药物的循环物质流在重症监护病房的重症监护病房
Jasper Klasen1, Silke Rijcks2, Diederik Gommers3
1Department of Adult Intensive Care, Erasmus MC University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. j.klasen@erasmusmc.nl.
重症监护病房产生大量的药物废物. 材料流量分析显示,辅助剂和包装构成了大部分的废物,突出了在重症监护机构改善可持续性的机会.
科学领域:
- 环境科学 环境科学
- 医疗保健的可持续性 医疗保健的可持续性
- 药品分析 药品分析
背景情况:
- 重症监护病房 (ICU) 对环境产生重大影响,主要是由于药物使用.
- 了解药物物质流对于开发可持续的医疗保健实践至关重要.
研究的目的:
- 在一个大型学术ICU中对药物进行全面的物质流分析 (MFA).
- 量化材料流动,并确定药物管理中可持续性改进的关键领域.
主要方法:
- 在2023年,在50个床位的ICU中进行了单中心MFA.
- 药物和包装被权衡并根据活性药物成分 (API),辅料和包装类型进行分类.
- 计算了每年和每天每患者的药物和包装废物.
主要成果:
- 总年药物流入量为234,337公斤,其中API仅占药物含量的2.3%.
- 每名患者的每日浪费平均为5.0公斤药物和1.7公斤包装.
- 废物流出包括大量的污水 (194,413公斤) 和焚烧 (21,894公斤),回收有限 (18,030公斤),主要是连续脏替代疗法 (CRRT) 袋.
结论:
- 显著的机会存在,以改善ICU药物可持续性.
- 针对CRRT相关的废物,优化液体配方以减少助剂,并尽量减少包装是关键策略.
- 研究结果支持有针对性的干预措施,以减少重症监护的环境足迹.
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