{"id":8101,"date":"2024-09-16T10:00:52","date_gmt":"2024-09-16T08:00:52","guid":{"rendered":"https:\/\/eu.bd.com\/iv-news\/?p=8101"},"modified":"2024-07-26T10:09:09","modified_gmt":"2024-07-26T08:09:09","slug":"pose-dun-catheter-iv-veterinaire-comment-gerer-les-defis","status":"publish","type":"post","link":"https:\/\/eu.bd.com\/iv-news\/fr\/actualites-et-innovation\/pose-dun-catheter-iv-veterinaire-comment-gerer-les-defis\/","title":{"rendered":"Pose d\u2019un cath\u00e9ter IV v\u00e9t\u00e9rinaire : comment g\u00e9rer les d\u00e9fis"},"content":{"rendered":"

Les cath\u00e9ters veineux p\u00e9riph\u00e9riques (CVP) sont fr\u00e9quemment plac\u00e9s chez des patients v\u00e9t\u00e9rinaires pour administrer des liquides et des m\u00e9dicaments.1<\/sup> Cependant, ces dispositifs d’acc\u00e8s vasculaire (DAV) sont associ\u00e9s \u00e0 un risque de complications intraveineuses (IV) m\u00e9caniques, inflammatoires et infectieuses.1<\/sup> La pose des cath\u00e9ters IV pr\u00e9sente des d\u00e9fis sp\u00e9cifiques pour les patients non humains.<\/p>\n

D\u00e9fis lors de la pose de cath\u00e9ters IV v\u00e9t\u00e9rinaires<\/h2>\n

Anxi\u00e9t\u00e9 et stress<\/h3>\n

Un cadre de soins v\u00e9t\u00e9rinaires peut provoquer de l’anxi\u00e9t\u00e9 chez les patients non humains en raison des odeurs, du bruit, de la s\u00e9paration d’avec les ma\u00eetres, des environnements peu familiers et des interactions avec d’autres patients.2<\/sup> Les patients f\u00e9lins sont particuli\u00e8rement sensibles \u00e0 leur environnement et peuvent r\u00e9agir au stress d’une mani\u00e8re qui entrave l’\u00e9valuation clinique et le traitement.3<\/sup><\/p>\n

Risque de complications IV<\/h3>\n

Les taux de complications des CVP ont tendance \u00e0 \u00eatre plus faibles chez les patients canins et f\u00e9lins que chez les humains.4<\/sup> Il a \u00e9t\u00e9 d\u00e9montr\u00e9 que le taux global de complications des CVP chez les patients canins atteignait 20\u00a0%.4<\/sup> Il est estim\u00e9 entre 35 et 50\u00a0% chez les patients humains.5<\/sup><\/p>\n

Les patients v\u00e9t\u00e9rinaires pr\u00e9sentant des r\u00e9actions mod\u00e9r\u00e9es \u00e0 fortes \u00e0 l\u2019insertion d\u2019un cath\u00e9ter IV peuvent affecter la stabilit\u00e9 du dispositif, entra\u00eenant un risque de complications IV m\u00e9caniques.1<\/sup> Lorsqu\u2019il y a plus d\u2019une tentative d\u2019insertion, il a \u00e9t\u00e9 d\u00e9montr\u00e9 que des complications IV<\/a> sont plus susceptibles de survenir chez les patients canins et f\u00e9lins.1<\/sup><\/p>\n

L’endommagement de la couche endoth\u00e9liale lors de la mise en place du cath\u00e9ter IV peut entra\u00eener des complications IV, telles qu’une phl\u00e9bite, une extravasation ou une douleur.6<\/sup> Si des veines p\u00e9riph\u00e9riques sont cath\u00e9t\u00e9ris\u00e9es plusieurs fois, cela peut entra\u00eener une d\u00e9pl\u00e9tion veineuse.4<\/sup><\/p>\n

Les autres complications IV rapport\u00e9es chez les patients v\u00e9t\u00e9rinaires comprennent le retrait du cath\u00e9ter par le patient et la rupture de la ligne, ce qui est fr\u00e9quent dans l’unit\u00e9 de soins interm\u00e9diaires.4<\/sup> C’est pourquoi la fixation du cath\u00e9ter est essentielle dans la gestion de l’acc\u00e8s vasculaire chez les patients v\u00e9t\u00e9rinaires.<\/p>\n

Risque d\u2019exposition \u00e0 des pathog\u00e8nes zoonotiques<\/h3>\n

Comme pour les patients humains, du sang peut\u00a0 gicler ou se d\u00e9verser du cath\u00e9ter IV pendant l\u2019insertion.7<\/sup> Le personnel v\u00e9t\u00e9rinaire a signal\u00e9 des taux de blessures par piq\u00fbre d\u2019aiguille particuli\u00e8rement \u00e9lev\u00e9s (environ 80\u00a0%).8 <\/sup>Les v\u00e9t\u00e9rinaires pr\u00e9sentent un risque \u00e9lev\u00e9 d\u2019infection par des maladies zoonotiques.9<\/sup> \u00ab\u00a0Zoonotiques\u00a0\u00bb signifie qu\u2019elles peuvent \u00eatre transmises entre l\u2019homme et d\u2019autres animaux vert\u00e9br\u00e9s.10<\/sup><\/p>\n

Les facteurs suivants doivent \u00e9galement \u00eatre pris en compte avant de poser un cath\u00e9ter IV chez un patient v\u00e9t\u00e9rinaire.<\/p>\n

Consid\u00e9rations lors de la pose d\u2019un cath\u00e9ter IV v\u00e9t\u00e9rinaire<\/h2>\n

Le site d’insertion p\u00e9riph\u00e9rique le plus courant chez les patients canins et f\u00e9lins est la veine c\u00e9phalique.11<\/sup> Si les membres ant\u00e9rieurs ne sont pas disponibles pour la mise en place d’un cath\u00e9ter IV, il peut \u00eatre n\u00e9cessaire de placer le cath\u00e9ter IV dans la veine saph\u00e8ne lat\u00e9rale d’un membre post\u00e9rieur.11<\/sup><\/p>\n

Avant la mise en place du cath\u00e9ter IV, le patient v\u00e9t\u00e9rinaire doit \u00eatre confortable et calme. Il peut \u00eatre n\u00e9cessaire d’endormir le patient avant l\u2019insertion.4<\/sup><\/p>\n

Il est apparu que la conception des cath\u00e9ters IV a un impact sur le risque de complications IV chez l’homme.5<\/sup> Il a \u00e9t\u00e9 d\u00e9montr\u00e9 chez l’homme que les taux de phl\u00e9bite m\u00e9canique varient en fonction de la composition plastique et des caract\u00e9ristiques de surface des cath\u00e9ters IV.5<\/sup> Chhugani et al. ont constat\u00e9 que les CVP en polyur\u00e9thane pr\u00e9sentaient des taux de phl\u00e9bite plus faibles chez l’homme que les CVP en polyt\u00e9trafluoro\u00e9thyl\u00e8ne.12<\/sup><\/p>\n

Il a \u00e9t\u00e9 d\u00e9montr\u00e9 que les embouts de cath\u00e9ter con\u00e7us avec un septum int\u00e9gr\u00e9 emp\u00eachaient les fuites de sang lors de l\u2019insertion.7,13<\/sup><\/p>\n

La gauge du cath\u00e9ter est un \u00e9l\u00e9ment important \u00e0 prendre en compte. Chez la plupart des patients canins il est possible de placer des cath\u00e9ters IV de calibre\u00a020.11<\/sup> Les patients canins de plus grande taille peuvent recevoir un cath\u00e9ter IV de calibre\u00a018.11<\/sup> Il est g\u00e9n\u00e9ralement recommand\u00e9 de placer un cath\u00e9ter IV de calibre\u00a022 chez les patients f\u00e9lins.11<\/sup> Pour les animaux plus petits, un cath\u00e9ter de calibre\u00a022 ou 27 peut \u00eatre utilis\u00e9.14<\/sup><\/p>\n

Schears et al. rapportent des taux plus faibles de phl\u00e9bite\u00a0 chez les patients humains dont les cath\u00e9ters IV \u00e9taient fix\u00e9s avec des dispositifs de stabilisation de cath\u00e9ter par rapport \u00e0 ceux fix\u00e9s avec du ruban adh\u00e9sif.15<\/sup><\/p>\n

10 recommandations pratiques pour aider \u00e0 optimiser la mise en place des cath\u00e9ters IV v\u00e9t\u00e9rinaires<\/h2>\n
    \n
  1. S\u00e9lectionner un CVP dot\u00e9 d’un septum qui p\u00e9n\u00e8tre dans l\u2019embase du cath\u00e9ter pour aider \u00e0 contr\u00f4ler le d\u00e9bit sanguin lors de l’insertion, des connexions et des d\u00e9connexions,7,13<\/sup> en \u00e9liminant la n\u00e9cessit\u00e9 d’une compression veineuse et en r\u00e9duisant le risque d’exposition au sang.13<\/sup>,\u2020,*<\/sup><\/li>\n
  2. Utiliser un CVP fabriqu\u00e9 dans un mat\u00e9riau qui se ramollit dans la veine pour aider \u00e0 minimiser les red\u00e9marrages et r\u00e9duire le risque de phl\u00e9bite m\u00e9canique.5,12,16,17<\/sup>,* <\/sup><\/li>\n
  3. Adapter la gauge du cath\u00e9ter \u00e0 la taille de l\u2019animal.11,14<\/sup><\/li>\n
  4. Choisir un site d\u2019insertion appropri\u00e9 en fonction de l\u2019\u00e9tat et de la maladie du patient.11<\/sup><\/li>\n
  5. Retirer tout le pelage de la partie du membre o\u00f9 l’insertion sera effectu\u00e9e, ainsi qu’au niveau de l\u2019embase du cath\u00e9ter et des connexions.11<\/sup><\/li>\n
  6. Utiliser une technique aseptique pour pr\u00e9parer le site d\u2019insertion.18<\/sup>,*<\/sup><\/li>\n
  7. Demander \u00e0 votre assistant v\u00e9t\u00e9rinaire de retenir le patient en position allong\u00e9e sternale, tout en \u00e9tendant le membre o\u00f9 le cath\u00e9ter IV sera plac\u00e9.11<\/sup><\/li>\n
  8. Demander \u00e0 votre assistant v\u00e9t\u00e9rinaire de soulever la veine en la faisant rouler de la position m\u00e9diale vers la position lat\u00e9rale avec son pouce.11<\/sup><\/li>\n
  9. Apr\u00e8s l’insertion, fixer le CVP avec un dispositif de stabilisation de cath\u00e9ter.15<\/sup>,* <\/sup><\/li>\n
  10. Fixer un prolongateur pour limiter le mouvement de l\u2019embase du cath\u00e9ter.19<\/sup>,*<\/sup><\/li>\n<\/ol>\n

    Pour en savoir plus sur la gestion des acc\u00e8s vasculaires v\u00e9t\u00e9rinaires, consulter le site web Infuse 4 VetsTM<\/sup><\/a>.<\/p>\n

    EN SAVOIR PLUS<\/span><\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

    Les cath\u00e9ters veineux p\u00e9riph\u00e9riques (CVP) sont fr\u00e9quemment plac\u00e9s chez des patients v\u00e9t\u00e9rinaires pour administrer des liquides et des m\u00e9dicaments.1 Cependant,…<\/p>\n","protected":false},"author":8,"featured_media":8103,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[748],"tags":[],"class_list":["post-8101","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-actualites-et-innovation","speciality-abord-vasculaire","speciality-anesthesie","speciality-oncologie-medicale","contenttype-article-fr","target-medecin","target-medecine-du-travail","target-soins-infirmiers"],"acf":[],"yoast_head":"\nPose d\u2019un cath\u00e9ter IV v\u00e9t\u00e9rinaire : comment g\u00e9rer les d\u00e9fis - BD IV News<\/title>\n<meta name=\"description\" content=\"Surmonter les difficult\u00e9s de la mise en place d'un cath\u00e9ter IV v\u00e9t\u00e9rinaire pour aider \u00e0 r\u00e9duire les complications IV et pr\u00e9venir le stress.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/eu.bd.com\/iv-news\/fr\/actualites-et-innovation\/pose-dun-catheter-iv-veterinaire-comment-gerer-les-defis\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pose d\u2019un cath\u00e9ter IV v\u00e9t\u00e9rinaire : comment g\u00e9rer les d\u00e9fis - 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