骨髓腔输液患者液体外渗的危险因素分析

doi:10.3761/j.issn.2096-7446.2022.02.008

Abstract

Abstract: Objective To analyze the risk factors of extravasation in emergency patients with intraosseous infusion,to provide early assessment and screening of extravasation in patients with intraosseous infusion. Methods We retrospectively analyzed the data of 358 patients with bone marrow cavity infusion in three hospitals in Zhejiang Province from January 2017 and December 2020. The patients were divided into two groups according to whether there was any extravasation. Compared the differences of clinical indicators in two groups,analyzed independent factors of extravasation in patients with intraosseous infusion by Logistic regression model. Results A total of 15 patients（4.18%） were found to have extravasation. Multivariate Logistic regression analysis showed that Body Mass Index（BMI）,pain grade,transport times,intraosseous retention time were independent risk factors for extravasation. The position of catheterization and previous experience of catheterization were independent protective factors（P< 0.05）. Conclusion Nurses should pay attention to obese patients, and patients with intraosseous tube in the humeral site and obvious pain, and reduce moving the patients,try to arrange experienced nurses to guide the rescue.

Key words: Intraosseous Infusion, Fluid Extravasation, Risk Factors, Factor Analysis, Statistical, Critical Care Nursing

YANG Minfei, WANG Weifen, WANG Haihong, CHEN Bin, ZHAN Yue, YAO Xiaoyue. Risk factors of extravasation in patients with intraosseous infusion[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(2): 140-144.

References

[1] 詹玥,杨旻斐,姚晓月,等. 心搏骤停患者骨髓腔输液通路建立时机的研究[J]. 中华急危重症护理杂志,2020,1(4):293-297.
Zhan Y,Yang MF,Yao XY,et al.The research on the timing of intraosseous catheterization in patients with cardiac arrest[J]. Chin J Emerg Crit Care Nurs,2020,1(4):293-297.
[2] Schindler P,Helfen A,Wildgruber M,et al. Intraosseous contrast administration for emergency computed tomography:a case-control study[J]. PLoS One,2019,14(5)67-75.
[3] Chalopin T,Lemaignen A,Guillon A,et al.Acute tibial osteomyelitis caused by intraosseous access during initial resuscitation:a case report and literature review[J]. BMC Infect Dis,2018,18(1):665-671.
[4] 汪宇鹏,刘艳艳. 中国骨髓腔内输液通路临床应用专家共识[J]. 中国急救医学,2019,39(7):620-624.
Wang YP,Liu YY.Expert consensus on clinical application of intraosseous infusion access in China[J]. Chin J Crit Care Med,2019,39(7):620-624.
[5] 王飒,封秀琴,张茂,等. 骨髓腔输液通路临床应用护理专家共识[J]. 中华急危重症护理杂志,2020,1(4):362-370.
Wang S,Feng XQ,Zhang M.Expert consensus on nursing clinical application of intraosseous infusion access[J]. Chin J Emerg Crit Care Nurs,2020,1(4):362-370.
[6] 吴玉芬,陈利芬. 静脉输液并发症预防及处理指引[M]. 北京:人民卫生出版社,2016:321-325.
Wu YF,Chen LF.Guidelines on prevention and management of complications of intravenous infusion[M]. Beijing:People's Medical Publishing House,2016:321-325.
[7] Teasdale G,Jennett B.Assessment of coma and impaired consciousness. A practical scale[J]. Lancet,1974,2(7872):81-84.
[8] 杨霞. 重症监护疼痛观察量表在内科机械通气患者疼痛评估的适用性研究[D]. 北京:北京协和医学院,2014.
Yang X.The study of application of the Critical Care Pain Observation Tool among medical patients with mechanical ventilation[D]. Beijing:Peking Union Medical College,2014.
[9] 张敏,路潜,张海燕. 客观疼痛评估工具在ICU成人机械通气病人中的应用研究与特点分析[J]. 护理研究,2018,32(11):1675-1679.
Zhang M,Lu Q,Zhang HY.Objective pain assessment in ICU patients with mechanical ventilation[J]. Chin Nurs Res,2018, 32(11):1675-1679.
[10] 刘冬华,童莺歌,冯翠翠,等. 4种工具用于老年患者术后疼痛评估效果比较[J]. 护理学杂志,2018,33(7):1-4.
Liu DH,Tong YG,Feng CC,et al.Effects comparison among 4 tools assessing postoperative pain for elderly patients[J]. J Nurs Sci,2018,33(7):1-4.
[11] 宫能凯. 弋矶山医院急诊病人的流行病学研究[D]. 芜湖:皖南医学院,2016.
Gong NK.Epidemiologic studies of emergency patients in Yijishan hospital[D]. Wuhu:Wannan Medical College,2016.
[12] 茅昌敏,孟爱凤,郑晓宇,等. 基于安全输液示范病房的静脉治疗护理质量持续改进[J]. 护理学杂志,2018,33(23):36-39.
Mao CM,Meng AF,Zheng XY,et al.Continuous nursing quality improvement of intravenous therapy based on safe infu-sion model ward[J]. J Nurs Sci,2018,33(23):36-39.
[13] 崔丽梅,吕纳强. 肥胖的疾病特征[J]. 中国比较医学杂志,2019,29(10):22-25,111.
Cui LM,Lü NQ.The clinical characteristics of obesity[J]. Chin J Comp Med,2019,29(10):22-25,111.
[14] Song KH,Cho SU,Lee JW,et al.Is it possible to reduce intra-hospital transport time for computed tomography evaluation in critically ill cases using the Easy Tube Arrange Device?[J]. Clin Exp Emerg Med,2018,5(1):14-21.
[15] 李梅,曾妃,黄晓霞,等. 气悬浮转运垫在危重症患者搬运中的效果研究[J]. 中华急诊医学杂志,2019,28(5):637-639.
Li M,Zeng F,Huang XX,et al.Study on the effect of air suspension transport pad in transport of critically ill patients[J]. Chin J Emerg Med,2019,28(5):637-639.
[16] 张海文,陈秋莲. 骨髓腔输液在危重症抢救中应用与护理[J]. 创伤与急危重病医学,2015,3(6):380-381.
Zhang HW,Chen QL.Application and nursing care of bone marrow infusion in the rescue of critical patients[J]. Trauma Crit Care Med,2015,3(6):380-381.

Risk factors of extravasation in patients with intraosseous infusion

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	GUO Miao, YANG Yanjun, QIAO Li, YANG Tingting, ZHANG Ping. Study on the impact of humanistic care nursing based on the peak-end rule on satisfaction of ICU patients and their families [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 773-779.
[2]	YANG Li, XU Xiaobin, WANG Huafen. Application progress of functional near-infrared spectroscopy in critical care nursing [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 836-840.
[3]	ZHANG Yixiang, LÜ Wei, HE Cuili, LIU Liping, NONG Kang, XIE Fangna. Rapid identification and nursing for 109 patients with botulinum toxin type A injection-induced poisoning [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 846-848.
[4]	LIU Xiaoting, WANG Ping, XU Yihong, FAN Tingting, FU Zhenzhen, XIONG Zihan, HE Beilei, CHEN Xiaohui, ZHANG Xiaoming, SHU Yan. Nursing care for a patient with ultra-short bowel syndrome and multiple stomas after surgery for allied disorders of Hirschsprung’s disease [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 849-851.
[5]	SHAO Lihong, LI Chunyan, DONG Xiaoqi, WANG Qiaolin, YE Guofeng, ZHAO Qiaomei. Nursing care for multiple severe complications after free flap transplantation in a patient with oral multiple primary cancer [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 852-855.
[6]	ZHANG Hui, HE Xuehua, WANG Li, GONG Xiaoyan, ZHUANG Yiyu. Early warning and nursing intervention for primary graft dysfunction after heart transplantation using a marginal donor heart：a case report [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 682-684.
[7]	ZENG Fei. Nursing care of a patient with familial hypertrophic cardiomyopathy complicated with liver failure undergoing simultaneous heart-liver transplantation [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 685-688.
[8]	YANG Muying, FAN Wenqi, HU Han. Early identification and emergency nursing of cerebral hemorrhage during dialysis in a maintenance hemodialysis patient [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 704-706.
[9]	ZHUANG Jiani, LI Xiaozhen, SHI Chaoqiang, WANG Ying, TAN Liping. Perioperative nursing care for a patient with malignant mediastinal abscess secondary to deep neck infection [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 707-709.
[10]	LI Gaile, PAN Wenyan, LI Jingjing, LIU Xiao, TANG Yingjia, HOU Jin. Nursing care of a post-liver transplantation patient complicated with pneumocystis jirovecii and cytome-galovirus infection [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 710-713.
[11]	WANG Yan, LU Fangyan, LIU Yuan, WANG Fang. Postoperative care of children with progressive familial intrahepatic cholestasis undergoing parental liver transplantation [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 714-716.
[12]	LI Zunzhu, CHANG Xiaowei, CAO Qianqian, ZHAO Mingxi, LUO Hongbo, JING Jie, SUN Jianhua, LAN Yuanmei, WU Xinjuan. The construction and applicability analysis of a respiratory rehabilitation management program for the early postoperative period in patients undergoing cardiopulmonary bypass cardiac surgery [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(5): 532-539.
[13]	YU Xiangling, ZHAO Xiaoyan, CHEN Fan, LIN Yumin, DENG Sufen, HUANG Yufeng. Nursing care of a premature infant with difficulty in catheterization and PICC catheter placement via thoracoepigastric vein [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(5): 561-563.
[14]	WANG Shujun, LU Hongyan, YANG Linna. Interpretation of the group standard “Endotracheal Suctioning Technology for Adult Patients with Inhalation Injury after Tracheotomy” [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(5): 569-573.
[15]	DONG Lianlian, LUO Xueli, WEI Wenjing, CHEN Lingxin, REN Hongyan, GONG Xiaoyan. Nursing care of a patient with wet beriberi and multiple organ failure caused by thiamine deficiency [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(5): 591-594.