J Korean Soc Neonatol.
1998 Jun;5(1):55-60.
The Success Rate and Complication Rate of Percutaneous Central VenousCatheterization Performed by well Trained Nurses
Abstract
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PURPOSE: We report clinical charateristics of percutaneous central venous catheteriza- tion(PCVC) that is performed
commonly as a vascular access procedure in the neonatal intensive care unit(NICU) including comparision between
the success rate and com- plication rate of groups performed by a doctor and by nurses who were accustomed to
the IV procedure. METHODS: We evaluated a total of 158 PCVC cases performed in the NICU of Soonchunhyang Chunan
hospital over 2 years 5 rnonths from May, 1995 to September, 1997. The 24 cases of PCVC were performed by doctors
and 134 cases of this proce- dures were performed by well trained nurses. We have compared success rates,
clinical characteristics, insertion sites, indwelling time, causes of removal of the catheters, and associated complication
of both doctor performed group (D) and nurse performed group (N) retrospectively.
RESULTS
The mean gestational age, birth weight, weight at the time of insertion were significantly lower in the doctor
performed group than in the nurse group(P<0.001). There were significant differences in postnatal age and mean duration
per catheter in both groups. The overall success rate of insertions was 89.9%(142/158), the success rate of doctor
performed group was 54.2%(13/24) and nurse group was 96.3%(129/134) and there was significant difference(P<0.001).
In the doctor performed group, 100% were axillary however in the nurse group 43.4% were axillary, 38.8% were
antecubital, 9.4% were temporal, and 5.4% were hand. The most common cause of the removal of the catheter was
elective in both groups but there was also substantial spontaneous removal by the patients and mechanical complication.
Cultures of catheter tips were done after removal in 110 cases, among then were positive in 36 cases(33.6%), the most
common causes were Staphylococcus aureus and Candida albicans. CONCLUSION: In this report, the authors emphasize
that percutanous central venous catheterization performed by well trained nurses has a higher success rates than the
doctor performed group and can be considered safe. We would also like to emphasize that more attention should be
paid to the maintanace of PCVC.