Expert consensus on perioperative nursing standards for pediatric kidney transplantation / 器官移植

Pediatric kidney transplant recipients differ from adult counterparts in primary disease, physiology, psychology, organ function and immune status and their perioperative treatment and nursing management are different from those of adult kidney transplantation. To standardize holistic perioperative nursing regimens for pediatric kidney transplantation, Surgery Nursing Committee of Shanghai Nursing Association organized national medical and nursing experts in the fields of transplantation to jointly draft "expert consensus on perioperative nursing standards for pediatric kidney transplantation " (abbreviated as "consensus"). After three rounds of online expert inquiry, all revised opinions were jointly discussed combined with literature evidence, and the expert consensus was finally reached. The highlights of perioperative treatment and nursing care for pediatric kidney transplantation were summarized and stated, including preoperative evaluation, preoperative and postoperative nursing care, which were of scientific and practical value.

Prevention from PICC-related venous thrombosis in the upper limbs of malignant tumor patients with moxibustion combined with plucking at Jiquan (HT 1): a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of moxibustion combined with plucking technique at Jiquan (HT 1) for preventing peripherally inserted central catheter (PICC)-related venous thrombosis in the upper limbs of malignant tumor patients.@*METHODS@#A total of 80 malignant tumor patients undergoing PICC were randomized into an observation group and a control group, 40 cases in each one. In the control group, the routine care for PICC was exerted. In the observation group, besides the routine care, moxibustion combined with plucking technique at Jiquan (HT 1) was added. Mild moxibustion was exerted along the venous distribution of PICC (avoiding the entry site) for 10 to 15 min, and then, the circling moxibustion was applied to Quchi (LI 11), Xuehai (SP 10) and Tianfu (LU 3), 3 to 5 min at each acupoint. Finally, plucking technique was given at Jiquan (HT 1) for 5 to 10 min. This combined therapy was intervened since the 2nd day of PICC placement, once daily, 5 times a week, for 3 weeks totally. The incidence of the PICC-related venous thrombosis in the upper limbs was compared between the two groups on day 42 of placement. On day 2, 7, 14, 21, 28, 35 and 42 of PICC placement, the peak systolic velocity (PSV) and the end-diastolic velocity (EDV) of the subclavicular vein on the placement side were observed separately in the two groups.@*RESULTS@#The incidence of the PICC-related venous thrombosis in the upper limbs in the observation group was lower than that in the control group (2.5% [1/40] vs 17.5% [7/40], P<0.05). From day 7 to 35 of PICC placement, PSV of the subclavicular vein on the placement side was higher than that on the day 2 of PICC placement in the observation group (P<0.05). On day 28 and 42 of PICC placement, PSV of the subclavicular vein on the placement side was lower than that on the day 2 of PICC placement in the control group (P<0.05). In the observation group, EDV of the subclavicular vein on the placement side was higher than that on the day 2 of PICC placement from day 7 to 28 of PICC placement (P<0.05). In the control group, EDV of the subclavicular vein on the placement side from day 28 to 42 of PICC placement was lower than that on the day 2 of PICC placement (P<0.05). From day 7 to 42 of PICC placement, PSV and EDV of the subclavicular vein on the placement side in the observation group were all higher than those in the control group (P<0.01, P<0.05).@*CONCLUSION@#The combined treatment of moxibustion with plucking technique at Jiquan (HT 1) can effectively prevent PICC-related venous thrombosis in the upper limbs and improve venous blood flow velocity in malignant tumor patients.

Clinical Study on Hot Compress with Medicinal Salt Pack in Preventing PICC-associated Mechanical Phlebitis / 上海针灸杂志

Objective To observe the effect of hot compress with medicinal salt pack in preventing PICC-associated mechanical phlebitis.Method Totally 200 inpatients undergone PICC intubation were randomized into a treatment group and a control group, 100 cases in each group. After PICC intubation, the treatment group was intervened by hot compress with medicinal salt pack, while the control group was by hot compress with warm wet towel. The occurrence of mechanical phlebitis was observed at different time points and compared between the two groups. Result The occurrence rate of mechanical phlebitis was 9.0% in the treatment group versus 26.0% in the control group, and the difference was statistically significant (P72 h, versus 16.0% and 10.0% in the control group, and the differences were statistically significant (P<0.05). Conclusion Hot compress with medicinal salt pack can effectively reduce the occurrence of PICC-associated mechanical phlebitis.

Study on effect of different family nursing methods on major catheter-related complications in cancer patients with PICC / 中国实用护理杂志

Objective To study the effect of different family nursing methods on major catheter-re-lated complications in cancer patients with peripherally inserted central catheter (PICC) during chemother-apy intermission so as to reduce the incidence of complications and prolong the indwelling time and service life of the catheter. Methods We randomly divided 213 cancer patients who were discharged from hos-pital with PICC into two groups. One group(108 cases) routinely came back to our outpatient clinic and the other (105 cases) went to the community for nursing of the catheter. Results The total incidence rate of complications of the group who came back to our outpatient clinic for nursing of the catheter was 13.8%(15/ 108) and the other group was 51.4%(54/105). There existed statistical significance between the two groups (P<0.01). Conclusions There exists correlation between different family nursing methods and catheter complication rate. We suggest patients come back to our outpatient clinic for nursing of the catheter as pos-sible as they can.

Removal of a Peripherally Inserted Central Catheter Remnant using Cardiac Catheterization in Preterm Infant

The peripherally inserted central catheter (PICC) is used frequently in preterm infants. The known complications associated with the PICC include infection, thrombosis, extravasation, phlebitis, leakage of insertion site, fracture, accidental removal, occlusion of the PICC, and arrhythmia. We herein report a case of a spontaneously fractured PICC remnant that was successfully removed by cardiac catheterization.