Assay and counter measure for complicatios after intravenous indwelling catheter in severe burn patient

【Objective】To explore the cause of complicatios after intravenous indwelling catheter in severe burn patient,and to present evidence for clinical nursing interventions.【Methods】Complications after intravenous indwelling catheter in 998 severe burn patients from 2002 January to 2007 June were analyzed retrospectively.Unplanned extubation,catheter related sepsis,catheter obstruction,phlebothrombosis,local fluid leakage,local hematoma were used as index to study the correlation between the incidence of the complications and puncture point,type of intravenous indwelling catheter.【Results】(1)136 cases among 998 suffered from complications,the incidence was 13.0%.Among these,83 cases were unplanned extubation;27 cases were catheter related sepsis;15 cases were catheter obstruction;3 cases were phlebothrombosis;4 cases were local fluid leakage;4 cases were local hematoma.(2)According to puncture point,the proportion in complications were as following: femoral venous catheterization was 19.6%,infraclavicula venous catheterization was 7.8%,PICC was 6.5%.There was significant difference between femoral venous catheterization and internal jugular venous catheterization(χ2=33.7,P0.01).According to the channel of intravenous indwelling catheter,the two-lumen central venous catheterization was 19.1%,single-lumen central venous catheterization was 6.4%,PICC was 6.2%.There was significant difference between the two-lumen central venous catheterization and the central venous catheterization(χ2=38.3,P0.01).【Conclusions】According to characteristics in severe burn patients femoral venous catheterization is better than infraclavicula venous catheterization,and the single-lumen central venous catheterization is better than the two-lumen central venous catheterization.Deep venous catheterization is indicated for shock stage after burn,major operation or IVH patients.PICC is indicated for long-term intravenous fluid infusion patients or during convalescence stage