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  • Title: Drawing blood from peripheral intravenous cannula compared with venepuncture: A systematic review and meta-analysis.
    Author: Coventry LL, Jacob AM, Davies HT, Stoneman L, Keogh S, Jacob ER.
    Journal: J Adv Nurs; 2019 Nov; 75(11):2313-2339. PubMed ID: 31115075.
    Abstract:
    AIMS: To synthesize the evidence evaluating if blood samples are similar when obtained from peripheral intravenous cannula compared with venepuncture. DESIGN: A systematic review and meta-analysis was undertaken. DATA SOURCES: Searches were conducted in databases for English language studies between January 2000-December 2018. REVIEW METHODS: The search adhered to the Meta-analysis of Observational Studies in Epidemiology guidelines. The methodological quality of studies was assessed using Joanna Briggs critical appraisal instruments. The overall quality of the evidence was assessed using the GRADE. RESULTS: Sixteen studies were identified. Findings suggest haemolysis rates are higher in blood sampled from peripheral intravenous cannula. However, haemolysis rates may be lower if a peripheral intravenous cannula blood sampling protocol is followed. For equivalence of blood test results, even though some results were outside the laboratory, allowable error and were outside the Bland-Altman Level of Agreement, none of these values would have required clinical intervention. With regard to the contamination rates of blood cultures, the results were equivocal. CONCLUSION: Further research is required to inform the evidence for best practice recommendations, including, if a protocol for drawing blood from a peripheral cannula is of benefit for specific patient populations and in other settings. IMPACT: Venepuncture can provoke pain, anxiety and cause trauma to patients. Guidelines recommend blood samples from peripheral intravenous cannula be taken only on insertion. Anecdotal evidence suggests drawing blood from existing cannulas may be a common practice. Further research is required to resolve this issue. 目的: 在于综合证据,用以评价从外周静脉插管获得的血样与静脉穿刺法获得的血样是否相似。 设计: 进行了系统综述和荟萃分析。 资料来源: 在2000年1月至2018年12月期间,在数据库中进行了英语研究搜索。 综述方法: 这项研究遵循流行病学指导方针中观察性研究的荟萃分析。采用了Joanna Briggs的严格评价手段来评估研究的方法学质量。使用GRADE来评估证据的整体质量。 结果: 共确定了16项研究。研究结果表明,从外周静脉插管取样的血液中溶血度较高。然而,如果遵循外周静脉插管血液取样方案,溶血度可能会更低。为了血液检测结果的等效性,即使一些结果超出了实验室允许的误差和布兰德-奥特曼协议限制,这些数值都不需要临床干预。关于溶血培养的污染率,结果尚不明确。 结论: 需要进一步的研究来提供最佳实践建议的证据,包括外周静脉插管采血方案是否对特定患者群体和其他情况有益。 影响: 静脉穿剌术会引起疼痛、焦虑,并对患者造成创伤。根据指导方针,建议在插入时,只从外周静脉进行插管采血。轶事证据表明,现有插管采血可能是一种常见的做法。需要进一步的研究来解决这个问题。.
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