Mustafa KARA, Kadir TEKGÜNDÜZ, Naci CEVİZ

Yenidoğan Bebeklerde Periferden Yerleştirilen Santral Kateter Deneyimlerimiz

Amaç Preterm bebekler yenidoğan yoğun bakım ünitelerinde (YYBÜ) uzun süre takip edilirler ve bu nedenle uzun süreli damar yolu ihtiyaçları olur. Uzun süreli damar yolu sağlamak amacıyla umbilikal ven kateterleri, santral venöz kateterler ve periferik olarak yerleştirilmiş santral kateterler (PYSK) kullanılır. Bu çalışmada PYSK uygulanan yeni doğan bebeklerin klinik özelliklerini değerlendirmeyi amaçladık. Gereç ve Yöntemler Haziran 2016 - Haziran 2019 tarihleri arasında YYBÜ’de PYSK yerleştirilen yenidoğan bebeklerin tıbbi kayıtları retrospektif olarak incelendi. Hastaların demografik özellikleri, PYSK yerleştirilme nedenleri, bebeklerin PYSK yerleştirme sırasındaki klinik özellikleri ve uygulama komplikasyonları kaydedildi. Bulgular 129 yenidoğan bebekte yerleştirilen 151 PYSK’ya ait veriler toplandı. PYSK takılan 134 (% 88,7) hastada enfeksiyon nedeniyle antibiyotik tedavisi gerekti. Sepsis bu vakaların 72'sinde (% 47.6) PYSK yerleştirilmeden önce, 17'sinde (% 11.2) ise PYSK yerleştirildikten sonra tespit edildi. PYSK yerleştirilen hastalarda vücudun üst bölge damarları, alt bölge damarları ve sağ taraf damarları ve sol taraf damarları arasında tıkanma, sızıntı ve / veya tromboflebit sıklığı açısından istatistiksel bir fark bulunmadı (p> 0.05). Sonuç Sonuçlarımız PYSK uygulamasının yenidoğan bebeklerde periferik damar yolu girişim sayısını önemli ölçüde azalttığını, uzun süreli TPN ve antibiyotik uygulamasının mümkün olduğunu, ayrıca üst veya alt ekstremite venlerinden ve sağ veya sol taraftaki venlerden PYSK uygulanmasının komplikasyon sıklığını etkilemediğini göstermektedir.

Anahtar Kelimeler:

periferden yerleştrilen santral kateter, infant, yenidoğan, yenidoğan yoğunbakım ünitesi, NICU, PICC

Our Experiences with Peripherally Inserted Central Catheters in Newborn Infants

Objective Preterm babies are followed in neonatal intensive care units (NICU) for long times, so they need long-term vascular access. For long-term vascular access umbilical vein catheters, central venous catheters and peripherally inserted central catheters (PICC) are used. In present study we aimed to evaluate the clinical features of newborn infants in whom PICC was inserted.Materials and Methods The medical records of the newborn infants in whom PICC had been inserted from June 2016 to June 2019 are evaluated retrospectively. Demographic features of the patients, reasons for PICC insertion, clinical features of the infants during PICC insertion, and complications of the application are recorded.Results The data of 151 PICC that were inserted in 129 newborn infants were collected. Antibiotic treatment was needed because of infections in 134 (88.7%) PICCs. In 72 (47.6%) of them sepsis was present before PICC insertion, and in 17 (11.2%) after PICC insertion. No statistical difference was found in terms of the frequency of occlusion, leak and/or thrombophlebitis between patients in whom PICCs were inserted via the upper body veins and lower body veins, and right veins and left veins (p>0.05). Conclusion Our results indicate that the PICC application significantly decreases the number of peripheral vascular access attempts in newborn infants, long-term total parenteral nutrition (TPN) and antibiotic administration becomes possible and insertion from upper or lower extremity veins and right or left side veins does not affect the frequency of complications.

Keywords:

peripherally inserted central catheter, infant, neonatal intensive care unit, NICU, PICC,

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