{"title":"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。","authors":"Leonardo Jatczak, Renan Camargo Puton, Alencar Junior Lopes Proença, Leonardo Colussi Rubin, Luiza Brum Borges, Jaber Nashat Saleh, Mateus Picada Corrêa","doi":"10.1590/1677-5449.202300702","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20230070"},"PeriodicalIF":0.8000,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545227/pdf/","citationCount":"0","resultStr":"{\"title\":\"Complications of central venous catheterization at a vascular surgery service in a teaching hospital: a prospective cohort study.\",\"authors\":\"Leonardo Jatczak, Renan Camargo Puton, Alencar Junior Lopes Proença, Leonardo Colussi Rubin, Luiza Brum Borges, Jaber Nashat Saleh, Mateus Picada Corrêa\",\"doi\":\"10.1590/1677-5449.202300702\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":14814,\"journal\":{\"name\":\"Jornal Vascular Brasileiro\",\"volume\":\"22 \",\"pages\":\"e20230070\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2023-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545227/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jornal Vascular Brasileiro\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1590/1677-5449.202300702\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jornal Vascular Brasileiro","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/1677-5449.202300702","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Complications of central venous catheterization at a vascular surgery service in a teaching hospital: a prospective cohort study.
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.
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.