Navegando por Palavras-chave "Intravenous Infusions"

Agora exibindo 1 - 3 de 3
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    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.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Influência da concentração, tempo de exposição e temperatura na estabilidade de soluções de cloridrato de vancomicina
    (Universidade Federal de São Paulo (UNIFESP), 2019-09-26) Onofre, Priscilla Sete De Carvalho [UNIFESP]; Peterlini, Maria Angelica Sorgini [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Vancomycin hydrochloride is an antimicrobial widely used in the treatment of children with severe infections. Clinical practice has verified different methods of administration of drug solutions, with different diluents and concentrations, infusion period over one hour and exposure to environmental conditions, such as temperature and luminosity. These conditions raise the question about the possible impairment the stability of the medication, and scientific support is required to ensure proper administration practices, and safe nursing interventions. Objectives: To develop and validate analytical methodology to determine vancomycin hydrochloride content using High Performance Liquid Chromatography (HPLC); to analyze the stability of vancomycin hydrochloride solutions by verification of hydrogenic potential (pH) and content by HPLC based in concentration, infusion time, and exposure to high temperatures. Materials and Methods: The experimental study was developed in the Laboratory of Nursing Experiments of the Federal University of São Paulo. To validate the analytical methodology the selectivity parameters, linearity, work range, matrix effect, robustness, precision, and accuracy were determined. The sample was composed of 12 solutions. Chemical stability was analyzed using the pH and content of vancomycin hydrochloride at 5 and 10 mg/mL diluted in 0.9% sodium chloride and exposed to temperatures of 22 ± 2° C and 37 ± 2° C. The analyses were conducted immediately after preparation (T0), and after two (T2), and four (T4) h of exposure. The content analyzed was collected in three aliquots of each solution in all experimental situations, for a total of 108 analyses. For the pH, an aliquot of each solution was collected at all studied times, completing 36 measurements. The results were analyzed based on the mean (± standard deviation) and using ANOVA Variance and the multilevel linear regression model. Data normality was verified by Kolmogorov-Smirnov and Bonferroni correction tests (p ≤ 0.05). Results: The method was validated for the separation and quantification of vancomycin hydrochloride, and proved selective, linear, precise, accurate and robust. The pH did not vary during the 4 h exposure to the solution in all proposed situations, keeping its acid characteristic. In the diluted vancomycin hydrochloride solutions, to obtain 5 mg/mL and submitted to a temperature of 22 ℃. The men who did this were similar; however, there was a reduction at T4 (T0 = 101.93% ± 1.66; T2 = 101.45% ± 1.46; T4 = 100.31% ± 0.87; p < 0.001); the same situation was observed in the experiment at 37 ℃ (T0 = 106.12% ± 2.60; T2 = 106.02 ± 1.43; T4 = 104.83% ± 1.66; p < 0.001). The drug diluted to 10 mg/mL and exposed to a temperature of 22 °C resulted in an increase in T0 to T2 content, with a consecutive decrease in T4 (T0 = 92.96% ± 1.38; T2 = 94.39% ± 3.69; T4 = 91.86% ± 1.12; p = 0.006). For the 10 mg/mL vancomycin hydrochloride solution exposed at 37 ℃, the mean at T0 was lower when compared to other analysis times (T0 = 96.17% ± 2.25; T2 = 97.70% ± 1.50; T4 = 97.47% ± 0.68; p < 0.001). Despite the identified variations in drug content, the pharmacological stability of the solutions was observed due to changes of less than 10%. Conclusions: The chromatographic method for content analyses of vancomycin hydrochloride was considered valid. In the four-hour interval vancomycin hydrochloride diluted to 5 or 10 mg/mL showed statistically significant differences but remained stable according to the proportion of variability accepted to maintain pharmacological stability.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Mimetização in vitro da prática transfusional em neonatos: influência do tipo de cateter e da irradiação de concentrados de hemácias sobre marcadores de hemólise
    (Universidade Federal de São Paulo (UNIFESP), 2019-11-28) Orsi, Kelly Cristina Sbampato Calado [UNIFESP]; Avelar, Ariane Ferreira Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: In transfusion practice in neonates, predominantly irradiated red blood cell (RBC) are administered by smaller caliber catheters due to small diameter and vascular fragility of neonates. The literature does not define precisely whether the mechanical action of the devices on the RBC, as well as the irradiation process can influence on occurrence of harmful hemolysis levels to newborn´s health. Objectives: To evaluate the effect of RBC irradiation on hemolysis marker levels; to compare the levels of irradiated and non-irradiated RBC hemolysis markers after in vitro infusion by peripheral intravenous catheter (PIV), umbilical catheter and peripheral inserted central catheter (PICC); to verify the influence of the infusion method on hemolysis markers administered in vitro in PIV. Materials and methods: Experimental study conducted in laboratory under controlled temperature and humidity conditions. Data collection occurred after approval of the ethical merit (nº 3,116,300) .Irradiated and non-irradiated RBC type A+ conserved in CPDA-1, with maximum 7 days of storage, were used. RBC was randomly administered in triplicate by syringe pump at 10 ml/h velocity, in 24 Gauge PIV, 2 French PICC and , 5Fr umbilical catheter, and gravitational method only on 24G PIV. Aliquots were collected directly from the RBC bag - M1, after manual filling of the infusion system (syringe and extension tube)-M2 and after infusion by catheters -M3. The hemolytic markers analyzed were: hemolysis degree (%), hematocrit - Ht (%); total hemoglobin - Hbt (g / dl); free hemoglobin - Hbl (g / dl); potassium - K (mmol / l) and lactate dehydrogenase - LDH (U / L). 360 aliquots were analyzed and levels of 1800 irradiated and non-irradiated RBC hemolysis markers were identified. The mean storage time of RBC were 4.9 (± 2.1) days Descriptive and inferential analysis were used and, according to the nature of the variables, the Mann – Whitnney, Wilcoxon, Kruskall Wallis, and / or Student's T tests, p <0.05, were applied. Results: Irradiated RBC presentes higher potassium levels 25,40±7,19) than non irradiated (18,92± 4,83) (p<0,001). CIVP have no influence in hemolysis markers, in both blood types. After umbilical cateter infusion we noted incremente in Hbl [0,04±0,01 to 0,05±0,02g/dl]; Ht [69,60±5,84 to 75,60±4,29%]; K [17,95±19,69 to 19,69±3,30] of RBc non irradiated, and Ht [65,80±5,96 to 68,20±7,46%]; e LDH [118,73(107,93-82,13) to 146,01(113,33-irradiated RBC, and Hbl [0,03±0,01 to 0,04± 0,02g/dl] e grau de hemólise [0,04±0,01 to 0,05±0,02g/dl] (p=0,020) on irradiated RBC. The gravitational infusion influenced on incremente of Hbl [0,03±0,02 to 0,05±0,02g/dl], Ht [72,00(70,00-73,00) to74,00(72,00-74,5)%], K [26,27±5,19 to 30,2±4,23] e LDH [118,73(107,93-223,96) to 159,20(122,77-236,10)U/L] of irradiated RBC.Conclusion: Red blood cell irradiation had an influence on potassium and LDH levels, and in vitro infusion with CCIP and umbilical catheter resulted in significant changes in the levels of some hemolysis markers, regardless of the type of blood evaluated. In the infusion of irradiated and non-irradiated RBC by PIV, the gravitational method caused greater variation of hemolysis markers when compared to the syringe infusion pump. The levels of hemolysis markers identified, regardless of blood type, catheter or infusion method, do not suggest clinical repercussions in the neonate and are safe for transfusion therapy.