Complications of central venous catheterization at a vascular surgery service in a teaching hospital: a prospective cohort study.

IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Jornal Vascular Brasileiro Pub Date : 2023-09-18 eCollection Date: 2023-01-01 DOI:10.1590/1677-5449.202300702
Leonardo Jatczak, Renan Camargo Puton, Alencar Junior Lopes Proença, Leonardo Colussi Rubin, Luiza Brum Borges, Jaber Nashat Saleh, Mateus Picada Corrêa
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Abstract

Background: Central venous catheters are essential for management of hospitalized patients, but their insertion is subject to complications that can make them unusable and/or cause patient morbidity. There are few data on the incidence of these complications and the variables associated with these outcomes in Brazil.

Objectives: To determine the incidence of mechanical complications and failures of short stay central venous catheters fitted by the vascular surgery service at a teaching hospital and identify variables associated with their occurrence.

Methods: This was a prospective cohort of 73 attempts to fit patients with a central venous catheter performed by the vascular surgery service at a teaching hospital from July to October of 2022.

Results: Mechanical complications occurred in 12 cannulation attempts (16.44%) and there were 10 failures (13.70%). The factors associated with mechanical complications were less experienced operators (p < 0.001), less specialized operators (p = 0.014), a failed attempt prior to requesting help from the vascular surgery service (p = 0.008), and presence of at least two criteria for difficulty (p = 0.007).

Conclusions: The local incidence of mechanical complications and central venous cannulation failures was similar to rates described in the international literature, but higher than rates in other Brazilian studies. The results suggest that the degree of experience of the person fitting the catheter, history of a failed prior attempt, and presence of at least two criteria for difficulty identified before the procedure were associated with worse outcomes.

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教学医院血管外科中心静脉导管插入术的并发症:一项前瞻性队列研究。
背景:中心静脉导管对住院患者的管理至关重要,但其插入会出现并发症,导致其无法使用和/或导致患者发病。在巴西,关于这些并发症的发生率和与这些结果相关的变量的数据很少。目的:确定教学医院血管外科服务部门安装的短期中心静脉导管的机械并发症和故障的发生率,并确定与其发生相关的变量。方法:这是一个前瞻性队列,包括2022年7月至10月由一家教学医院的血管外科服务部门为患者安装中心静脉导管的73次尝试。结果:12次插管尝试中发生了机械并发症(16.44%),10次失败(13.70%)。与机械并发症相关的因素是经验不足的操作员(p<0.001),不太专业的操作人员(p=0.014),在向血管外科服务部门寻求帮助之前的失败尝试(p=0.008),以及至少存在两个困难标准(p=0.0027)。结论:机械并发症和中心静脉插管失败的局部发生率与国际文献中描述的发生率相似,但高于巴西其他研究中的比率。结果表明,安装导管的人的经验程度、先前尝试失败的历史以及在手术前确定的至少两个困难标准的存在与较差的结果相关。
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来源期刊
Jornal Vascular Brasileiro
Jornal Vascular Brasileiro Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.20
自引率
0.00%
发文量
57
审稿时长
20 weeks
期刊介绍: The Jornal Vascular Brasileiro is editated and published quaterly to select and disseminate high-quality scientific contents concerning original research, novel surgical and diagnostic techniques, and clinical observations in the field of vascular surgery, angiology, and endovascular surgery. Its abbreviated title is J. Vasc. Bras., which should be used in bibliographies, footnotes and bibliographical references and strips.
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