Edivane Pedrolo

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.

Chlorhexidine and gauze and tape dressings for central venous catheters: a randomized clinical trial

OBJECTIVE: to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters. METHOD: a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing) or control (gauze and micro porous tape) groups. RESULTS: a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170); local reactions to the dressing (p-value = 0.3774); and dressing fixation (p-value = 0.2739). CONCLUSION: both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.OBJECTIVE: to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters. METHOD: a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing) or control (gauze and micro porous tape) groups. RESULTS: a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170); local reactions to the dressing (p-value = 0.3774); and dressing fixation (p-value = 0.2739). CONCLUSION: both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.

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.

Infection, local reaction and poor fixation of dressings for central venous catheter

OBJECTIVE: To identify factors related to the occurrence of infection, local reaction and poor fixation of dressings for central venous catheters.METHODS: Randomized clinical trial conducted with adult patients using central venous catheter for short periods, hospitalized in intensive and semi-intensive care units of a university hospital.RESULTS: 85 patients (43 chlorhexidine dressings; 42 gauze and tape). Use of blood component increases the chance of catheter-related infection; use of dressings for more than three days increases the chance of local reaction; catheter in the jugular vein increases the chance of poor fixation of the dressing. Catheter permanence for more than five days increases the chance of infection, local reaction and poor fixation.CONCLUSION: Both dressings are effective to cover central venous catheters and can be used for this purpose.

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.

Inovação tecnológica para punção venosa periférica: capacitação para uso da ultrassonografia

Objetivo: avaliar a capacitacao dos enfermeiros para o uso da tecnologia da ultrassonografia na puncao venosa periferica. Metodo: pesquisa descritiva de abordagem quantitativa, realizada com enfermeiros como etapa de um estudo transversal analitico em dois centros de atendimento ao paciente critico: uma unidade de terapia intensiva e uma unidade de pronto atendimento adulto. Resultados: os resultados demonstraram contribuicoes da capacitacao na habilidade e visibilidade profissional dos enfermeiros, com necessidade, entretanto, de maior tempo de vivencia e aprendizado dos participantes para o dominio e assimilacao desta inovacao tecnologica enquanto pratica clinica mais segura. Conclusao: na medida em que o uso desta tecnologia representa uma inovacao destinada a facilitar o procedimento de puncao venosa de dificil acesso e prover subsidios a tomada da decisao clinica mais adequada para cada paciente, faz-se premente a enfermagem capacitar-se para o seu uso.Objective: to evaluate the training of nurses in the use of ultrasound in peripheral venipuncture. Method: descriptive research of quantitative approach performed with nurses as part of an analytical cross-sectional study in two patient care centers: an intensive care unit and an adult emergency center. Results: the results showed contributions of training for professional skill and visibility of nurses, requiring, however, more time for complete assimilation of this technological innovation as a safer clinical practice. Conclusion: as the use of this technology represents an innovation aimed to facilitate difficult venipuncture and to provide subsidies to the most appropriate clinical decision-making, it is urgent to qualify nurses for its use.

Curativo de clorhexidina y gasa y esparadrapo para catéter venoso central: ensayo clínico aleatorio

OBJECTIVE: to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters. METHOD: a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing) or control (gauze and micro porous tape) groups. RESULTS: a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170); local reactions to the dressing (p-value = 0.3774); and dressing fixation (p-value = 0.2739). CONCLUSION: both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.OBJECTIVE: to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters. METHOD: a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing) or control (gauze and micro porous tape) groups. RESULTS: a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170); local reactions to the dressing (p-value = 0.3774); and dressing fixation (p-value = 0.2739). CONCLUSION: both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.