Çocuklarda Kullanılan Yeni Bir Tespit Yönteminin Periferik Venöz Kateter Komplikasyonlarına Etkisi

Öz

Periferik venöz kateterizasyon (PVK) hastaneye yatan çocukların %80’inden fazlasına en sık yapılan invaziv girişimdir. Masum gibi görünen PVK’nin çocuklarda flebit, enfeksiyon, infiltrasyon, ekstravazasyon gibi çok sayıda komplikasyona, hatta mortaliteye neden olduğu bilinmektedir. Bu çalışmada, eklem lokalizasyonunda PVK takılan çocuk hastalarda kullanılan yeni tespit tahtasının PVK ömrü ve komplikasyon oranına etkisinin araştırılması amaçlanmıştır. Haziran-Temmuz 2018 tarihleri arasında çocuk cerrahisi servisinde tedavi edilen ve eklem bölgesinde PVK takılan 49 hasta prospektif olarak takip edildi. Hastalar grup 1 tespit tahtası kullanılan ve grup 2 hipoalerjenik elastik fiksasyon bandı kullanılan kontrol grubu olarak ikiye ayrıldı. İki grup arasında yeni tespit tahtasının, intraket çapının ve yaşın PVK yaşam süresi ve komplikasyon oranına etkisi incelendi. İki grup arasında komplikasyon oranında önemli ölçüde azalma olmasına rağmen, PVK ömrü ile ilgili anlamlı bir sonuç elde edilmedi.

Anahtar Kelimeler

• Periferik venöz kateter,kateter komplikasyonları,kateter ömrü,çocuklar

Effects of a New Fixation Method in Children on the Complication Rates of Peripheral Venous Catheters

Öz

Peripheral intravenous catheter (PIVC) insertion is the most frequently used invasive intervention that is performed in more than 80% of hospitalized children. It is a known that seemingly innocent PIVC may result in various morbidities such as phlebitis, infection, extravasation, and may even lead to mortality. In this study, we aimed to investigate the effect of a new fixation board on PIVC lifespan and complications rates in pediatric patients undergoing PIVC insertion in the joint area. A total of 49 patients who were treated in the pediatric surgery ward between June and July 2018 and who underwent PIVC insertion were prospectively followed. The patients were divided into the following two groups: Group 1 in which a fixation boardwas used and Group 2, which was allocated as the control group using Hypoallergenic Elastic Fixation Tape. The effects of cannula fixation device, cannula gauge, and age on PIVC lifespan and complication rates were comparatively evaluated between the two groups. Although the complication rate in this study was significantly reduced, no significant result was obtained regarding PIVC lifespan. 

Anahtar Kelimeler

• Peripheral intravenous catheter,catheter complications,catheter lifespan,children

Kaynakça

1. Laudenbach N, Braun CA, Klaverkamp L, et al. Peripheral iv stabilization and the rate of complications in children: an exploratory study. Journal of Pediatric Nursing: Nursing Care of Children and Families 2014; 29: 348-353.
2. Saliba P, Hornero A, Cuervo G, et al. Interventions to decrease short-term peripheral venous catheter-related bloodstream infections. Impact on incidence and mortality. Journal of Hospital Infection. 2018.
3. Webster J, Osborne S, Hall J, et al. Clinically indicated replacement versus routine placement of peripheral venous catheters. Cochrane Database of Systematic Reviews 2013; 4: 1-42.
4. Gunes, A, Bramhagen, AC. Heparin or Sodium Chloride for Prolonging Peripheral Intravenous Catheter Use in Children–A Systematic Review. Journal of pediatric nursing 2018.
5. Özalp G, Kahraman A, Yardimci F, et al. Infiltration and extravasation in pediatric patients: A prevalence study in a children’s hospital. The journal of vascular Access 2018;19(3): 266-271.
6. Gupta P, Rai R, Basu S, et al. Lifespan of peripheral intravenous cannula in a neonatal intensive care unit of a developing country. J Pediatr Nurs 2003; 18: 287–292.
7. Infusion Nurses Society. Infusion nursing standards of practice. Journal of Infusion Nursing 2011; 54: 46–47.
8. O'Grady, N, Alexander M, Burns L, et al. Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases 2011; 52: 162-193

9. Moreno MM, Villamor AO, Gutiérrez M. et al. Comparison of dressings and devices to secure peripheral venous catheters in the emergency department: suitability according to patient profile. Emergencias: revista de la Sociedad Espanola de Medicina de Emergencias, 2016; 28(5) :320-326.
10. Machado AF, Pedreira MLG, Chaud MN. Prospective, randomized and controlled trial on the dwell time of peripheral intravenous catheters in children, according to three dressing regimens. Revista latino-americana de enfermagem 2005; 13: 291-298.
11. Abdelaziz RB, Hafsi H, Hajji H, et al. Full title: peripheral venous catheter complications in children: predisposing factors in a multicenter prospective cohort study. BMC pediatrics 2017; 17: 208.
12. Shenoy S, Karunakar BP. Factors influencing the peripheral venous catheter survival in critically ill children in a pediatric intensive care unit. Indian J Pediat. 2014; 81: 1293–1296.
13. Hetzler R, Wilson M, Hill EK, et al. Securing pediatric peripheral i.V.Catheters–application of an evidence-based practice model. J Pediatr Nurs 2011; 26: 143–148.
14. Shenoy S, Karunakar B P. Factors influencing the peripheral venous catheter survival in critically ill children in a pediatric intensive care unit. The Indian Journal of Pediatrics 2014; 81(12) :1293-1296.
15. Loveday HP, Wilson JA, Pratt RJ, et al. national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. The Journal of hospital infection 2014; 86: 1–70.
16. Infusion Nurses Society. Infusion related complication. Journal of Infusion Nursing 2011;65-66.
17. Legemaat M, Carr PJ, van Rens RM, et al. Peripheral intravenous cannulation: complication rates in the neonatal population: a multicenter observational study. The journal of vascular access. 2016;17(4):360–365.
18. Unbeck M, Forberg U, Ygge BM, et al. Peripheral venous catheter related complications are common among paediatric and neonatal patients. Acta Paediatr. 2015;104(6):566–74.
19. Marsh N, Webster J, Mihala G, et al. Devices and dressings to secure peripheral venous catheters: a Cochrane systematic review and meta-analysis. Int J Nurs Stud. 2017; 67: 12–19.
20. Hugill K. Is there an optimal way of securing peripheral IV catheters in children? British journal of nursing (Mark Allen Publishing) 2016; 25: 20–1.
21. Ullman A, Marsh N, Rickard C. Securement for vascular access devices: looking to the future. British journal of nursing (Mark Allen Publishing). 2017; 26(8): 24–26. Malyon, L, Ullman AJ, Phillips N, et al. Peripheral intravenous catheter duration and failure in paediatric acute care: a prospective cohort study. Emergency Medicine Australasia, 2014; 26(6): 602-608.
22. Limm EI, Fang X, Dendle C, et al. Half of all peripheral intravenous lines in an Australian tertiary emergency department are unused: pain with no gain? Ann Emerg Med 2013; 62: 521–525.