[1]徐婷婷 张伟英 李燕 王祝平 罗雯懿 吕剑虹.儿童外周动脉导管管理的最佳证据总结[J].中国卫生质量管理,2024,31(06):044-49.[doi:10.13912/j.cnki.chqm.2024.31.6.10]
　XU Tingting,ZHANG Weiying,LI Yan.Summary of the Best Evidence for Peripheral Arterial Catheter Management in Children[J].Chinese Health Quality Management,2024,31(06):044-49.[doi:10.13912/j.cnki.chqm.2024.31.6.10]
点击复制

儿童外周动脉导管管理的最佳证据总结()
分享到：

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第31卷
期数:
2024年06期
页码:
044-49
栏目:
护理质量
出版日期:
2024-06-15

文章信息/Info

Title:
Summary of the Best Evidence for Peripheral Arterial Catheter Management in Children
作者:
徐婷婷 张伟英 李燕 王祝平 罗雯懿 吕剑虹
上海市儿童医院/上海交通大学医学院附属儿童医院
Author(s):
XU Tingting; ZHANG Weiying; LI Yan
Shanghai Children’s Hospital/Shanghai Children’s Hospital,School of Medicine,Shanghai Jiao Tong University
关键词:
动脉导管; 外周动脉; 儿童; 导管管理; 证据总结; 循证护理
Keywords:
Arterial Catheter; Peripheral Artery; Children; Catheter Management; Summary of Evidence; Evidence-Based Nursing
分类号:
R322.121R47
DOI:
10.13912/j.cnki.chqm.2024.31.6.10
文献标志码:
A
摘要:
目的检索、评价和总结儿童外周动脉导管管理的最佳证据，为临床医护人员规范化操作提供循证依据。方法检索UpToDate、BMJ Best Practice、国内外相关指南网站、中英文数据库以及专业协会网站中关于儿童外周动脉导管管理的临床决策、指南、专家共识、证据总结、系统评价文献。由两名研究人员独立对文献进行筛选、质量评价、证据提取。结果共纳入16篇文献，其中临床决策1篇、指南5篇、证据总结8篇、系统评价2篇。汇总形成包括导管留置、导管维护、并发症预防与处理、导管拔除4个方面共31条的最佳证据。结论在证据转化应用过程中，医护人员可结合临床情境制订儿童外周动脉导管管理策略，以规范临床操作。
Abstract:
ObjectiveTo retrieve, evaluate and summarize the best evidence of peripheral arterial catheter management in children, and provide evidence-based basis for the standardized operation of clinical staff.MethodsThe literatures were searched from UpToDate, BMJ Best Practice, guideline networks, domestic and international databases, and website of professional associations involving peripheral arterial catheter management in children. Literatures included best practice, guidelines, expert consensuses, evidence summaries, systematic reviews. Literature screening, quality evaluation, evidence extraction were conducted independently by two researchers.ResultsA total of 16 publications were included, involving 1 best practice, 5 guidelines, 8 evidence summaries, 2 systematic reviews. 31 pieces of evidence related to peripheral arterial catheter management in children were extracted and summarized into 4 items, including placement, maintenance, complication prevention and management, and extubation.Conclusion In the process of evidence transformation and application, the medical staff can formulate the management strategy of children’s peripheral arterial catheter according to the clinical situation, so as to standardize the clinical operation.

参考文献/References:

［1］袁翠,杨晓旸,肖艳艳,等.ICU患者外周动脉导管并发症发生情况及穿刺部位渗血影响因素研究［J］.中国护理管理,2022,22(11):1612-1617.［2］庄文鹰,杨玉霞,顾莺,等.《儿童动脉血气分析临床操作实践标准》采血流程的实施研究［J］.中国护理管理,2022,22(11):1623-1629. ［3］RAPHAEL CK, EL HAGE CHEHADE NA, KHABSA J, et al.Ultrasound-guided arterial cannulation in the paediatric population［J］.Cochrane Database Syst Rev,2023,3(3):CD011364. ［4］HUANG HP, ZHAO WJ,WEN F,et al.Application of ultrasound-guided radial artery cannulation in paediatric patients: a systematic review and meta-analysis［J］.Aust Crit Care,2021,34(4):388-394. ［5］BRZEZINSKI M,LUISETTI T,LONDON MJ.Radial artery cannulation:a comprehensive review of recent anatomic and physiologic investigations［J］.Anesth Analg, 2009,109(6):1763-1781.［6］KING MA,GARRISON MM,VAVILALA MS,et al.Complications associated with arterial catheterization in children［J］.Pediatr Crit Care Med,2008,9(4):367-371. ［7］MACNICOL MF,ANAGNOSTOPOULOS J.Arrest of the growth plate after arterial cannulation in infancy［J］.J Bone Joint Surg Br,2000,82(2):172-175.［8］MOUROT JM,OLIVEIRA HM,WOODSON LC,et al.Complications of femoral artery catheterization in pediatric burn patients［J］.J Burn Care Res,2009,30(3):432-436.［9］O’GRADY NP,ALEXANDER M,BURNS LA,et al.Guidelines for the prevention of intravascular catheter-related infections［J］.Clin Infect Dis,2011,52(9):162-193.［10］PORRITT BNK.Peripheral arterial catheters: dressing and catheter securement［EB/OL］.(2021-09-03)［2023-09-06］.http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi&NEWS =N&AN=JBI17412.［11］ROBERTSON-MALT S,MALT GN,FARQUHAR V,et al.Heparin versus normal saline for patency of arterial lines［J］.Cochrane Database Syst Rev,2014(5):CD007364. ［12］邢唯杰,胡雁,周英凤,等.推动证据向临床转化(六)证据总结的制作与撰写［J］.护士进修杂志,2020,35(12):1129-1132. ［13］ALPER BS,HAYNES RB.EBHC pyramid 5.0 for accessing preappraised evidence and guidance［J］.Evid Based Med,2016,21(4):123-125.［14］BROUWERS MC,KHO ME,BROWMAN GP,et al.AGREE II: advancing guideline development, reporting and evaluation in health care［J］.CMAJ,2010,182(18): 839-842.［15］FOSTER MJ,SHURTZ S.Making the Critical Appraisal for Summaries of Evidence (CASE) for evidence-based medicine (EBM): critical appraisal of summaries of evidence［J］.J Med Libr Assoc, 2013,101(3):192-198. ［16］朱政,胡雁,周英凤,等.推动证据向临床转化(五)证据临床转化研究中的文献质量评价［J］.护士进修杂志,2020,35(11):996-1000.［17］王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)［J］.护士进修杂志,2015,30 (11):964-967.［18］BAJAJ L. Arterial puncture and cannulation in children［EB/OL］.(2022-02-10)［2023-09-06］. https://www.uptodate.com/contents/arterial-puncture-and-cannulation-in-children?search=Arterial%20puncture%20and%20cannulation%20in%20children&source=search_re sult&selectedTitle=1~150&usage_type=default&display_rank=1.［19］Registered Nurses Association of Ontario.Vascular Access.Second Edition［M］.Toronto:Registered Nurses Association of Ontario,2021:30.［20］TIMSIT JF,BALEINE J,BERNARD L,et al.Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit［J］.Ann Intensive Care,2020,10(1):118.［21］BUCHANAN C, BURT A,MOUREAU N,et al.Registered Nurses’ Association of Ontario (RNAO) best practice guideline on the assessment and management of vascular access devices［J］.J Vasc Access,2023,26:1-14.［22］GORSKI LA,HADAWAY L,HAGLE ME,et al.Infusion therapy standards of practice,8th edition［J］.J Infus Nurs,2021,44(1S Suppl 1):S1-S224.［23］MOOLA S. Arterial lines: flushing media［EB/OL］.(2021-03-11)［2023-09-06］. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi& NEWS=N&AN=JBI17411.［24］KYAWT S. Arterial lines:site of line placement［EB/OL］.(2021-03-17)［2023-09-06］. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi&NEWS=N&AN=JBI17415.［25］MOOLA S.Arterial lines: monitoring and transducers［EB/OL］.(2021-03-11)［2023-09-06］.http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jb i&NEWS=N&AN=JBI17414.［26］QUEIROZ AB.Arterial catheters: bloodstream infection［EB/OL］.(2023-04-01)［2023-09-06］.http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=j bi&NEWS=N&AN=JBI12760.［27］PRIYANKA P.Arterial lines: peplacement［EB/OL］.(2023-03-31)［2023-09-06］.http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi&NEWS=N&AN=JBI17413.［28］PRIYANKA P. Arterial lines (adult and pediatric): insertion［EB/OL］.(2023-04-03)［2023-09-06］.http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PA GE=reference&D=jbi&NEWS=N& AN=JBI17409. ［29］何立环,祝林林,安庆,等.小儿外周动脉导管冲洗系统的最佳证据总结［J］.中国实用护理杂志,2022,38(11):843-848.［30］PATOUT M, LAMIA B, LHUILLIER E, et al. A randomized controlled trial on the effect of needle gauge on the pain and anxiety experienced during radial arterial puncture［J］.PLoS One, 2015,10(9):e0139432.［31］VALLEJO DE LA HOZ G,REGLERO GARCA L,FERNNDEZ AEDO I,et al. Alternatives to subcutaneous injection of amino-amide or amino-ester anesthetics before arterial puncture for blood gas analysis: a systematic review［J］. Emergencias,2019,31(2):115-122.［32］梁晓晶,祝红娟,郭剑颖,等.影响危重患者有创血压监测准确性相关因素的研究进展［J］.中华灾害救援医学,2022,10(2):84-87.［33］GOTTLIEB M, BAILITZ J.Is ultrasonographic guidance more successful than direct palpation for arterial line placement?［J］. Ann Emerg Med, 2016, 68(2):227-229.［34］张明博,罗渝昆,王艳秋,等.建立超声规培生个体化培养体系［J］.中国卫生质量管理,2019,26 (6):96-101.［35］EVERSON M,WEBBER L,PENFOLD C, et al. Finding a solution: Heparinised saline versus normal saline in the maintenance of invasive arterial lines in intensive care［J］.J Intensive Care Soc,2016, 17(4):284-289.［36］ULLMAN AJ,COOKE ML,MITCHELL M,et al.Dressing and securement for central venous access devices (CVADs): a Cochrane systematic review［J］. Int J Nurs Stud, 2016, 59:177-196.［37］TIMSIT JF,MIMOZ O,MOURVILLIER B,et al.Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter related infections in critically ill adults［J］. Am J Respir Crit Care Med,2012,186(12):1272-1278.［38］THEODORE AC,CLERMONT G,DALTON A.Intra-arterial catheterization for invasive monitoring Indications, insertion techniques, and interpretation［EB/OL］.(2022-11-02)［2023-09-06］.https://www.uptodate.cn/contents/zh-Hans/intra-arterial-catheterization-for-invasive-monitoring-indications-insertion-techniques-and-interpretation?search=Intra-arterial%20cathe terization%20for%20invasive%20monitoring%20Indications,%20insertion%20techniqu es,%20and% 20interpretation&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.［39］BRZEZINSKI M,LUISETTI T,LONDON MJ.Radial artery cannulation:a comprehensive review of recent anatomic and physiologic investigations［J］. Anesth Analg,2009,109(6):1763-1781.［40］付强,董宏亮,樊静.患者安全目标：预防和减少卫生保健相关感染［J］.中国卫生质量管理,2020,27(6):1-4.

更新日期/Last Update: 2024-06-15