| Revue: | Revista latino-americana de enfermagem |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000400189 |
| ISSN: | 0104-1169 |
| Autores: | Costa, Priscila1 Kimura, Amelia Fumiko1 Brandon, Debra Huffman2 Paiva, Eny Dorea3 Camargo, Patricia Ponce de4 |
| Instituciones: | 1Universidade de Sao Paulo, Escola de Enfermagem, Sao Paulo. Brasil 2Duke University, School of Nursing, Durham, Carolina del Norte. Estados Unidos de América 3Universidade Federal Fluminense, Escola de Enfermagem, Rio de Janeiro. Brasil 4Universidade de Sao Paulo, Faculdade de Medicina, Sao Paulo. Brasil |
| Año: | 2015 |
| Periodo: | May-Jun |
| Volumen: | 23 |
| Número: | 3 |
| Paginación: | 475-482 |
| País: | Brasil |
| Idioma: | Español, portugués, inglés |
| Tipo de documento: | Estadística o encuesta |
| Enfoque: | Analítico |
| Resumen en español | OBJETIVO: elaborar un puntaje de riesgo para remoción no electiva del catéter central de inserción periférica en neonatos. MÉTODO: estudio de cohorte prospectivo realizado en una unidad de terapia intensiva neonatal con recién nacidos sometidos a instalación de 524 catéteres centrales de inserción periférica. Las características clínicas del neonato, la técnica de inserción del catéter y la terapia intravenosa fueron verificadas como factores de riesgo para remoción no electiva del catéter en un análisis bivariado. El puntaje de riesgo fue elaborado a partir de regresión logística, fue validado internamente y su precisión evaluada por medio de la área bajo la curva receiver operating characteristic. RESULTADOS: el puntaje de riesgo fue compuesto por los factores de riesgo: diagnóstico de trastorno transitorio del metabolismo, inserción previa del catéter, uso de catéter doble lumen de poliuretano, infusión de múltiples soluciones intravenosas a través de catéter mono lumen, y posición no central de la punta del catéter. Su aplicación permitió clasificar a los recién nacidos en tres categorías de riesgo: bajo (0 a 3 puntos), moderado (4 a 8 puntos) y alto (≥ 9 puntos) para remoción no electiva, con precisión de 0,76. CONCLUSIÓN: se recomienda adoptar estrategias preventivas basadas en evidencias de acuerdo con la clasificación y factores de riesgo del recién nacido, objetivando minimizar la ocurrencia de remoción no electiva del catéter |
| Resumen en inglés | OBJECTIVE: to develop a risk score for unplanned removal of peripherally inserted central catheter in newborns. METHOD: prospective cohort study conducted in a neonatal intensive care unit with newborn babies who underwent 524 catheter insertions. The clinical characteristics of the newborn, catheter insertion and intravenous therapy were tested as risk factors for the unplanned removal of catheters using bivariate analysis. The risk score was developed using logistic regression. Accuracy was internally validated based on the area under the Receiver Operating Characteristic curve. RESULTS: the risk score was made up of the following risk factors: transient metabolic disorders; previous insertion of catheter; use of a polyurethane double-lumen catheter; infusion of multiple intravenous solutions through a single-lumen catheter; and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points). Accuracy was 0.76. CONCLUSION: the adoption of evidence-based preventative strategies based on the classification and risk factors faced by the newborn is recommended to minimize the occurrence of unplanned removals |
| Resumen en portugués | OBJECTIVE: to develop a risk score for unplanned removal of peripherally inserted central catheter in newborns. METHOD: prospective cohort study conducted in a neonatal intensive care unit with newborn babies who underwent 524 catheter insertions. The clinical characteristics of the newborn, catheter insertion and intravenous therapy were tested as risk factors for the unplanned removal of catheters using bivariate analysis. The risk score was developed using logistic regression. Accuracy was internally validated based on the area under the Receiver Operating Characteristic curve. RESULTS: the risk score was made up of the following risk factors: transient metabolic disorders; previous insertion of catheter; use of a polyurethane double-lumen catheter; infusion of multiple intravenous solutions through a single-lumen catheter; and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points). Accuracy was 0.76. CONCLUSION: the adoption of evidence-based preventative strategies based on the classification and risk factors faced by the newborn is recommended to minimize the occurrence of unplanned removals |
| Disciplinas: | Medicina |
| Palabras clave: | Cirugía, Pediatría, Recién nacidos, Catéter venoso central, Factores de riesgo, Enfermería pediátrica |
| Keyword: | Medicine, Pediatrics, Surgery, Newborn, Central venous catheter, Risk factors, Pediatric nursing |
| Texte intégral: | Texto completo (Ver HTML) |
