McLeod Fiona, Flowers Charne
Heidelberg Centre, 100 Oriel Road, Heidelberg 3081, Victoria, Australia.
Int J Palliat Nurs. 2006 Dec;12(12):558, 560-65.
Appropriate diluent selection in continuous subcutaneous infusion optimises symptom management and client well-being. The responsibility of diluent selection is commonly one of the attending nurse. This paper was developed with the intention of providing nurses with practical instruction for diluent selection when preparing medications for administration subcutaneously using a syringe driver. A literature review was undertaken of published journal databases and published guidelines sites. Recommendations regarding diluent choice were reviewed in two iterations by an expert panel of palliative care nurse clinicians. The principles for diluent selection are presented. They are based primarily on expert opinion level of evidence given a lack of primary research evidence in the area of diluent selection. There is a pressing need for manufacturers' guidance on diluent selection and independent research to establish the impact of diluents on drug and drug combinations when using syringe drivers. Until such time that this evidence is available to guide practice, clinicians need to be trained to inspect solutions and assess the effectiveness of the medication in controlling symptoms. The capacity of this paper to provide practical instruction has been limited by the lack of rigorous evidence available, and indeed, the process of developing this guide identified perhaps more questions than answers available at the present time.
连续皮下输注中合适的稀释剂选择可优化症状管理及患者福祉。稀释剂的选择通常由主班护士负责。本文旨在为护士在使用注射器驱动器皮下给药准备药物时选择稀释剂提供实用指导。对已发表的期刊数据库和已发布的指南网站进行了文献综述。姑息护理临床护士专家小组对关于稀释剂选择的建议进行了两轮审查。介绍了稀释剂选择的原则。由于在稀释剂选择领域缺乏初步研究证据，这些原则主要基于专家意见证据水平。迫切需要制造商提供关于稀释剂选择的指导以及开展独立研究，以确定使用注射器驱动器时稀释剂对药物及药物组合的影响。在有此类证据可指导实践之前，临床医生需要接受培训，以检查溶液并评估药物控制症状的有效性。由于缺乏严格的现有证据，本文提供实用指导的能力受到了限制，事实上，制定本指南的过程发现目前可能问题比答案更多。
