Potencial hidrogeniônico de soluções de cloridrato de dobutamina expostas ao ambiente de uma unidade de cuidados intensivos pediátricos e neonatais
Data
2015-07-30
Autores
Barbosa, Danielli Soares 
Orientadores
Peterlini, Maria Angelica Sorgini
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O cloridrato de dobutamina é uma amina vasoativa amplamente utilizada em pacientes internados em Unidades de Cuidados Intensivos Pediátricos e Neonatais (UCIPN). A prática de administração do medicamento é realizada, comumente, pela equipe de enfermagem, que deve possuir conhecimentos técnicos e científicos acerca do paciente pediátrico e do medicamento. Fatores como luz e temperatura ambiente necessitam ser controlados durante a infusão do fármaco, que pode sofrer aumento na velocidade de degradação, ocasionado por tais fatores. Objetivo: Verificar o comportamento do potencial hidrogeniônico (pH) de soluções de cloridrato de dobutamina em cloreto de sódio a 0,9% (SF) e em solução de glicose a 5% (SG5%), quando expostas às condições de temperatura e luminosidade provenientes do ambiente de uma Unidade de Cuidados Intensivos Pediátricos e Neonatais de um Hospital de nível terciário do estado de Minas Gerais. Material e Método: Pesquisa experimental realizada em dois períodos do ano, denominados de Etapa I (quente e úmido) e Etapa II (frio e seco). Utilizou-se o cloridrato de dobutamina na dosagem de 15mcg/kg/min diluído em SF e em SG5%, com infusão programada para 24 horas. As soluções foram acondicionadas em seringas de polipropileno em sistemas para administração intravenosa incolores (SAII), âmbares (SAIA) e protegidos da luminosidade (SAIP), e foram infundidas em bombas de infusão para seringas na vazão de 0,5 ml/h, em temperatura ambiente, temperatura de 36ºC, luminosidade ambiente e luminosidade proveniente do aparelho de fototerapia. A análise do pH das soluções ocorreu após o preparo (T0), em 4 horas (T1), 12 horas (T2) e 24 horas de simulação de infusão (T3). Os dados foram analisados segundo média e desvio padrão (m±dp). Resultado: Estudaram-se 96 valores de pH, sendo 48 referentes ao cloridrato de dobutamina em SF e 48 valores do cloridrato de dobutamina em SG5%. As soluções formadas após a diluição em SF apresentaram, na Etapa I, média de pH=3,28 e variação de ±0,07 e na Etapa II, valor médio de 3,26 (±0,06). Ao utilizar o diluente SG5% a média de pH na Etapa I foi de 3,23 (±0,07) e de 3,24 (±0,07) na Etapa II. Ao analisar o comportamento do pH das soluções notou-se que as menores médias com discreto aumento nas variações ocorreram nas soluções acondicionadas no SAII em ambos os diluentes, 3,16 (±0,10) em SF e de 3,07 (±0,09) em SG5%. As soluções acondicionadas no SAIA permaneceram mais estáveis, exibindo menores variações de pH e médias semelhantes, tanto em SF quanto em SG5% (3,23±0,06 e 3,24±0,06, respectivamente). Ao manter as soluções sem ação da luz com o SAIP, as médias foram mais altas do que as obtidas nas soluções acondicionadas no SAII e SAIA e a maior variação ocorreu no diluente SG5%, 3,42 (±0,17). Conclusão: Todas as soluções avaliadas mantiveram valores de pH semelhantes aos recomendados pela literatura, sendo que as soluções infundidas nos dispositivos de coloração âmbar permaneceram mais estáveis durante a infusão do medicamento, apresentando menores variações de pH no decorrer do tempo de simulação de infusão.
Introduction: Dobutamine hydrochloride is a vasoactive amine widely used in patients admitted to pediatric and neonatal intensive care units (UCIPN). The practice of drug administration is carried out, usually, by the nursing staff, who must possess scientific and technical knowledge about the pediatric patient and drug. Factors such as light and temperature need to be controlled during the infusion of the drug because they may cause the increase in degradation speed of the drug. Objective: To determine the behavior of potential hydrogenionic (pH) of dobutamine hydrochloride solution diluted with sodium chloride 0.9% (SF) and dextrose 5% solution (5% SS) when exposed to conditions of temperature and light from the environment a Care Unit Pediatric and Neonatal Intensive of a tertiary hospital in the state of Minas Gerais. Material and Methods: experimental study carried out in two periods of the year, known as Stage I (hot and humid) and Phase II (cold and dry). Was used the dobutamine hydrochloride in the dosage 15mcg/kg/min, diluted in SF and 5% SS, with the infusion set to 24 hours. The solutions were stored in polypropylene syringes in systems for colorless intravenous (SAII), amber (SAIA) and protected from light (SAIP), and were infused in an infusion pumps for syringe in the flow of 0,5 ml/h, at room temperature, 36 °C temperature, environment light and light from the phototherapy unit. The analysis of the pH solutions occurred after preparation (T0), 4 hours (T1), 12 hours (T2) and 24 hours infusion simulation (T3). Data were analyzed using mean and standard deviation (m±SD). Results: They studied up 96 values of pH, and 48 values to dobutamine hydrochloride in the SF and 48 values of dobutamine hydrochloride in 5% SS. The solution formed after dilution in SF presented in Step I pH (3.28± 0.07) and the (mean) value of Stage II 3.26 (±0.06). By using the diluent SG 5% mean pH in Step I was 3.23 (± 0.07) and 3.24 (±0.07) in Step II. By analyzing the pH behavior of the solutions it was noted that the lowest means with a slight increase in the variations occurred in the solutions put in SAII, in both solvents, 3.16 (±0.10) in SF and 3.07 (±0.09) in SG5%. The solutions packaged in SAIA remained more stable, exhibiting smaller changes in pH and similar means, both in SF as for SG5% (3.23±0.06 and 3.24±0.06 respectively). By keeping solutions without action of light with SAIP, the means were higher than those obtained in the solutions put in SAII and SAIA and the highest change occurred in the diluent SG5%, 3.42 (±0.17). Conclusion: All solutions evaluated kept pH values similar to recommended in the literature, and the solution infused in the amber coloring devices remained more stable during infusion of the drug, showing smaller changes in pH over time in the simulation of infusion.
Introduction: Dobutamine hydrochloride is a vasoactive amine widely used in patients admitted to pediatric and neonatal intensive care units (UCIPN). The practice of drug administration is carried out, usually, by the nursing staff, who must possess scientific and technical knowledge about the pediatric patient and drug. Factors such as light and temperature need to be controlled during the infusion of the drug because they may cause the increase in degradation speed of the drug. Objective: To determine the behavior of potential hydrogenionic (pH) of dobutamine hydrochloride solution diluted with sodium chloride 0.9% (SF) and dextrose 5% solution (5% SS) when exposed to conditions of temperature and light from the environment a Care Unit Pediatric and Neonatal Intensive of a tertiary hospital in the state of Minas Gerais. Material and Methods: experimental study carried out in two periods of the year, known as Stage I (hot and humid) and Phase II (cold and dry). Was used the dobutamine hydrochloride in the dosage 15mcg/kg/min, diluted in SF and 5% SS, with the infusion set to 24 hours. The solutions were stored in polypropylene syringes in systems for colorless intravenous (SAII), amber (SAIA) and protected from light (SAIP), and were infused in an infusion pumps for syringe in the flow of 0,5 ml/h, at room temperature, 36 °C temperature, environment light and light from the phototherapy unit. The analysis of the pH solutions occurred after preparation (T0), 4 hours (T1), 12 hours (T2) and 24 hours infusion simulation (T3). Data were analyzed using mean and standard deviation (m±SD). Results: They studied up 96 values of pH, and 48 values to dobutamine hydrochloride in the SF and 48 values of dobutamine hydrochloride in 5% SS. The solution formed after dilution in SF presented in Step I pH (3.28± 0.07) and the (mean) value of Stage II 3.26 (±0.06). By using the diluent SG 5% mean pH in Step I was 3.23 (± 0.07) and 3.24 (±0.07) in Step II. By analyzing the pH behavior of the solutions it was noted that the lowest means with a slight increase in the variations occurred in the solutions put in SAII, in both solvents, 3.16 (±0.10) in SF and 3.07 (±0.09) in SG5%. The solutions packaged in SAIA remained more stable, exhibiting smaller changes in pH and similar means, both in SF as for SG5% (3.23±0.06 and 3.24±0.06 respectively). By keeping solutions without action of light with SAIP, the means were higher than those obtained in the solutions put in SAII and SAIA and the highest change occurred in the diluent SG5%, 3.42 (±0.17). Conclusion: All solutions evaluated kept pH values similar to recommended in the literature, and the solution infused in the amber coloring devices remained more stable during infusion of the drug, showing smaller changes in pH over time in the simulation of infusion.
Descrição
Citação
BARBOSA, Danielli Soares. Potencial hidrogeniônico de soluções de cloridrato de dobutamina expostas ao ambiente de uma unidade de cuidados intensivos pediátricos e neonatais. 2015. 81 f. Dissertação (Mestrado) - Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.