静脉用药y位点不相容的处理:系统综述

IF 0.7 Q4 PHARMACOLOGY & PHARMACY INDONESIAN JOURNAL OF PHARMACY Pub Date : 2022-06-15 DOI:10.22146/ijp.2262
S. Hanifah, P. Ball, R. Kennedy
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引用次数: 2

摘要

重症监护病房的患者有静脉注射(IC)药物管理的关键问题。努力减少不相容或管理不相容风险对降低发病率和死亡率至关重要。本文对已发表的关于预防或解决y位不相容的各种方法的研究进行了整理,评价了这些方法的有效性,并提出了建议。PUBMED在2010年1月1日至2021年2月28日期间进行了范围审查。所有类型的随机对照试验、观察性研究、前后研究以及综述文章均被纳入。我们确定了944项研究;其中78例符合纳入标准,44例被排除在外。共有34篇文章被纳入分析。六篇文章报道了方案、二维图表、数据库或pH值色码,以提供不兼容信息。二维图和pH值与金标准比较。特定协议显著减少了不兼容事件。生理盐水冲洗可有效延长通畅,降低不相容率。NS优于与血小板减少相关的肝素。在线过滤已被证明可以减少由于不相容而产生的颗粒物和降水。过滤器也明显减少炎症、感染和并发症。四项研究使用了三个以上的管腔导管,成功地减少了沉淀和不相容事件的数量。因此,应优先根据图表使用多腔分离不相容药物。然而,当必须同时给药时,需要冲洗或过滤。
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Management of Y-Site Incompatibility of Intravenous Medication: A Systematic Review
Patients in intensive care units have a critical problem with Intravenous (IC) drug administration. The effort to decrease incompatibility or manage the incompatibility risks is paramount significant to reduce morbidity and mortality. This review collates all published studies about kinds of approaches to prevent or solve y-site incompatibility, evaluate the effectiveness of those approaches, and provide the recommendation. A scoping review was conducted in PUBMED in a time frame 1 Januari 2010- 28 February 2021. All type studies of randomised controlled trials, observational studies, before and after studies, also review articled were considered to include. We identified 944 studies; of these, 78 met the inclusion criteria, but 44 were excluded. A total 34 articles were included in the analyses.  Six articles reported protocol, two-dimensional chart, database, or pH colour code to provide information of incompatibilities. Two-dimensional chart and pH code were comparable with a gold standard. Specific protocol markedly reduced the incompatibility event. Normal saline (NS) flushing effectively prolonged patency and reduced the incompatibility rate. NS was preferred over heparin associated with thrombocytopenia. In-line filtration has been proved to reduce particulate matter, as well as the precipitation, resulted from incompatibility. The filter also reduced inflammation, infection, and complication appreciably. Four studies used more than three lumen catheters which successfully decrease the number of precipitation and incompatibility events. Therefore, separating incompatible drugs using multi-lumens according to the chart should be preferred. However, when co-administration is inevitable, flushing or filter is needed.
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来源期刊
INDONESIAN JOURNAL OF PHARMACY
INDONESIAN JOURNAL OF PHARMACY PHARMACOLOGY & PHARMACY-
CiteScore
1.20
自引率
0.00%
发文量
38
审稿时长
12 weeks
期刊介绍: The journal had been established in 1972, and online publication was begun in 2008. Since 2012, the journal has been published in English by Faculty of Pharmacy Universitas Gadjah Mada (UGM) Yogyakarta Indonesia in collaboration with IAI (Ikatan Apoteker Indonesia or Indonesian Pharmacist Association) and only receives manuscripts in English. Indonesian Journal of Pharmacy is Accredited by Directorate General of Higher Education. The journal includes various fields of pharmaceuticals sciences such as: -Pharmacology and Toxicology -Pharmacokinetics -Community and Clinical Pharmacy -Pharmaceutical Chemistry -Pharmaceutical Biology -Pharmaceutics -Pharmaceutical Technology -Biopharmaceutics -Pharmaceutical Microbiology and Biotechnology -Alternative medicines.
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