIVC 1 (2.95 cm 20 gauge [Autoguard, Becton Dickinson]) and PIVC 2 (3.68 cm 20 gauge [Osprey, SkyDance Vascular]). Adult ED patients with PIVCs placed via traditional palpation/visualization method and with ultrasound capturing the flushing were eligible participants. Ultrasounds were reviewed to determine vein, catheter, and flow characteristics. The primary outcome was angle of the infusate leaving the catheter. Secondary outcomes included direction of catheter tip against vein wall, distance away from vein wall, vasospasm, and laminar/turbulent flow.

Results: Data from December 2023 included 28 catheters (10 PIVC 1, 18 PIVC 2). The average patient age was 53.7 years; 53.6% were female. Vein diameter/depth were similar: 0.35 cm/0.41 cm for PIVC 1 and 0.37 cm/0.47 cm for PIVC 2. The catheter tip pointed posteriorly towards the vein wall in 60% of PIVC 1 vs 11.1% in PIVC 2 (P=0.018). The angle of infusate flow away from the vein wall was 0.20° (SD 0.63) for PIVC 1 and 7.61° (SD 5.71) for PIVC 2 (P<0.001). Flow at 0° occurred in 90% of PIVC 1 vs 16.7% in PIVC 2 (P<0.001).

Conclusion: In this exploratory investigation, a peripheral vascular access device with an off-axis tip aperture of demonstrated a sharper infusate flow angle away from the vein wall compared to a traditional central opening device. This redirection may reduce vein wall trauma and complications, though further research is needed to pair clinical outcomes with this technology.

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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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