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

Johann, Derdried Athanasio; Lazzari, Luciana Souza Marques De; Pedrolo, Edivane; Mingorance, Priscila; Almeida, Tatiana Queiroz Ribeiro de; Danski, Mitzy Tânnia Reichembach

doi:10.1590/s0080-62342012000600030

Cited by 12 publications

(13 citation statements)

References 33 publications

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“…Deve-se adotar medidas preventivas de infecção de corrente sanguínea (ICS) relacionada ao cateter 1,13 , tais como: barreira máxima na inserção, higienizar as mãos antes e após a manipulação do PICC; realizar a desinfecção das conexões e do hub com álcool à 70% antes da infusão de qualquer solução; substituir periodicamente o sistema infusional (equipo, polifix,) conforme rotina estabelecida pelo fabricante ou pela unidade; proteger o PICC e as conexões durante o banho e remover o PICC tão logo não seja mais necessário 13,15,16 .…”

Section: Revisão De Literaturaunclassified

Cateter venoso central de inserção periférica: práticas da equipe de enfermagem na atenção intensiva neonatal [Peripherally inserted central catheter: practics of nursing team in the neonatal intensive care] [Catéter central de inserción periférica: práctica del equipo de enfermería en la atención intensiva neonatal]

et al. 2017

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Objetivo: traçar o perfil de utilização do cateter venoso central de inserção periférica (PICC) na realidade assistencial da unidade de terapia intensiva neonatal (UTIN). Método: estudo observacional, descritivo de abordagem quantitativa, utilizando amostra de conveniência de 47 PICC instalados em 33 bebês internados na UTIN de um hospital escola do Sul do Brasil. Resultados: a maioria dos bebês era prematuro (72,7%), do sexo masculino (52%) e com peso inferior a 2500 gramas (72,7%). Grande parte dos dispositivos foi instalado nos três primeiros dias de vida (59,6%), com uma média de 3,7 punções, sendo o membro superior esquerdo (44,2%) o mais acessado. Quase metade dos dispositivos teve localização inicial intracardiaca (48,8%) e foram retirados não eletivamente (48,8%). Conclusão: este estudo possibilitou verificar que o perfil de pacientes que utilizam PICC na unidade investigada assemelha-se ao encontrado na literatura, e que existem problemas inerentes à sua inserção e manutenção.ABSTRACT Objective: to describe the application profile of the peripherally inserted central catheter (PICC) in the health care reality at Neonatal Intensive Care Unit (NICU). Method: observational and descriptive study with quantitative approach, using a convenience sample of 47 PICC installed in 33 newborn, in the NICU of a university hospital in the Southern of Brazil. Results: most newborns were premature (72.7%), males (52.0%) and with ess than 2,500g (72.7%). Most of devices have been installed in the first three days of life (59.6%) with an average of 3.7 venipunctures, being the left upper limb (44.2%) the most most accessed. Almost half of devices had intracardiac as first location (48.8%) and were not removed electively (48.8%). Conclusion: the study pointed that the profile of patients using PICC in the studierd unit is similar to literature, and there are problems related to its insertion and mantenance.RESUMENObjetivo: describir el perfil de aplicación del catéter central de inserción periférica (PICC) en la realidad del cuidado en unidad de cuidados intensivos neonatales (UCIN). Método: estudio observacional y descriptivo, con abordaje cuantitativa, utilizando una muestra de conveniencia de 47 PICC instalados en 33 recién nacidos, en la UCIN de un hospital universitario del sur de Brasil. Resultados: la mayoría de los recién nacidos fueron prematuros (72,7%), varones (52,0%) y con un resultado inferior a 2,500 g (72,7%). La mayoría de los dispositivos se han instalado en los primeros tres días de vida (59.6%) con un promedio de 3.7 venopunciones, siendo el miembro superior izquierdo (44.2%) el más accesible. Casi la mitad de los dispositivos tenían intracardiaco como primera ubicación (48.8%) y no fueron eliminados de manera electiva (48.8%). Conclusión: el estudio apuntó que el perfil de los pacientes que usan PICC en la unidad estudiada es similar a la literatura, y existen problemas relacionados con su inserción y mantenimiento. DOI: http://dx.doi.org/10.12957/reuerj.2017.28143

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Section: Revisão De Literaturaunclassified

Cateter venoso central de inserção periférica: práticas da equipe de enfermagem na atenção intensiva neonatal [Peripherally inserted central catheter: practics of nursing team in the neonatal intensive care] [Catéter central de inserción periférica: práctica del equipo de enfermería en la atención intensiva neonatal]

et al. 2017

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“…28 In relation to care for maintaining the catheter they emphasized the use of heparin to prevent obstruction, aseptic dressing technique and the pressure applied to the catheter and prevent disruption. 19,21,26,29,34 The continuous infusion of low dose of heparin (0.5 IU/ kg/h) into the fluids is an effective measure to reduce the occlusion of the catheter, allowing the completion of therapy without observing adverse effects. 26,34 The healing practice is essential in maintaining the PICC because it covers and prevents local trauma and contamination, and respect the aseptic technique and the evidence as to the material used and the frequency of change.…”

Section: Insertion and Maintenance Practices Categorymentioning

confidence: 99%

“…26,34 The healing practice is essential in maintaining the PICC because it covers and prevents local trauma and contamination, and respect the aseptic technique and the evidence as to the material used and the frequency of change. 21 In reporting experience with 491 catheters that evaluates technique of dressing with a protective base layer they concluded that catheter complication rates were low, and that dressing changes catheters wereminimized. 37 As for the pressure applied to the catheter and the risk of rupture, only one study addressed the issue.…”

Section: Insertion and Maintenance Practices Categorymentioning

confidence: 99%

Cateter central de inserção periférica em neonato: revisão integrativa da literatura Central catheter of peripherally insertion in neonates: integrative literature review

Rangel

Castro

Primo

et al. 2016

R. pesq. cuid. fundam. online

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Objective: To evaluate the evidence published on the practices of the use of Peripheral Inserted Central Venous Catheter (PICC) in newborns. Method: Integrative review researching the databases LILACS, MEDLINE, and COCHRANE, from 2008 to 2012. Results: Forty one articles were selected and ranked by evidence level: 4.9% level one; 9.8% level two; 31.7% level three; 34.2% level four; 17% level five; and 2.4% level six. These articles were grouped into the categories: general complications; blood flow infection related to catheter; utilization description and insertion of practices and maintenance. Conclusion: The evidence highlighted the importance of the permanent education for the insertion, maintenance and application of new technologies, in order to

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“… 12 , 13 The lack of scientific evidence and standardization through protocols leads to the use of several heparin concentrations, which can often be abusive as well as be as underdoses, which can result in unknown side effects or failure in catheter clearance. 14 …”

Section: Introductionmentioning

confidence: 99%

“… 12 , 13 A falta de evidência científica e a não padronização por meio de protocolos levam ao uso de concentrações diversas, muitas vezes abusivas, e outras com subdosagens, que podem resultar em efeitos colaterais desconhecidos ou o insucesso na desobstrução. 14 …”

Section: Introductionunclassified

Heparina para desobstrução de cateter venoso central de inserção periférica no recém‐nascido: estudo in vitro

Balaminut¹,

Venturini²,

Silva³

et al. 2015

Revista Paulista de Pediatria

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Objective:To compare the efficacy of two concentrations of heparin to clear the lumen of in vitro clotted neonatal peripherally inserted central catheters (PICCs).Methods:This is an in vitro, experimental quantitative study of 76 neonatal 2.0-Fr PICCs coagulated in vitro. The catheters were divided into two groups of 38 PICCs each. In both groups an infusion of low molecular weight heparin was administered with a dose of 25IU/mL for Group 1 and 50IU/mL for Group 2. The negative pressure technique was applied to the catheters of both groups at 5, 15 and 30min and at 4h to test their permeability. Kaplan-Meier survival analysis was used to verify the outcome of the groups according to time intervals.Results:The comparison between both groups in the first 5min showed that more catheters from Group 2 were cleared compared to Group 1 (57.9 vs. 21.1%, respectively). Kaplan-Meier survival analysis showed that less time was needed to clear catheters treated with 50IU/mL of heparin (p<0.001).Conclusions:The use of low molecular weight heparin at a concentration of 50IU/mL was more effective in restoring the permeability of neonatal PICCs occluded in vitro by a clot, and the use of this concentration is within the safety margin indicated by scientific literature.

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

Cited by 12 publications

References 33 publications

Cateter central de inserção periférica em neonato: revisão integrativa da literatura Central catheter of peripherally insertion in neonates: integrative literature review

Heparina para desobstrução de cateter venoso central de inserção periférica no recém‐nascido: estudo in vitro

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