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首页> 外文期刊>Journal of paediatrics and child health >Prevention of occlusion ofcEnTral lInesfor children with cancer: An implementation study
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Prevention of occlusion ofcEnTral lInesfor children with cancer: An implementation study

机译：预防癌症儿童中央线的闭塞：实施研究

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Aim Central venous access devices (CVADs) are vital medical devices to support the treatment of paediatric cancer; however, device occlusion is common, which disrupts treatment. This study aimed to improve the identification and management of CVAD occlusions in children with cancer, as well as to identify the demographic, clinical and device characteristics associated with increased risk for CVAD occlusion. Methods A pre-post-implementation study was conducted at a metropolitan paediatric oncology facility in Australia, using the Theoretical Domains Framework. Patients with a CVAD for anti-cancer therapy were prospectively followed for occlusive events pre- and post- the implementation of clinical resources to support the identification and management of CVAD occlusive events. CVAD occlusion and management data were collected and compared pre- and post-implementation. Risk factors for CVAD occlusion were described by mixed-effects Poisson regression and incident rate ratios (IRR). Results A total of 133 CVADs were inserted into 131 patients for a total of 6784 catheter days. The incidence of CVAD-related occlusion pre-implementation was 59.7 (95% confidence interval (CI) 51.4-69.0, per 1000 catheter days); compared to 31.6 (95% CI 26.4-37.6);P < 0.01) post-implementation of clinical resources. In multivariate models, other than post-implementation phases (IRR 0.51 (95% CI 0.32-0.81)), only neutropaenia significantly increased the risk of CVAD occlusion (IRR 2.14 (95% CI 1.15-3.97)). Conclusion CVAD occlusions in paediatric oncology are common. The development and implementation of CVAD occlusion resources to guide the identification and management of occlusive episodes led to a significant decrease in occlusive events.
机译：目的中心静脉通路装置（CVAD）是支持儿科癌症治疗的重要医疗设备；然而，设备堵塞很常见，这会干扰治疗。本研究旨在改善癌症儿童CVAD闭塞的识别和管理，以及识别与CVAD闭塞风险增加相关的人口统计学、临床和设备特征。方法采用理论域框架，在澳大利亚的一个大都会儿科肿瘤中心进行实施前后研究。在实施临床资源以支持识别和管理CVAD闭塞事件之前和之后，前瞻性跟踪CVAD患者进行抗癌治疗。收集并比较实施前后的CVAD闭塞和管理数据。CVAD闭塞的危险因素用混合效应泊松回归和事件率比率（IRR）描述。结果131例患者共植入133个CVAD，共6784天。实施前CVAD相关闭塞的发生率为59.7（95%可信区间（CI）51.4-69.0，每1000导管天）；与31.6（95%可信区间26.4-37.6）相比；P<0.01）临床资源实施后。在多变量模型中，除了实施后阶段（IRR 0.51（95%可信区间0.32-0.81）），只有中性粒细胞增多症显著增加CVAD闭塞的风险（IRR 2.14（95%可信区间1.15-3.97））。结论儿童肿瘤科常见CVAD闭塞。开发和实施CVAD闭塞资源，以指导闭塞事件的识别和管理，导致闭塞事件显著减少。

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