Sevil OLGUN, Ayşe DEMİRAY, İsmet EŞER, Leyla KHORSHID

ÇOCUKLARDA PERİFERİK İNTRAVENÖZ KATETER UYGULAMALARINDA FLEBİT VE İNFİLTRASYON GELİŞME DURUMU

Amaç: Periferal intravenöz kateterler flebit ve infiltrasyon gibi lokal komplikasyonlara neden olabilirler. Flebit ve infiltrasyon kateterin çıkarılmasını ve tekrar takılmasını gerektirir. Çocuklarda önerilmemektedir. Periferal intravenöz kateterlere bağlı flebit ve infiltrasyon görülme durumunu belirlemek amacıyla tanımlayıcı bir çalışma yapıldı.Gereç ve Yöntem: Hastaneye yatırılan 3-18 yaş grubundaki hastalar n= 74 çalışma kapsamına alındı. Kateterizasyon bölgesi her gün araştırmacılardan biri tarafından, infiltrasyon ve flebit gelişme ile şiddeti açısından kontrol edildi. Yerel araştırma komitesi çalışmayı onayladı, çocukların ebeveynlerinden yazılı onam alındı. Bağışıklığı baskılanmış olan ve kemoterapi alan hastalar çalışma kapsamına alınmadı. Veriler 18 Aralık 2010- 26 Ocak 2012 tarihleri arasında toplandı. Verilerin analizinde sayısal ve yüzdelik dağılım, ki-kare ve korelasyon testi kullanıldı.Bulgular: Çocukların yaş ortalaması 8.29 + 3.83 yıldı. Çalışmamızda kateterler 3-303 saat yerinde bırakıldı. Kateterizasyon süre ortalaması 83.52 + 56.44 saat idi. Hastaların %64.9' una takılan İV kateterden kortikosteroid türü ilaç, %40.5'ine 1/3 izomiks, %58.1'ine pump seti kullanılarak sıvı veya ilaç verilmekteydi. Hastaların %54.1'inde ise infiltrasyon geliştiği, %45.9'ünde flebit geliştiği saptandı. Hastaların %23'ünde 3. derecede flebit, %20.3'ünde ise 1. derecede infiltrasyon gelişmiştir. Hastaların %45.9'unda tedavi sonlandırıldığı için, %4.1'inde kateter tıkandığı için kateter çıkarılmıştır. Kateterleri pediatri kliniğinde takılan hastalarda infiltrasyon oranı daha yüksekti. Aynı bölgeye defalarca kateter takılan hastalarda flebit ve infiltrasyon oranı daha yüksekti.Sonuç: Flebit ve infiltrasyon oranının yüksek olduğu bulundu. Daha geniş bir örneklemde, pediatri ve pediatrik yoğun bakım ünitelerini de kapsayacak şekilde ileri araştırmalar yapılmalıdır

Anahtar Kelimeler:

Flebit, infiltrasyon, hastaneye yatırılan çocuk

PHLEBITIS AND INFILTRATION STATUS İN PERIPHERAL INTRAVENOUS CATHETERISATION INCHILDREN

Objective: Periferal intravenous catheters can cause local comlications such as phlebitis and infiltration. Phlebitis and infiltration needs catheter removal and replacement. Routinely replacement o f intravenous catheters in childrens is not recommended. A descriptive study was performed to examine the status o f phlebitis and infiltration associated with peripheral intravenous catheterisation.Methods: Children n=74 hospitalized in pediatric clinic betvveen 3-18years were included to the study. The catheterisation sites examined daily by one o f the investigator for the presence and severity o f phlebitis and infiltration using a scale. Local research ethics committee approved the study and written informed consent was obtained from parents o f children. Patients those who were immunocompromised and those receiving chemotherapy were excluded from the study. Data were collected betvveen the date o f 18 December 2010- 26 th January 2012. Numerical and percentage distribution, Chi-square test and correlation were used in analysis o f the data.Results: The mean age o f children was 8.29 ± 3.83 year. Mean dwell time for catheters in situ in our study were 3-303 hours. The mean catheterisation time was 83.52 ± 56.44 hours. Corticosteroids have been given to 64.9% o f the patients and 40.5% o f the patients have been given drugs or fluids İV 1/3 izomiks with a set o f the pump. The phlebitis in 45.9% o f patients was occured, and the infiltration was occured in 54.1% ofpatient. The severity o f phlebitis in 23% o f patients was in 3 degree, and the severity o f infiltration in 20.3% o f patients was in 1 degree. Catheters wer removed in 45.9% o f patients because o f discontinuation o f treatment and in 4.1 % because o f occlusion o f catheters. The rate o f patients that developed infiltration was significantly more in patients in whom a catheter was inserted in pediatric clinic. The percentage o f patients that developed infiltration and phlebitis was significantly more in patients in whom the same area have been used repeatedly for insertion o f a catheter.Conclusion: it was found that the rate for phlebitis and infiltration were high. Future studies with large samples should implemented both in general pediatric units and in pediatric intensive çare unit

Keywords:

phlebitis, infiltration, hospitalized children,

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