Navegando por Palavras-chave "Flebite"

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    Comparação do sistema de infusão endovenosa sem agulhas com o sistema de infusão convencional
    (Universidade Federal de São Paulo (UNIFESP), 2000) Batista, Ruth Ester Assayag [UNIFESP]; Wey, Sergio Barsanti [UNIFESP]; Wey, Sergio Barsanti [UNIFESP]
    O sistema sem agulhas (SSA) tem sido utilizado para infusoes endovenosas e arteriais, com o objetivo de reduzir o uso de agulhas de aco nesses acessos e assim diminuir o numero de acidentes ocupacionais. Porem, ha estudos que relatam aumento das complicacoes infecciosas para os pacientes. Este estudo comparou o SSA com o sistema convencional (SC), quando utilizados em acessos venosos, em relacao: a incidencia de infeccao de corrente sanguinea relacionada ao cateter intravascular; a infeccao do sitio de insercao do cateter central; a taxa de colonizacao dos cateteres (perifericos e centrais); a taxa de flebite associada a cateter periferico. Avaliou-se tambem o numero de acidentes ocupacionais com material perfurocortante com a utilizacao do SSA e do SC, o custo dos dois sistemas de infusao e a aceitacao dos enfermeiros em relacao ao sistema sem agulha. Para atingirmos nossos objetivos, foi escolhido um Estudo Clinico Randomizado Controlado. O estudo foi desenvolvido em um hospital geral, com 141 leitos, terciario, privado e sem fins lucrativos. No estudo foram incluidos 656 pacientes, dos quais 323 foram submetidos a tratamento clinico e 333 a tratamento cirurgico. Nestes pacientes, foram instalados setenta cateteres centrais, dos quais 32 cateteres foram utilizados com o SSA e 38 como SC. Foram utilizados 1.152 cateteres perifericos. Destes, 601 cateteres foram utilizados com o SSA e 551 com o SC. A randomizacao foi realizada pelo numero do apartamento que o paciente era internado. O setor de internacao responsavel pela locacao dos clientes nos apartamentos desconhecia a realizacao do trabalho. Durante o periodo de estudo, ocorreram duas infeccoes de corrente sanguinea relacionada ao cateter, uma em cada sistema de infusao. Nao houve diferenca significante na taxa de infeccao e na colonizacao dos cateteres centrais entre o grupo de pacientes que utilizou o SSA e os que utilizaram o SC. Em relacao aos cateteres perifericos, tambem nao houve diferenca significante na taxa de colonizacao e na incidencia de flebites entre os dois grupos. Foi registrado um acidente ocupacional com agulha no periodo em que era utilizado somente SC e nenhum acidente foi notificado quando o SSA comecou a ser utilizado em 50 por cento dos pacientes. Para comparar o custo do SSA com o do SC, foram realizadas tres analises. Na primeira, foram utilizadas prescricoes hipoteticas, constando-se que o SSA era 117 por cento mais ...(au)
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    Eficácia de cobertura estéril de cateteres intravenosos periféricos na prevenção de flebite: estudo clínico pragmático, randômico e controlado com cegamento
    (Universidade Federal de São Paulo (UNIFESP), 2020-08-27) Enes, Sandra Maria Sampaio [UNIFESP]; Pedreira, Mavilde Da Luz Goncalves [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Peripheral venous catheterization is the most commonly performed invasive procedure in healthcare. Care practices and the use of technologies may influence the results of the use peripheral intravenous catheters (PIC), contributing to the reduction of complications and adverse events. Phlebitis is characterized as one of the most serious complication related to the use of PIC and this study has as hypothesis to analyze if the occurrence of phlebitis associated with PIC is influenced by the use of sterile dressing. Objectives: To verify the effect of using sterile dressing and sterile adhesive tape compared to non-sterile adhesive tape in PIC on the occurrence of phlebitis in adult patients attended at a hospital from the Western Brazilian Amazon. Methods: Pragmatic, randomized, controlled and single-blinded clinical study conducted in Rio Branco, Acre. The sample was calculated in 330 patients, aged 18 years or older and who met the inclusion criteria. Data collection took place between June 2018 and September 2019, after approval of ethical merit. To identify the type of sterile transparent dressing to be studied, was carried out an implementation study with a final sample of 71 patients, focusing analysis from the perspective of the patient, professional and clinics. The patients of the clinical study were randomly allocated to one of the study groups: Experimental group (sterile transparent dressing) or Standard Group (nonsterile adhesive tape). Phlebitis was diagnosed by the bedside nurse, according to presence and severity. If present, the nurse removed the CIP and an external evaluator was called to perform a diagnose of phlebitis with blindness regarding the intervention. Variables related to patient characterization, intravenous therapy, peripheral venipuncture, reasons for withdrawal and length of PIC stay, reasons for removal and length of coverage, and associated complications were investigated. For the statistical analysis, Chi-square, Fisher's Exact, student t test, and Mann-Whitney U tests were used. The multiple analysis was performed using the logistic regression model to estimate the Relative Risk (RR) and the Kaplan-Meier model, Cox regression, for survival analysis. RR calculation for 95% Confidence Interval (IC) was applied to estimate the degree of association between variables. In all tests, the significance level of 5% was considered. Result: In the implementation study, the IV3000TM ported dressing obtained the best result of the satisfaction indicators of professional and patient (p <0.0001). The average survival rate of PIC with IV3000TM ported dressing was 3.096 greater than Tegaderm3MTM Basic (p=0.006). The clinical study was carried out with 306 patients, 153 in each study group (24 follow-up losses), the majority being female (52.3%), with an average of 47.22(±16.1) years of age, with brown skin color (68.3%) and 51% had chronic diseases. Phlebitis was identified in 24.2% of the patients, with a difference between the study groups (p<0.0001). Using non-sterile tapes increased the chance of developing phlebitis by 5.958 times compared to patients who received sterile dressing (p=0.0001; 95% CI; 13.09-10.78). The average survival rate for PICs using sterile dressing was 5.387 times greater than catheters with non-sterile adhesive tape for stabilization (p = 0.0001). Conclusion: The use of sterile dressing was significantly effective in reducing phlebitis and other complications related to PIC, and longer catheter dwell time, when compared to the use of non-sterile adhesive tape.
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    Fatores associados à ocorrência de flebite relacionada à administração intravenosa periférica de amiodarona
    (Universidade Federal de São Paulo (UNIFESP), 2014-05-29) Buzatto, Leandro Loureiro [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]; http://lattes.cnpq.br/4954772252354513; http://lattes.cnpq.br/5994521028134638; Universidade Federal de São Paulo (UNIFESP)
    A ocorrência de flebite resultante da administração de amiodarona intravenosa periférica torna essa terapêutica um desafio na prática diária. Objetivos: Identificar os fatores associados à ocorrência de flebite relacionada à administração intravenosa periférica de amiodarona. Método: Estudo prospectivo e longitudinal realizado na Unidade Coronariana e Semi-Intensiva geral de um hospital privado, na cidade de São Paulo. A amostra foi constituída de pacientes com idade acima de 18 anos e infusão exclusiva de amiodarona em cateter venoso periférico. Os testes qui-quadrado de Pearson, exato de Fisher e t de Student foram aplicados para a análise univariada. As variáveis com p < 0,05 compuseram o modelo de análise de regressão logística. Resultados: A amostra foi constituída de 160 punções de acesso venoso periférico e a flebite foi observada em 49 (30,6%) punções. No grupo de infusão rápida exclusiva (nove punções), a flebite não foi observada. No grupo infusão rápida seguida de contínua (76 punções), observou-se maior frequência de flebite em mulheres (p = 0,039), em idade média mais elevada (p = 0,041) e em punções cujas soluções permaneceram até 12 horas (44,4%; p = 0,016). Sexo e tempo de permanência da infusão constituíram o modelo final da análise de regressão logística, sendo que a chance de flebite para mulheres foi 3,3 vezes maior (p = 0,040). No grupo de infusão contínua exclusiva (75 punções), a frequência de flebite foi estatisticamente maior (p = 0,008) nas punções que receberam soluções com concentração acima de 3,1 mg/ml. Conclusão: No grupo de infusão rápida seguida de contínua, o sexo feminino e a idade mais avançada foram identificados como fatores associados à flebite. No grupo de infusão contínua exclusiva, as soluções com concentração acima de 3,1 mg/ml relacionaram-se com a flebite.
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    Fatores de risco para o desenvolvimento de flebite relacionada ao uso de cateteres intravenosos periféricos em pacientes adultos
    (Universidade Federal de São Paulo (UNIFESP), 2021) Simoes, Adriana Moreira Noronha [UNIFESP]; Pedreira, Mavilde Da Luz Goncalves [UNIFESP]; Universidade Federal de São Paulo
    Introduction: The occurrence of phlebitis associated to peripheral intravenous catheter is a complication that compromises the continuity of intravenous therapy and the patient's experience with nursing care. The global large scope of use of millions of peripheral intravenous catheters annually, for the most diverse clinical indications, is contradictory to the few and opposing results of studies that describe risk factors for the occurrence of phlebitis, with a knowledge gap for the institution of prevention and control interventions. Objective: This study aimed to identify the predictive risk factors for the development of phlebitis associated to peripheral intravenous catheter in adult patients. Methods: This study is a secondary analysis of a randomized, controlled and non-inferiority clinical trial, entitled ResPeCt. The sample compromised 1319 patients using peripheral intravenous catheters, comparing cases, the patients that developed phlebitis, according to the controls, patients that did not develop the complication. In addition to the study of the dependent variable the phlebitis and the description of the phlebitis severity, demographic, clinical, catheter and therapy variables were measured. Data analysis comprised frequency and central tendency and dispersion measurement, student's t test, Pearson's Chi-square association test. To the univariate and multivariate logistic regression, the Chi-square Association Test and Fisher's Exact Test were applied, and Odds Ratio was calculated with a 95% confidence interval and a significance level of 5%. Results: The results showed that 80 (6.1%) patients developed phlebitis, Grade I (40.0%), Grade II (50.0%) and Grade III (10.0%), without diagnosed of catheter-related bloodstream infection. The patients characterization demonstrated 59.8 (± 20.5) years old, female gender (50.2%) and overweight (56.8%); with chronic diseases (65.9%), hospitalized for surgery (84.8%) and at risk for venous thromboembolism (73.9%). The research was carried out in two hospitals and 88.4% of the sample was attended at one of the institutions. Regarding the study of the peripheral intravenous catheter, the predominant use was 22 Gauge (75.4%) integrated catheters (58.8%), inserted in the right upper limb (57.3%), in the forearm (51 ,1%). The majority of peripheral intravenous catheters were used intermittently (85.0%), for infusion of antibiotics (72.5%). Among those who developed phlebitis, 67.5% had pain related to the peripheral intravenous catheter. According to the final regression model, the risk factors for phlebitis were the presence of family history of venous thromboembolism (p=0.050), reduced mobility (p=0.015), pain related to the peripheral intravenous catheter (p<0.010), insertion in veins on the dorsum of the hand (p=0.012), infusion of amoxicillin potassium clavulanate (p=0.015) and omeprazole (p=0.029). Conclusion: The risk factors for phlebitis related to the peripheral intravenous catheter involved intrinsic and extrinsic characteristics to the patient, suggesting preventive nursing interventions regarding the promotion of patient mobility, non-insertion in veins on the hands, cautious infusion of drugs and enhance attention to the pain related to peripheral intravenous catheter as indicative of phlebitis.
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    Flebite associada a cateteres intravenosos periféricos em adultos internados em hospital da Amazônia Ocidental Brasileira
    (Univ Sao Paolo, 2016) Enes, Sandra Maria Sampaio [UNIFESP]; Opitz, Simone Perufo; Faro, Andre Ricardo Maia da Costa de [UNIFESP]; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]
    Objective: To identify the presence of phlebitis and the factors that influence the development of this complication in adult patients admitted to hospital in the western Brazilian Amazon. Method: Exploratory study with a sample of 122 peripheral intravenous catheters inserted in 122 patients in a medical unit. Variables related to the patient and intravenous therapy were analyzed. For the analysis, we used chi-square tests of Pearson and Fisher exact test, with 5% significance level. Results: Complication was the main reason for catheter removal (67.2%), phlebitis was the most frequent complication (31.1%). The mean duration of intravenous therapy use was 8.81 days in continuous and intermittent infusion (61.5%), in 20G catheter (39.3%), inserted in the dorsal hand vein arc (36.9 %), with mean time of usage of 68.4 hours. The type of infusion (p=0.044) and the presence of chronic disease (p=0.005) and infection (p=0.007) affected the development of phlebitis. Conclusion: There was a high frequency of phlebitis in the sample, being influenced by concomitant use of continuous and intermittent infusion of drugs and solutions, and more frequent in patients with chronic diseases and infection.
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    Flebite associada a cateteres intravenosos periféricos em crianças: estudo de fatores predisponentes
    (Universidade Federal do Rio de Janeiro, 2014-04-01) Jacinto, Amanda Karina de Lima; Avelar, Ariane Ferreira Machado [UNIFESP]; Wilson, Ana Maria Miranda Martins; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)
    Objective: To identify risk factors for phlebitis related to peripheral intravenous catheters (PIC) in children. Methods: A retrospective cohort study conducted in 338 children submitted to intravenous. The variables related to the children and intravenous therapy were investigated, after approval of the ethical merit. Results: From 338 children, nine (2.7%) developed phlebitis. None of the demographic characteristics influenced significantly the development of phlebitis. Regarding to the therapy, there were significant: the use of the PIC for more than five days (p = 0.001), intermittent maintenance (p = 0.001) and greater time permanence of the PIC (p = 0.006). The risk factors were: the presence of predisposing conditions to puncture failure (p = 0.041, OR = 4.645), history of complications (p < 0.001, OR = 40.666); administration of drugs or solutions with extreme pH and osmolarity (p = 0.004, OR = 7.700). Conclusion: The occurrence of the phlebitis did not showed association with demographic characteristics and therapy aspects that represent risk factors, were predisposing conditions for puncture failure, previous complications, drugs administration and solutions with pH extremes and osmolarity.
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    Flebite no pré e pós-operatório de pacientes neurocirúrgicos
    (Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2007-03-01) Ferreira, Lucilene Reno; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]; Diccini, Solange [UNIFESP]; Fundação Zerbini Programa da Saúde da Família; Unidade Básica de Saúde; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To identify the risk factors for the development of phlebitis, the length of time with a peripheral intravenous catheter, and the incidence of phlebitis among neurosurgical patients. METHODS: this was a prospective cohort study. The sample consisted of 60 patients who underwent neurosurgery in a Brazilian hospital. A total of 152 peripheral intravenous catheters were identified. RESULTS: The risk factors for the development of phlebitis were the permanence of catheter longer than 72 hours, intermittent maintenance of the catheters, and catheters that had been inserted in the postoperative period. The length of time with a catheter ranged from 2 to 216 hours. Phlebitis developed among 10.5% of patients. CONCLUSIONS: The incidence of phlebitis among this study's sample is higher than the rate recommended by the International Standards of Practice.
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    Terapia ultra-sônica oclusora percutânea das varizes telangiectasias dos membros inferiores: ensaio clínico aleatório
    (Universidade Federal de São Paulo (UNIFESP), 2004) Araujo, Marcelo [UNIFESP]; Baptista-Silva, José Carlos Costa [UNIFESP]
    O tratamento de varizes de pequeno calibre e telangiectasias dos MMII, tem sido tradicionalmente realizado com uma combinacao de tecnicas que envolvem cirurgia, escleroterapia quimica e fototermolise com a utilizacao de LASER ou FLIP com sucesso variavel. Embora sejam metodos terapeuticos a demanda por estes servicos tem, na maioria das vezes, interesse estetico. Reacoes adversas com complicacoes como pigmentacao, desconforto local e ate neoformacao vascular nao sao incomuns tanto com a escleroterapia quimica quanto com o LASER/FLIP. Radiofrequencia e ultra-som sao metodos fisicos a serem investigados. A possibilidade de utilizar o ultra-som de baixa intensidade, um metodo fisico bastante conhecido, mas ate entao nao empregado com este proposito, encontra-se embasado em estudos experimentais e clinicos que relatam bioefeitos sobre o sistema vascular. Objetivo: promover a melhora estetica das telangiectasias e varizes dos MMII pelo processo de oclusao fisica com ultra-som de baixa intensidade. Metodos: Tipo de estudo - ensaio clinico aleatorio, duplo-cego com seguimento entre 28 e 40 dias. Local - clinica especializada privada Med Angio, Itabuna, Bahia. Amostra - 58 pacientes do sexo feminino, portadoras de varizes, classificacao CEAP (C1-4asEpAsdpPr) e Duffy 1, 1 A, 2 e 3, selecionadas foram sorteadas aleatoriamente e alocadas 29 no grupo `tratado' e 29 no `controle'. Foram excluidas as portadoras de doenca mental, gestantes, menores de 21 e maiores de 70 anos, portadoras de linfopatia, usuarias de hormonios flebotropicos, anti-agragantes plaquetarios e anticoagulantes. Procedimento -apos a obtencao do consentimento esclarecido as pacientes foram submetidas a exposicao do ultra-som no modo pulsado, na frequencia de 3MHz e 3W/cm2 por um periodo de 2 minutos. O grupo controle foi submetido ao mesmo manuseio, com o aparelho ligado, entretanto com a saida acustica ajustada para zero, portanto sem emissao do ultra-som. Foram feitas fotografias antes da aplicacao e apos um periodo de 28 a 40 dias procurando-se manter os ajustes da camera mais adequados a cada caso. As imagens foram avaliadas por dois examinadores independentes sendo utilizados criterios estritamente qualitativos na comparacao dos grupos codificando como piora, inalterado ou melhora da aparencia estetica da areaa(au)