上腺素的周围管理:一个前性的观察性研究
Jason R Yerke1, Eduardo Mireles-Cabodevila2, Alyssa Y Chen1
1Department of Pharmacy, Cleveland Clinic, Cleveland, OH.
上腺素的外周施用安全地减少了中央静脉导管 (CVC) 的使用,避免每名患者每天使用1个CVC. 超过一半的接受上腺素外周治疗的患者完全避免了CVC插入.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 血管接入 血管接入
背景情况:
- 北上腺素传统上是通过中央静脉导管 (CVC) 进行的,因为外流的担忧.
- 新出现的证据表明,对周围进行的诺阿皮内林可能是安全的.
- 周围IV导管 (PIVCs) 提供潜在的好处比CVCs如果安全性确立.
研究的目的:
- 为了评估一个对周围诺阿基尼林 (norepinephrine) 管理的协议的安全性和有效性.
- 为了确定外周用诺阿基尼林是否可以减少中央静脉导管 (CVC) 的使用日和放置频率.
- 评估外流动事件和相关组织损伤的发生率.
主要方法:
- 在医疗重症监护室 (ICU) 进行前性观察队列研究.
- 根据预先规定的标准,实施一项基于外周诺阿基因林 (norepinephrine) 给药的协议.
- 包括在2019年2月至2021年6月期间通过PIVC接受诺尔上腺素的成年患者.
主要成果:
- 平均每位患者避免使用1天的中央静脉导管 (CVC).
- 51.6%的患者作为初始暴露接受了周围的诺阿基尼林,从来没有需要CVC插入.
- 35名患者 (75.8例/1000天PIVC输液) 发生了扩张,大多数患者造成的伤害很小;不需要手术干预.
结论:
- 实施一个对外围上腺素 (norepinephrine) 管理的协议可以安全地避免每名患者每天大约1次CVC.
- 超过一半的患者可以避免CVC插入与周围的北上腺素的管理.
- 进一步的随机化,多中心试验是有必要的,以证实与CVC管理相比净益处.
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