Derdried Athanasio Johann

Ensaio clínico controlado sobre o curativo de cateter venoso central

Objective: To evaluate the effectiveness of gauze and tape as compared to transparent polyurethane film for dressing central venous catheters. Methods: A randomized controlled clinical trial was conducted. Results: No significant difference was identified in catheterrelated infection (p = 1) or the stability of the dressing (p = 0.670). There was no statistically significant difference with respect to the absorption of exudate (p <0.001). The likelihood of local reaction in the control group (gauze and tape) was different from the study group (p = 0.024). Conclusion: The type of dressing does not decrease the incidence of catheter-related infection, the binding capacity is similar, and the gauze dressing has the capacity to absorb exudate. However, the gauze dressing resulted in a higher probability of developing a local reaction. Record WHO: ACTRN12609000951257.

Clinical controlled trial on central venous catheter dressings

Objective: To evaluate the effectiveness of gauze and tape as compared to transparent polyurethane film for dressing central venous catheters. Methods: A randomized controlled clinical trial was conducted. Results: No significant difference was identified in catheterrelated infection (p = 1) or the stability of the dressing (p = 0.670). There was no statistically significant difference with respect to the absorption of exudate (p <0.001). The likelihood of local reaction in the control group (gauze and tape) was different from the study group (p = 0.024). Conclusion: The type of dressing does not decrease the incidence of catheter-related infection, the binding capacity is similar, and the gauze dressing has the capacity to absorb exudate. However, the gauze dressing resulted in a higher probability of developing a local reaction. Record WHO: ACTRN12609000951257.

[Peripherally inserted central catheter care in neonates: an integrative literature review].

O cateter central de insercao periferica e tecnologia comum empregada na terapia intravenosa de neonatos. Trata-se de revisao integrativa, cujo objetivo foi investigar e analisar as evidencias disponiveis na literatura acerca da tematica. As bases de dados pesquisadas foram Literatura Latino-Americana e do Caribe em Ciencias da Saude (LILACS) e Biblioteca Nacional de Medicina dos Estados Unidos (PubMed). Resultados apontam lacunas no que tange a populacao neonatal; conhecimento insuficiente dos profissionais quanto indicacoes (n=1); e variados temas sobre uso de anticoagulantes (n=6), comparacao com outros cateteres (n=4), diagnostico por imagem (n=2), dor (n=2), infeccao relacionada a cateter e sua prevencao (n=7), entre outros fatores. Conclui-se que ha necessidade de atualizacao profissional, evidencias cientificas de facil acesso e publicacoes nacionais.The peripherally inserted central catheter is a common technology employed in the intravenous therapy of neonates. This integrative review was performed with the objective to investigate and analyze the evidence available in the literature regarding this technology. The databases searched included the Latin American and Caribbean Health Sciences Literature (LILACS) and the United States National Library of Medicine (PubMed). Results point at gaps in relation to their use in the neonatal population (n=1); various themes regarding the use of anticoagulants (n=6), comparison with other catheters (n=4), diagnostic imaging (n=2), pain (n=2), and catheter-relation infection and its prevention (n=7), among others. There is a need for staff education regarding their use; scientific evidence with easy access; and national publications regarding their use.

Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates

OBJETIVO Avaliar a incidencia de complicacoes relacionadas ao uso do cateter intravenoso periferico em neonatos e identificar fatores de risco associados. METODO Coorte prospectiva, realizada em Unidade de Terapia Intensiva Neonatal. Os participantes foram os neonatos internados submetidos a puncao intravenosa periferica, no periodo de fevereiro a junho de 2013. RESULTADOS A incidencia de complicacoes foi de 63,15%, sendo infiltracao/extravasamento (69,89%), flebite (17,84%) e obstrucao (12,27%). Os fatores de risco foram: presenca de infeccao (p=0,0192) e peso no dia da puncao (p=0,0093), tipo de infusao intermitente associada a continua (p<0,0001), intubacao orotraqueal (p=0,0008), infusao de plano basico (p=0,0027), nutricao parenteral total (p=0,0002), hemotransfusao associada a outras infusoes (p=0,0003) e outros medicamentos (p=0,0004). Maior risco de desenvolver complicacao nas primeiras 48 horas pos-puncao. CONCLUSAO Uma taxa elevada de complicacoes relacionadas ao uso do cateter intravenoso periferico e fatores de risco associados a infeccao, peso, drogas e solucoes infundidas e tipo de infusao.OBJECTIVE To evaluate the incidence of complications related to the use of peripheral intravenous catheter in neonates and identify the associated risk factors. METHOD Prospective cohort study conducted in a Neonatal Intensive Care Unit. Participants were the hospitalized neonates undergoing peripheral intravenous puncture in the period from February to June 2013. RESULTS The incidence of complications was 63.15%, being infiltration/extravasation (69.89%), phlebitis (17.84%) and obstruction (12.27%). The risk factors were the presence of infection (p = 0.0192) and weight at the puncture day (p = 0.0093), type of intermittent infusion associated with continuous infusion (p <0.0001), endotracheal intubation (p = 0.0008), infusion of basic plan (p = 0.0027), total parenteral nutrition (P = 0.0002), blood transfusion associated with other infusions (p = 0.0003) and other drugs (p = 0.0004). Higher risk of developing complications in the first 48 hours after puncture. CONCLUSION A high rate of complications related to the use of peripheral intravenous catheter, and risk factors associated with infection, weight, drugs and infused solutions, and type of infusion.

Prevenção de úlceras por pressão no calcanhar com filme transparente de poliuretano

OBJECTIVE: Evaluate the effectiveness of transparent polyurethane film in prevention of pressure ulcer of the calcaneus. Methods: A sample of 100 patients enrolled in a non-randomized controlled trialreceived a paired analysis of both calcaneus areas; each received the experimental intervention on the left heel and the control intervention on the right heel (clinical guideline only), constituting a total of 200 heel sites for analysis. RESULTS: The incidence of pressure ulcers was 32%, with 6% occurring in the experimental intervention, 18% in the control intervention, and 8% bilaterally, with significant incidence in the first 15 days of hospitalization. The length of time without pressure ulcers occurrence with the experimental intervention was 19.2 days, with a 95% confidence interval. CONCLUSION: It was concluded that the transparent polyurethane film associated with the pressure ulcers clinical guideline was effective in the prevention of heel pressure ulcer.

Incidência de complicações locais no cateterismo venoso periférico e fatores de risco associados

Objective To estimate the incidence of local complications associated with peripheral catheters and identify risk factors for the development of most common complications. Methods This prospective cohort study included 92 adult inpatients at clinical and surgical units who had peripheral catheterization. By daily observance of the catheters we determined time of permanence and local complications due to the use of a complete safety catheter. All actions began after training of nursing teams. Statistical tests used were the Fisher exact test, G test (Williams), chi-square, Mann-Whitney U test, and relative risk. Results Local complications occurred in 56.2% of cases. Time of catheter permanence over 72 hours increased the risk for phlebitis development in 2.34% of cases (RR; p=0.0483; CI [0.91; 6.07]). Conclusion Incidence of local complications was high. Phlebitis was the predominant complication and the time of catheter permanence over 72 hours was a considered risk factor for this complication.

Risk factors for complications in peripheral intravenous catheters in adults: secondary analysis of a randomized controlled trial

Objetivo: analisar os fatores de risco relacionados a ocorrencia de complicacoes no cateterismo venoso periferico. Metodo: analise secundaria de dados de um ensaio clinico randomizado, no qual 169 pacientes clinicos e cirurgicos foram alocados no grupo em uso de cateter de seguranca completo (n = 90) e no grupo que utilizou cateter sobre agulha simples (n = 79), tempo de seguimento de tres meses. Resultados: os fatores de risco que aumentaram as chances de desenvolvimento de complicacoes foram: periodos de internacao compreendidos entre 10 a 19 dias (p = 0,0483) e 20 a 29 dias (p = 0,0098), uso de antimicrobianos (p = 0,0288) e solucoes e planos de soro (p = 0,0362). O calibre 20 Gauge diminuiu os riscos de ocorrencia de complicacoes (p=0,0153). A analise multipla apontou reducao do risco para o calibre 20 (p = 0,0350); aumento do risco para a infusao de solucoes e planos de soro (p = 0,0351) e administracao de corticosteroides (p = 0,0214). Conclusao: os fatores de risco relacionados a ocorrencia de complicacoes no cateterismo venoso periferico foram tempo de internacao entre 10 e 29 dias, infusao de antimicrobianos, solucoes e planos de soro e corticosteroides. Ressalta-se o calibre 20 como fator protetor ao desenvolvimento de complicacoes, quando comparado ao 22. Registro Brasileiro de Ensaios Clinicos: RBR-46ZQR8.ABSTRACT Objective: analyze the risk factors linked to complications in peripheral intravenous catheters. Method: secondary data analysis of a randomized controlled trial with 169 medical and surgical patients placed in two groups, one with integrated safety catheter (n=90) and other using simple needle catheter (n=79), with three months follow-up time. Results: the risk factors that raised the odds of developing complications were: hospitalization between 10-19 days (p=0.0483) and 20-29 days (p=0,0098), antimicrobial use (p=0.0288) and use of fluid solutions (p=0.0362). The 20 Gauge lowered the risks of complications (p=0.0153). Multiple analysis showed reduction of risk for the 20 Gauge (p=0.0350); heightened risk for solutions and fluids (p=0.0351) and use of corticosteroids (p=0.0214). Conclusion: risk factors linked to complications in peripheral intravenous catheters were: hospitalization periods between 10-29 days, antimicrobial infusion, solutions and fluids and corticosteroids. Regarding complications, 20 Gauge is a protecting factor compared with 22. Brazilian Clinical Trials Registry: RBR-46ZQR8.

Complicações relacionadas ao uso do cateter venoso periférico: ensaio clínico randomizado

Objective To analyze the complications deriving from the use and type of peripheral venous catheter in adults. Methods Randomized clinical trial; undertaken at a teaching hospital between 2012 and 2015; 169 adults were included who were hospitalized at clinical and surgical services and needed peripheral venipuncture with an expected dwelling time of more than 96 hours. Through systemized randomization, 90 participants were allocated to the trial group (complete safety catheter) and 79 to the control group (short flexible catheter). Results The general complications rate was 55.62%, with 18.34% of phlebitis, 11.83% infiltration, 11.24% obstruction and 9.47% traction. No significant difference was found between the groups for the occurrence of complications, phlebitis, obstruction and traction. Conclusion The complication rate in peripheral venous catheterization was high but, when compared, without a statistically significant difference, the complete safety catheter showed lower complication rates after the fourth day of survival.

Significant relation on central catheter of peripheral insertion

Objective: to relate the socio-demographic and clinical characteristics of neonates using the peripherally inserted central catheter to the associated complications. Method: exploratory, descriptive and retrospective documentary research with a quantitative approach. The sample consisted of peripherally inserted central catheters inserted during July-December 2009, in neonates hospitalized in neonatal intensive care unit. We used SPSS version 15 Evaluation; we considered p <0.05. The study was approved by the Ethics in Research with CAAE 0036.0.091.000-10. Results: a total of 45 peripherally inserted central catheters, inserted in 36 neonates. Significant results were related from: parkin and weight on the day of insertion to local and systemic complications, birth weight and performance of flush draw to the infection, local and systemic complications; Apgar score less than seven in the first minute of life and number of attempts to local complication. Conclusion: we identified a significant relationship between clinical variables and the occurrence of complications. Descriptors: Neonatal Nursing; Newborn; Central Venous Catheterization; Complications; Technology.

Cuidados com cateter central de inserção periférica no neonato: revisão integrativa da literatura

O cateter central de insercao periferica e tecnologia comum empregada na terapia intravenosa de neonatos. Trata-se de revisao integrativa, cujo objetivo foi investigar e analisar as evidencias disponiveis na literatura acerca da tematica. As bases de dados pesquisadas foram Literatura Latino-Americana e do Caribe em Ciencias da Saude (LILACS) e Biblioteca Nacional de Medicina dos Estados Unidos (PubMed). Resultados apontam lacunas no que tange a populacao neonatal; conhecimento insuficiente dos profissionais quanto indicacoes (n=1); e variados temas sobre uso de anticoagulantes (n=6), comparacao com outros cateteres (n=4), diagnostico por imagem (n=2), dor (n=2), infeccao relacionada a cateter e sua prevencao (n=7), entre outros fatores. Conclui-se que ha necessidade de atualizacao profissional, evidencias cientificas de facil acesso e publicacoes nacionais.The peripherally inserted central catheter is a common technology employed in the intravenous therapy of neonates. This integrative review was performed with the objective to investigate and analyze the evidence available in the literature regarding this technology. The databases searched included the Latin American and Caribbean Health Sciences Literature (LILACS) and the United States National Library of Medicine (PubMed). Results point at gaps in relation to their use in the neonatal population (n=1); various themes regarding the use of anticoagulants (n=6), comparison with other catheters (n=4), diagnostic imaging (n=2), pain (n=2), and catheter-relation infection and its prevention (n=7), among others. There is a need for staff education regarding their use; scientific evidence with easy access; and national publications regarding their use.