Eficácia da técnica convencional de fluxo com solução fisiológica para retirada de resíduos de soluções de cloridrato de vancomicina de sistemas de infusão parenteral com câmara graduada e equipo
Data
2021-11
Autores
Mendes, Kamila Alberto [UNIFESP]
Orientadores
Peterlini, Maria Angélica Sorgini [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Verificar a eficácia das primeira e segunda técnicas convencionais de fluxo
com solução fisiológica (SF) para retirada de resíduos de soluções de cloridrato de
vancomicina do sistema de infusão parenteral com câmara graduada; comparar a
eficácia destas técnicas segundo duas marcas de sistemas de infusão parenteral com
câmara graduada. Materiais e Método: Pesquisa experimental desenvolvida no
Laboratório de Experimentos de Enfermagem (LEEnf) da Universidade Federal de
São Paulo, após aprovação institucional. A amostra foi composta por 60 sistemas de
infusão parenteral com câmara graduada e equipo (buretas), sendo 30 de marca
denominada como A e 30 de B. Simulou-se a técnica convencional de administração
de medicamentos diluídos no interior da câmara graduada e de retirada de resíduo do
sistema de infusão parenteral com SF (lavagem do equipo), e foram verificados pH e
osmolalidade das soluções. A SF foi acondicionada na câmara graduada e percorreu
o equipo em fluxo livre, coletando-se 7,5mL (SF0/Béquer1) que serviu como solução
controle. Em seguida diluiu-se cloridrato de vancomicina (5mg/mL) e a solução de 25
mL foi retirada do equipo em fluxo livre, coletando-se 7,5mL (vancomicina/Béquer2).
Para verificar a eficácia da técnica convencional de fluxo para a retirada de resíduo
de fármacos destes sistemas, introduziram-se 15mL de SF na câmara graduada vazia,
abriu-se o sistema para lavagem em fluxo livre e coletou-se duas alíquotas de 7,5mL
cada para análise, uma correspondendo ao volume inicial (SF1/Béquer 3) e outra ao
final (SF1/Béquer 4). Similares técnica e análise foram realizadas para estudar a
eficácia de realização de uma segunda lavagem com SF para retirada de resíduo de
cloridrato de vancomicina (SF2/Béquer 5 e SF2/Béquer 6). As medidas de pH e
osmolalidade ocorreram em duplicata e os dados submetidos a análise de medidas
de tendência central e dispersão, aplicando-se o teste de Wilcoxon para análise de
variância (p≤0,05). Resultados: Foram realizadas 900 análises (720 de pH e 180 de
osmolalidade). Ao comparar as médias dos valores de pH de SF0/Béquer1
(5,88±0,42) com SF1/Béquer4 (4,90±0,32), verificou-se diferença estatisticamente
significante (p<0,001). A comparação entre SF0/Béquer1 e SF2/Béquer6 (5,4±0,28)
também resultou em diferença estatisticamente significante (p<0,001). A comparação
entre as buretas A e B resultou em discreta diferença entre os valores (p≥0,05).
Conclusão: Houve diferença estatística na comparação de valores de pH entre as
soluções anteriores e posteriores à técnica de lavagem, sugerindo a presença de
resíduo de cloridrato de vancomicina no dispositivo, mesmo depois da segunda
técnica de fluxo com SF para retirada de resíduos de soluções de cloridrato de
vancomicina do sistema de infusão parenteral.
Objectives: To verify the efficacy of the first and second washing techniques with saline (SS) for the removal of vancomycin hydrochloride residues from the parenteral infusion set with graduated chamber; to compare the efficacy of these techniques according to 2 brands of infusion sets. Method: Single-blind experimental research developed at the Laboratory of Experiments in Nursing (LEEnf) of the Universidade Federal de São Paulo, after institutional approval. The sample consisted of 60 parenteral infusion systems with graduated chamber and administration set, 30 of them were named “brand A” and the remaining 30 were named “brand B”. The conventional technique of administering diluted drugs in the graduated chamber and then removing residue from the parenteral infusion system with SS (washing of the tubing) was simulated, and pH and osmolality of the solutions were verified. For the control solution, 7.5 mL (SS0/Beaker 1) of SS was collected after being placed in the graduated chamber and continuously ran through the set in free flow. Vancomycin hydrochloride (5 mg/mL) was then diluted and 7.5 mL (Vancomycin/Beaker 2) of the 25 mL solution was withdrawn from the equipment after continuous infusion in free flow. To verify the efficacy of the conventional flow technique for removing drug residues from these systems, 15 mL of SS was introduced into the empty graduated chamber; the roller clamp was opened for continuous infusion and 2 aliquots of 7.5 mL each were collected for analysis, 1 corresponding to the initial volume (SS1/Beaker 3) and the other to the final volume (SS1/Beaker 4). Similar technique and analysis were performed to study the efficacy of performing a second washing with SS to remove vancomycin hydrochloride residue (SS2/Beaker 5 and SS2/Beaker 6). Measurements of pH and osmolality were made in duplicate and the data were submitted to analysis of measures of central tendency and dispersion, applying the Wilcoxon test for analysis of variance (p≤0.05). Results: 900 analyses were performed (720 of pH and 180 of osmolality). When comparing the mean pH values of SS0/Beaker 1 (5.88 ± 0.42) with SS1/Beaker 4 (4.90±0.32), there was a statistically significant difference (p<0.001). The comparison between SS0/ Beaker 1 and SS2/Beaker 6 (5.4 ± 0.28) also resulted in a statistically significant difference (p<0.001). The comparison between the chambers A and B resulted in a slight difference between the values (p≥0.05). Conclusion: There was a statistical difference in the comparison of pH values between solutions before and after the conventional washing technique, suggesting the presence of vancomycin hydrochloride residue in the infusion system, even after the second flushing technique with SS to remove vancomycin hydrochloride solution residues from the parenteral infusion set.
Objectives: To verify the efficacy of the first and second washing techniques with saline (SS) for the removal of vancomycin hydrochloride residues from the parenteral infusion set with graduated chamber; to compare the efficacy of these techniques according to 2 brands of infusion sets. Method: Single-blind experimental research developed at the Laboratory of Experiments in Nursing (LEEnf) of the Universidade Federal de São Paulo, after institutional approval. The sample consisted of 60 parenteral infusion systems with graduated chamber and administration set, 30 of them were named “brand A” and the remaining 30 were named “brand B”. The conventional technique of administering diluted drugs in the graduated chamber and then removing residue from the parenteral infusion system with SS (washing of the tubing) was simulated, and pH and osmolality of the solutions were verified. For the control solution, 7.5 mL (SS0/Beaker 1) of SS was collected after being placed in the graduated chamber and continuously ran through the set in free flow. Vancomycin hydrochloride (5 mg/mL) was then diluted and 7.5 mL (Vancomycin/Beaker 2) of the 25 mL solution was withdrawn from the equipment after continuous infusion in free flow. To verify the efficacy of the conventional flow technique for removing drug residues from these systems, 15 mL of SS was introduced into the empty graduated chamber; the roller clamp was opened for continuous infusion and 2 aliquots of 7.5 mL each were collected for analysis, 1 corresponding to the initial volume (SS1/Beaker 3) and the other to the final volume (SS1/Beaker 4). Similar technique and analysis were performed to study the efficacy of performing a second washing with SS to remove vancomycin hydrochloride residue (SS2/Beaker 5 and SS2/Beaker 6). Measurements of pH and osmolality were made in duplicate and the data were submitted to analysis of measures of central tendency and dispersion, applying the Wilcoxon test for analysis of variance (p≤0.05). Results: 900 analyses were performed (720 of pH and 180 of osmolality). When comparing the mean pH values of SS0/Beaker 1 (5.88 ± 0.42) with SS1/Beaker 4 (4.90±0.32), there was a statistically significant difference (p<0.001). The comparison between SS0/ Beaker 1 and SS2/Beaker 6 (5.4 ± 0.28) also resulted in a statistically significant difference (p<0.001). The comparison between the chambers A and B resulted in a slight difference between the values (p≥0.05). Conclusion: There was a statistical difference in the comparison of pH values between solutions before and after the conventional washing technique, suggesting the presence of vancomycin hydrochloride residue in the infusion system, even after the second flushing technique with SS to remove vancomycin hydrochloride solution residues from the parenteral infusion set.